A profitable, scalable addiction-treatment company — built on a licensed Illinois provider.
One established clinic plus an outreach van runs at a 27% profit margin, climbing toward 36–38% as added sites share fixed costs. Grants fund the build and bridge the ramp; Medicaid and Medicare billing is the durable engine. We are raising capital and seeking partners to scale.
Use grants to build clinics and data-targeted mobile units on top of an already-licensed Illinois provider, then bill Medicaid and Medicare for medication and integrated behavioral-health care — a profitable per-unit business that gets more profitable as it grows.
The problem
About $50 billion in national opioid settlements is being paid out over ~18 years, with Illinois' share over $760 million verify. The hard part isn't the money — it's licensed treatment capacity where it's needed.
Across southern Illinois, overdose rates are high, providers are scarce, and most patients are on Medicaid. Licensing a new provider takes a year or more, so most entrants stall before they treat a patient or earn a dollar. We start past that gate.
The solution
We operate Two Dreams, an Illinois-licensed substance-use treatment provider. Medication for opioid use disorder (MOUD) is the front door; integrated behavioral health — care for the depression, anxiety, PTSD, and trauma that accompany addiction — is where patients stay longer and value compounds. Mobile units extend reach into surrounding communities and feed new patients to the clinic, and county-targeting data decides where to deploy for the most need, best fill rate, and strongest grant case.
This solves the three problems that sink most plans: who pays (grants plus recurring Medicaid, not a one-time fee), whether revenue recurs (steady Medicaid billing, year after year), and what keeps competitors out (an active license, top-tier clinical leadership, and targeting data are hard to copy). Full build sequence on the Plan.
Why now
The funding already exists
Illinois runs a settlement-funded mobile-unit grant, counties receive settlement money directly, and the federal rural opioid and state opioid-response programs round it out. The build is fundable today — the funding case is live, not hypothetical.
We can bill in weeks
In-clinic and telehealth buprenorphine treatment is billable in 4–8 weeks under the existing license — no waiver needed since the 2023 federal change. The slow, year-long licensing is done.
A 24–36 month window
Settlement dollars are front-loaded and the field is open but not yet crowded — counties are cash-rich and capacity-poor right now. The advantage compounds for whoever deploys first with credibility and good data.
The economics
At steady state, one clinic plus an outreach van carries ~340 active patients, earns ~$1.84M in revenue, spends ~$1.35M all-in (clinical and admin staff including a CTO and office coordinator, technology, facilities, the van, supplies, medication, insurance), and clears ~$497K in profit. Breakeven is ~248 patients.
| Steady-state P&L — one clinic + van | Annual |
|---|---|
| Revenue (~340 active patients) | ~$1,844,500 |
| Total operating cost (all-in) | ~$1,347,000 |
| Profit (~27% margin) | ~$497,500 |
Behavioral health is the biggest value lever. The ~70% of patients who add it roughly double revenue per patient — from ~$2,590/yr (medication alone) to ~$6,640/yr, with lifetime value ~$16,600 — while staying in treatment longer, which is both better care and more billed months.
Grants reimburse ~$173K of the costs above — peer and case-management staff, uninsured care, van operations, medication, and outreach — lifting single-unit net profit to ~$670K, a ~36% margin. Full P&L, role budget, and grant-coverage map on the Financial Model.
How it scales
The CTO and data team are a fixed network cost the first site carries in full — already baked into the 27% margin. Every site after that shares them, so the margin rises as the network grows.
| Network size | Revenue | Profit | Margin |
|---|---|---|---|
| 1 clinic + van | ~$1.84M | ~$0.50M | ~27% |
| 3 clinics + vans | ~$5.53M | ~$1.98M | ~36% |
| 6 clinics + vans | ~$11.07M | ~$4.21M | ~38% |
The path: prove the model on one clinic and van, then replicate across targeted counties into a multi-county network, with each unit's profit helping fund the next.
What makes it defensible
An existing licensed provider
The license is the slow, hard piece everyone else lacks — competitors spend a year getting one before they can bill a single service. We're already there.
Clinical authority
Dr. Andrea Barthwell — a leading addiction-medicine physician, former Deputy Director of the White House drug-policy office, past president of the national addiction-medicine society, and founder of Two Dreams — is the clinical anchor and the credibility that opens doors with the state, payers, counties, and federal funders.
County-targeting data
A county priority index — overdose burden, treatment scarcity, community vulnerability, viable payer base — that doubles as the needs case in every grant application and the deployment guide for every site.
Proven outcomes
Published methods and a multi-year track record of patient outcomes — evidence earned over time and hard for a new entrant to match.
The team
Dr. Andrea Barthwell — Founder & Chief Medical Officer. A leading addiction-medicine physician; former Deputy Director of the White House drug-policy office; past president of the national addiction-medicine society. She is the clinical anchor and the relationships that open state-health, Medicaid, county, and federal doors.
Around her runs a lean, repeatable team: prescribers, nurses, counselors, licensed clinical social workers, and peer-recovery specialists on the care side; a CTO and data team, an office coordinator, and a billing specialist on the operating side. Full role budget on the Financial Model; team detail on Team & Governance.
The ask
We are raising capital and welcoming partners to launch and scale the first unit. Grants fund the build and bridge the ramp; Medicaid and Medicare fund steady operations. The best partners bring county and provider relationships, help with clinical hiring, or provide bridge capital to carry the ramp before grants and claims arrive.
| Use of funds | What it buys |
|---|---|
| Clinic and telehealth stand-up | First billable patients within 4–8 weeks under the existing license |
| Behavioral-health clinical hires | The value lever — counselors, social workers, a peer specialist, and case management |
| One mobile outreach van | Community treatment and a steady channel of new patients into the clinic (largely grant-eligible) |
| Working capital to bridge the ramp | Covers the gap until the unit crosses breakeven at ~248 patients |
| Payer enrollment and credentialing | Gets the clinic enrolled with Medicaid and the managed-care plans so claims can be billed |
In order: (1) county settlement direct-share — fastest, 60–120 days; (2) the federal rural opioid program (RCORP, open now, due July 8, 2026, up to $750K/yr for four years, for-profits eligible); (3) the state opioid-response grant (SOR); and (4) the state mobile-unit grant (closed) when it reopens — plus stackable grants. Grants fund the build and riskiest early costs; recurring billing funds the durable core.
Impact
Every dollar does two jobs: it expands access to proven treatment in underserved communities and builds a durable, scalable company. Integrated care keeps patients in treatment for years — better outcomes and lives saved alongside steadier revenue — and our targeting data shows which spending actually works, the question every settlement dollar must answer.
Review the full P&L on the Financial Model, or walk the build sequence on the Plan. Figures marked verify are preliminary pending confirmation.