Most dashboards track marketing. Few track the operation.

Telehealth economics are decided by the interaction of acquisition, retention, and cost-to-serve. Watching any one alone produces confident, wrong decisions.

The four layers worth instrumenting

1. Acquisition efficiency CAC by channel and segment, plus 90-day retained CAC — the version that survives early churn.

2. Retention health Cohort retention curves, renewal save rates, and cancellation reason codes. A single blended churn number hides everything you need to know.

3. Cost-to-serve Fully loaded support, fulfillment-exception, and admin cost per active subscriber. This is the number that quietly decides your margin at scale — and the one most teams can't produce on demand.

4. Experience quality First-response time, resolution time, CSAT, and QA scores. Leading indicators: they move weeks before retention does.

One review, all four layers

The failure mode is four dashboards owned by four teams. Run a single monthly operating review where acquisition, retention, cost-to-serve, and experience appear on the same page — trade-offs become visible exactly where they're decided.

Make someone own each number

A metric without an owner is a screenshot. Every number in the review should have a name next to it and a target — whether that person sits in your team or your operating partner's.

Instrument these four layers and most strategy debates resolve themselves; the numbers usually already know.