---
title: "OpenLoop Health review (2026): what it is, pricing, alternatives"
description: "OpenLoop Health review 2026: what OpenLoop is, the 50 to 59% revenue share, who holds the merchant account, and the flat-fee alternative, Cuvo."
canonical: "https://cuvo.co/compare/cuvo-vs-openloop"
last-updated: "Oct 6, 2026"
---
# Cuvo vs OpenLoop: the 2026 comparison (Revenue-share telehealth platform)

Facts last reviewed Oct 6, 2026. OpenLoop: https://openloophealth.com

OpenLoop rents you a telehealth clinic, then keeps 50 to 59 percent of every maintenance patient's payment, forever, while owning your merchant account, card tokens, and patient data. Cuvo charges flat fees, takes no revenue share, and leaves you owning all of it. Here is the line-by-line math.

Prepared July 2026, platform capabilities re-checked October 6, 2026 · Based on OpenLoop's own written proposal (05/28/26 expiration), OpenLoop's public site, Cuvo's 05/01/2026 medication price list, Cuvo commercial terms, and publicly verifiable third-party sources. Shipping costs excluded from all calculations per scope.

## 01. Executive summary: Cuvo vs OpenLoop

Cuvo Health is the recommended OpenLoop alternative for an established consumer health brand adding GLP-1, hormone therapy or women's health programs, because Cuvo publishes its prices, publishes its API, and lets patient payments settle to the brand's own merchant account. Cuvo charges $25 per completed consult and takes no revenue share, on Launch at $997 a month after a $9,800 setup or Grow at $2,500 a month after a $15,000 setup, month to month. OpenLoop publishes no price list (its site says cost varies by the services selected and routes buyers to sales, checked October 6, 2026), publishes no API documentation, and in the proposal reviewed below keeps 50 to 59 percent of every maintenance patient's payment.

OpenLoop and Cuvo both offer white-label telehealth infrastructure: clinicians, EHR, e-prescribing, pharmacy fulfillment, and compliance. The similarity ends there. The two operate on fundamentally opposite business models:

**OpenLoop is a revenue-share landlord.** Patients pay into *OpenLoop's* merchant account. OpenLoop owns the billing relationship, the credit card tokens, and the patient data pipeline, then remits a "Membership Services Fee" back to you weekly. On maintenance patients, OpenLoop retains **50–59% of every dollar your patient pays**, indefinitely, on every patient, forever.

**Cuvo is a flat-fee utility.** Patients pay *you* first, into *your* merchant account. Cuvo charges a flat $25 per consultation and takes no per-patient cut whatsoever. Your margin scales with you, because Cuvo never takes a share of your revenue.

On identical retail pricing, a clinic nets roughly **35–90% more per maintenance patient per month on Cuvo**, and that's before considering that on OpenLoop you never own your merchant account, card tokens, or billing relationship, which is precisely what makes leaving OpenLoop so difficult. Add a January 2026 data breach affecting ~716,000 downstream patients, sub-3-star employer ratings, and a review-generation practice that puts OpenLoop's brand in front of *your* patients, and the picture is clear.

**Key takeaways**
- Recommendation: Cuvo Health, for a brand that wants published prices, a public API and its own merchant account
- Pricing: Cuvo publishes Launch ($997 a month, $9,800 setup) and Grow ($2,500 a month, $15,000 setup); OpenLoop routes pricing to sales
- Revenue model: Cuvo: $25 per completed consult, no revenue share. OpenLoop proposal: 50 to 59 percent of maintenance revenue retained
- API: Cuvo: public OpenAPI 3.1 contract at developers.cuvo.co, on Grow and Enterprise. OpenLoop: no public API documentation found
- Contract: Cuvo: month to month after setup. OpenLoop proposal: 12-month initial term

> **Our recommendation** Choose Cuvo Health if your brand already has the audience, the ad budget and often its own storefront or engineers, and you want the regulated backend without handing over your merchant account or a share of every refill. Cuvo runs the licensed providers, e-prescribing and compliance behind your brand, routes prescriptions to a partner pharmacy network of licensed pharmacies, and prices all of it on its website. Grow adds the API, webhooks, full revenue and LTV dashboards and cohort forecasting. OpenLoop's model, on the numbers below, asks a brand to accept a revenue share for a bundle it cannot price in advance.

> **Price your program on Cuvo's published terms** Bring your expected patient volume and your current stack; a 30-minute call maps your programs to Cuvo's plans, line by line. [Book a discovery call](/booking) · [See pricing](/pricing)

## 02. Business model and money flow

|  | Cuvo | OpenLoop |
| --- | --- | --- |
| Who charges the patient | **You**: your interface, your merchant account | OpenLoop: patient card charged into **OpenLoop's merchant account** |
| Who owns the merchant account | **You** | OpenLoop ("merchant account management... is OpenLoop's responsibility") |
| Who owns the credit card tokens | **You** | OpenLoop |
| Who owns patient records | **You** | OpenLoop's EHR holds patient processing; data lives in their system |
| When you get paid | **Immediately: money hits your account first** | Weekly remittance: "every Wednesday for the week ending Tuesday," calculated by OpenLoop from *their* count of net active patients |
| Revenue model | Flat fees only: $25/consult, no per-patient fee | Retains the spread between what the patient pays and what they remit to you (typically 42–59% of patient revenue) |
| Your pricing freedom | Set any retail price; your margin is yours | Retail prices and your remittance are fixed in their schedule; changing your economics means renegotiating with OpenLoop |
| Payment methods | Your merchant account: your choice (incl. Amex if you want) | Visa, MC, FSA/HSA, Apple Pay, Google Pay, but **no American Express** |

**Why this matters more than any single fee:** on OpenLoop, your entire revenue stream (every card token, every subscription billing record, every patient chart) lives inside OpenLoop's stack. Migrating away means re-acquiring payment authorization from every single patient and rebuilding billing from zero. That is functionally a customer-base reset, and it's the quiet mechanism that keeps clinics locked in regardless of how the relationship goes. On Cuvo, you could switch pharmacies, switch providers, or leave entirely tomorrow and your business would be intact, because **you already own everything that matters**: records, tokens, merchant account, and cash flow.

## 03. Fixed costs and contract terms

|  | Cuvo | OpenLoop |
| --- | --- | --- |
| Setup / implementation fee | **$9,800** (Launch program) | **$9,000** ($4,500 at signing, $4,500 at first patient) |
| LegitScript certification | **Application prepared and managed by Cuvo** on Launch; expedited certification included in the Grow setup | **+$3,000** flat fee (optional add-on, expedited) |
| Effective upfront cost with LegitScript | **$9,800** (application managed by Cuvo) | **$12,000** |
| Monthly platform fee | **$997 flat** on Launch, month to month | **$1,500/mo from first patient seen** |
| Contract commitment | **Month-to-month. No term.** | **12-month initial term** |
| Adding new business lines | Included: same flat model; anything beyond core is a purely optional add-on | Requires MSA addendum **plus a separate implementation fee** |
| Year-1 fixed outlay | **$21,764** ($9,800 + $997 x 12) | **$30,000** ($9,000 + $3,000 LegitScript + $1,500 x 12) |
| Year-2+ fixed outlay | **$11,964/yr** | **$18,000/yr** |

> **Comparison basis** Cuvo figures use the **Launch program**, the entry tier at $997 a month with a $9,800 setup, because it is the tier that matches OpenLoop's single quoted rate. Cuvo also publishes **Grow at $2,500 a month ($15,000 setup)** and a **custom-priced Enterprise program** for operators who want automation, integrations and multi-brand operations; every tier carries identical commercial terms (month to month, $25 consults, no cut of your revenue). Whichever tier you pick, the fixed-fee gap is the smaller half of this comparison: the per-patient economics below dwarf it at any real patient count.

Year one on OpenLoop runs **$30,000 in fixed fees, contractually locked for 12 months**, versus **$21,764 on Cuvo with zero commitment**: an $8,236 (27%) saving before a single patient-level dollar is counted. The gap persists at steady state ($11,964/yr vs. $18,000/yr), Cuvo's upfront is $2,200 lower with the LegitScript application already prepared and managed inside it, and Cuvo's $997 covers everything needed to run the clinic; anything beyond that is a genuinely optional add-on, not a required addendum with its own implementation fee. If your launch stalls, your funnel underperforms, or you simply want to change direction, OpenLoop holds you to the term; Cuvo lets you walk any month.

## 04. Per-patient economics: where the real money is

OpenLoop's proposal is transparent about its mechanism: the middle column is what your patient pays, the right column is what you receive, and "the difference... is what is retained by OpenLoop." Below, we hold retail price constant (using OpenLoop's own price points) and compute what the same patient is worth on each platform. Cuvo figures = retail - medication cost (Cuvo's dated price list, lowest to highest dose level) - $25 consult in month 1 and quarterly thereafter (~$8/mo amortized at steady state). Shipping excluded from both sides.

**Semaglutide injection: $249/mo retail**

| Month | Patient pays | You net on OpenLoop | You net on Cuvo | Cuvo advantage |
| --- | --- | --- | --- | --- |
| Month 1 (with consult) | $249 | $140 | **$156–$189** | +$16 to +$49 |
| Month 5+ (maintenance) | $249 | $124 | **$173–$206** | **+$49 to +$82 (+39–66%)** |
| **12-month patient value** | $2,988 | **$1,514** | **$2,047–$2,443** | **+$533 to +$929 per patient** |

**Tirzepatide injection: $339/mo retail**

| Month | Patient pays | You net on OpenLoop | You net on Cuvo | Cuvo advantage |
| --- | --- | --- | --- | --- |
| Month 1 | $339 | $196 | $169–$246 | -$27 to +$50 |
| Month 5+ (maintenance) | $339 | **$138** | **$186–$263** | **+$48 to +$125 (+35–90%)** |

Note what happens on OpenLoop's tirzepatide maintenance line: the patient pays $339 and you receive $138, and **OpenLoop keeps $201, or 59% of your patient's payment, every month, forever.** On Cuvo, even at the highest dose tier (Level 6, $145/vial), that same dollar goes 35% further to you; at typical mid-titration doses the gap approaches double.

**Semaglutide oral ODT: $279/mo retail**

| Month | Patient pays | You net on OpenLoop | You net on Cuvo | Cuvo advantage |
| --- | --- | --- | --- | --- |
| Month 1 | $279 | $136 | $155–$188 | +$19 to +$52 |
| Month 5+ | $279 | $128 | **$172–$205** | **+$34 to +$77 (+34–60%)** |

## The prepay penalty on long commitments

OpenLoop's long-commitment tiers compound the problem. On the 52-week semaglutide injection plan, the patient pays $2,327 and you receive $1,076, and OpenLoop retains **$1,251 (54%)** of a patient who committed to you for a year. On Cuvo, a 52-week patient at even a discounted $179/mo retail nets you roughly $1,400–$1,700 after meds and consults, on a patient paying *less*.

**Per maintenance patient, per month, at identical retail prices**

| Program (month 5+) | Difference in amount retained per patient (from the proposal's own figures) |
| --- | --- |
| Semaglutide injection, $249/mo | +$49 to +$82 |
| Tirzepatide injection, $339/mo | +$48 to +$125 |
| Semaglutide oral ODT, $279/mo | +$34 to +$77 |

Unlike the fixed-fee gap, this difference recurs for every maintenance patient, every month the patient stays. **OpenLoop's model taxes your growth; Cuvo's doesn't.**

> **Fairness note** OpenLoop's spread does bundle billing, clinical consults, base MWL labs, patient support, and medication cost into their retained share. But on Cuvo, consults are $25 flat and medication is priced from a dated list, so those same services cost you dramatically less than the 50–59% OpenLoop prices them at, and you keep the difference.

## 05. Flexibility and vendor independence

|  | Cuvo | OpenLoop |
| --- | --- | --- |
| Pharmacy network | **Licensed partner pharmacies**, or **bring your own** (Cuvo doesn't profit on meds, so has no incentive to block it) | OpenLoop's supply chain only; fulfillment and med costs run through them |
| Provider network | In-house provider network, or **bring your own providers** | OpenLoop-recruited/credentialed providers on their platform |
| Care model control | Yours | Defined in OpenLoop's schedules (consult cadence, age limits, program structure); "availability of any given GLP-1 option may change at any time, with no notice" |
| Exit path | Walk away any month with your records, tokens, merchant account, and patients | 12-month term; patient billing, tokens, and records live in OpenLoop's systems |

This is the structural point: because Cuvo's fees are flat and it takes no revenue share, it has **no conflict of interest** in letting you route around it. OpenLoop's economics depend on being the toll booth between you and your patients.

## 06. Platform capabilities: API, pharmacy, analytics, GLP-1

An established brand evaluating a backend partner, one with an audience, an ad budget and often its own storefront or engineering team, asks six practical questions: is there an API, how do prescriptions reach a pharmacy, what do the dashboards show, does the clinician network cover every state, is there a ready GLP-1 program, and what does it cost. The table answers each from Cuvo's published pages and from OpenLoop's own site as checked on October 6, 2026.

**Capabilities as published, checked October 6, 2026**

| Capability | Cuvo | OpenLoop | What it means for your brand |
| --- | --- | --- | --- |
| **API access** | Public Cuvo Integrations API at developers.cuvo.co: OpenAPI 3.1, 65 operations, signed webhooks, test-mode sandbox, MCP server; included on Grow, Enterprise and Cuvo Prescribe | No public API reference, sandbox or webhook guide found on openloophealth.com; integration is a sales conversation | Your engineers can read and test Cuvo's contract before you sign; OpenLoop's integration scope arrives only in a proposal |
| **E-prescribing and pharmacy routing** | E-prescribing over Surescripts on every plan, EPCS on Grow and Enterprise; orders route to licensed partner pharmacies or to your own pharmacy | E-prescribing built in; prescriptions route automatically to OpenLoop's pharmacy network | On Cuvo you can bring your own pharmacy at any time; in OpenLoop's proposal, medication cost sits inside its retained share |
| **Analytics and revenue dashboards** | Real-time new patient, revenue, retention and LTV dashboards (basic on Launch, full on Grow and Enterprise); cohort and rebill forecasting and a custom report builder on Grow and up; full data export | Admin dashboard with live volume and revenue reporting (patients seen, conversion, drop-off) | Both report revenue; on Cuvo it has already settled to your merchant account, while OpenLoop's proposal collects it into OpenLoop's account and remits weekly |
| **50-state clinician coverage** | 300+ board-certified MDs, NPs and PAs licensed across all 50 states, DC, Puerto Rico, Guam and the US territories, 24 hours a day, first review as fast as 15 minutes | Clinician network licensed in all 50 states across 35+ specialties, per its site | Comparable reach on paper; OpenLoop's proposal excludes holiday coverage and lists TRT with scheduled medications in about 35 states |
| **GLP-1 brand program** | Semaglutide and tirzepatide where clinically appropriate, on every plan, with cold-chain delivery, provider-reviewed refills and Labcorp and Quest labs | White-label GLP-1 program with care coaching, dietitians, supplement stacks and microdosing; its site says compounded GLP-1 availability varies by state | OpenLoop's proposal says any GLP-1 option may change with no notice, on a 12-month term; Cuvo runs month to month |
| **Published pricing** | Launch $997 a month after a $9,800 setup; Grow $2,500 a month after $15,000; Enterprise custom; $25 per completed consult | None published; its site says cost varies by the services selected and points to sales | You can model a Cuvo program before the first call; OpenLoop's economics arrive in a proposal that expires in 30 days |

## API access: a public contract versus a sales call

Cuvo publishes its clinical integration API where anyone can read it. The Cuvo Integrations API at api.cuvo.co is documented at developers.cuvo.co as an OpenAPI 3.1 contract with 65 operations across patients, consents, cases, messages, prescriptions, orders, visits, files, billing and events, with HMAC-signed webhooks for 32 versioned event types, a test-mode sandbox that plays the clinician and the pharmacy, TypeScript and Python SDKs and a CLI in prerelease, and an MCP server for AI agents. API, webhooks and MCP access come with Grow, Enterprise and Cuvo Prescribe; Launch does not include them.

OpenLoop's technology page tells companies that already have a tech stack to talk to OpenLoop about integration, and its licensing page lists API integrations as a feature of its private label platform, but as of October 6, 2026 no API reference, contract, sandbox or webhook guide was published on openloophealth.com. For a brand with its own storefront or app, that means the integration scope, and its cost, is set in the proposal rather than read in advance, which is the opposite of how Cuvo's developer portal works.

## Prescriptions and pharmacy routing on each platform

On Cuvo, a provider licensed where the patient is located decides every prescription, and e-prescribing runs over the Surescripts network on every plan, with EPCS on Grow, Enterprise and Cuvo Prescribe where rules permit. Each order routes to a licensed partner pharmacy that Cuvo contracts and verifies for the destination state, or to a pharmacy the brand already uses, at any time. Medication ships cold, typically within 2 business days, with a lot number and beyond-use date on every order.

OpenLoop describes e-prescribing built into its platform, with prescriptions routing automatically to OpenLoop's pharmacy and lab network and no vendor contracts for the brand to manage. In the proposal reviewed on this page, medication cost is bundled into the share OpenLoop retains, so the brand never sees a per-order medication price it could compare or route elsewhere. On Cuvo, bring-your-own-pharmacy is available on every plan.

## Analytics: who holds the revenue the dashboard shows

Both platforms give the owner a dashboard. OpenLoop's technology platform page advertises live volume and revenue reporting in its admin dashboard, including patients seen, conversion and drop-off, and its Launchpad page promises visibility into performance, retention and revenue. Cuvo's owner dashboards show new patients, revenue, retention and lifetime value in real time, with cohort and rebill forecasting, pre-built reports and a custom report builder on Grow and Enterprise, and Cuvo AI+ business intelligence as an add-on on every plan.

The difference is where the money in those reports sits. On Cuvo, patient payments settle to the brand's own merchant account and every record exports at any time, so the dashboard reports cash the brand already holds. In the OpenLoop proposal reviewed here, patients pay into OpenLoop's merchant account and the brand receives a weekly remittance calculated from OpenLoop's own count of active patients, with no audit right described.

## GLP-1 programs for brands that already have an audience

OpenLoop markets a white-label GLP-1 program with care coaching, registered dietitians, supplement stacks and microdosing protocols, and its own GLP-1 page notes that compounded GLP-1 availability varies by state. Cuvo operates six categories on every plan: GLP-1 weight loss (semaglutide and tirzepatide, where clinically appropriate), testosterone and hormone therapy, peptides, sexual health, women's health and wellness, with providers in all 50 states, provider-reviewed refills, labs through Labcorp and Quest, and a typical launch in under 30 days.

Cold chain is where a GLP-1 program is won or lost on the doorstep. The FDA notes that injectable GLP-1 drugs require refrigeration as indicated in their package inserts, and that it has received complaints of compounded GLP-1 drugs arriving warm or with inadequate ice packs. On Cuvo, GLP-1 orders ship at 2 to 8 degrees C in insulated packaging, typically within 2 business days. OpenLoop's proposal adds a risk a brand cannot plan around: it states that any given GLP-1 option may change at any time, with no notice, while the brand stays bound to a 12-month term.

## Ad accounts: LegitScript certification

For a brand with an ad budget, certification is part of the backend. Google allows telemedicine providers in the United States to advertise if they are accredited by LegitScript's Healthcare Merchant Certification Program, and the advertiser must also be certified with Google. Cuvo prepares and manages the LegitScript application for the brands on its platform; the OpenLoop proposal reviewed here sells LegitScript through its integration as a $3,000 add-on.

## Pricing: published on Cuvo, quoted by OpenLoop

Cuvo publishes every number a brand needs to build a model: Launch at $997 a month after a $9,800 setup, Grow at $2,500 a month after a $15,000 setup, a custom-priced Enterprise program for multi-brand operators, and the same $25 per completed consult and no revenue share on every plan, month to month after setup. OpenLoop's homepage answers the pricing question by saying cost varies by the services selected and directing buyers to sales (checked October 6, 2026); the only OpenLoop figures on this page come from the written proposal analyzed in sections 03 and 04.

> **See the API and the dashboards before you sign** Cuvo walks your team through the API contract, pharmacy routing and the owner dashboards on a 30-minute call, mapped to your programs. [Book a discovery call](/booking) · [Read the API overview](/telehealth-api)

## 07. Reputation, trust, and risk

## The January 2026 data breach: 716,000 patients exposed

This is not a rumor; it is confirmed on the HHS Office for Civil Rights breach portal and reported to the California and Texas Attorneys General. On January 7, 2026, an unauthorized third party accessed OpenLoop's systems and exfiltrated files containing patient names, addresses, email addresses, dates of birth, and medical information, affecting up to 716,000 individuals across the telehealth brands running on OpenLoop's infrastructure. A threat actor ("Stuckin2019") publicly claimed 1.6 million records and posted samples as proof. The affected population "spans patients across multiple client organizations rather than direct OpenLoop consumers," meaning **it was OpenLoop's clients' patients, under their clients' brand names, whose data was stolen.**

For a clinic evaluating OpenLoop, the lesson is architectural, not just reputational: OpenLoop's model *requires* concentrating the patient data of the 400+ virtual care brands it now claims in one honeypot. When it was breached, every downstream clinic inherited the incident (the notification obligations, the patient trust damage, the churn) for a security failure they had zero control over. On Cuvo's model, you own and control your patient records.

## The Google reviews illusion

OpenLoop shows 1,197 Google reviews averaging 4.5 stars, impressive until you read them. The reviews are overwhelmingly from *patients of client clinics* ("clinician was very attentive," "how fast my order was delivered by FedEx," "waiting on my prescription"), not from clinic operators evaluating OpenLoop as a B2B vendor. Per operator reports, OpenLoop generates these by emailing *the client clinics' patients* and soliciting reviews for OpenLoop, a practice with two problems:

1. **It breaks the white label.** The entire premise of the product is that your patients never know a third party is behind your brand. Soliciting your patients to publicly review OpenLoop puts OpenLoop's name directly in front of them.
2. **It makes the rating unusable as a B2B signal.** A patient's 5-star FedEx delivery experience tells you nothing about how OpenLoop treats the clinics that are its actual customers.

## What people who actually deal with OpenLoop say

The B2B-relevant signals point the other way:

| Source | Rating | Detail |
| --- | --- | --- |
| **Glassdoor** | **2.8 / 5** | Only **33% would recommend to a friend**; **37% approve of the CEO**; 45% positive business outlook (100 reviews) |
| **Indeed** | **2.4 / 5** | 51 reviews; heavily 1-star-weighted distribution; Job security & advancement rated **1.9**; reviewers flag lack of "trust in colleagues" (updated May 31, 2026) |

Employee reviews aren't client reviews, but they are a leading indicator of service quality: a company whose own staff rate job security at 1.9/5 and where barely a third would recommend working there is a company with turnover and morale problems, and turnover in credentialing, support, and account management lands directly on clients. Combined with operator reports of being "treated like a number on a take-it-or-leave-it basis" once signed, the 4.5-star Google facade and the 2.4–2.8 insider reality tell two very different stories.

## 08. The fine print: fifteen red flags inside OpenLoop's own proposal

Cuvo's team obtained an actual OpenLoop proposal (a "Summary of Proposed Services" prepared for a prospective clinic, complete with pricing schedules, program terms, and contract structure) and went through it line by line. Everything below is drawn directly from that document; nothing is paraphrased from marketing or hearsay. Read individually, each item is a concession; read together, they describe a contract engineered so that risk flows to the client and margin flows to OpenLoop.

1. **The maturity penalty: OpenLoop's cut grows the longer you keep a patient.** On tirzepatide, the patient pays the same $339 every month, but your remittance falls from $196 in month 1 to $138 at month 5+, while OpenLoop's take climbs from $143 (42%) to $201 (59%). That's a **41% increase in OpenLoop's cut and a 30% drop in your revenue on the identical patient paying the identical price.** Retention is the hardest thing to earn in telehealth; this schedule is built so that the fruits of *your* retention accrue to OpenLoop.
2. **You fund the patient discounts on long-term plans.** On the 52-week semaglutide plan, the patient's price drops 28% (from $249 to $179/cycle), but your remittance drops **33%** (from $124 to ~$83/cycle). OpenLoop offers your patients a discount and makes you absorb a disproportionate share of it.
3. **OpenLoop holds the float on annual prepayments.** A 52-week tirzepatide patient pays **$3,497 on day one, into OpenLoop's merchant account.** Your $1,572 share arrives dripped out weekly, contingent on OpenLoop's own determination that the patient is "active." OpenLoop banks a year of your patients' cash up front; you get yours on layaway.
4. **OpenLoop counts, OpenLoop calculates, you get what they say.** Your weekly payment is "based on count of net active patients for the week by Month Cohort," with active status "determined by successful credit card charge," all measured inside systems only OpenLoop can see. The proposal grants no audit rights, no reporting standard, and no recourse if their count and yours disagree. "Net" active also implies refunds and chargebacks are clawed back from *your* remittance.
5. **OpenLoop sets the refund policy for your customers.** The proposal dictates that patients "may request refund for any reason at any time." A generous refund policy is defensible, but it's imposed unilaterally, on revenue that flows through OpenLoop's account, with the resulting losses netted against your share. You carry refund exposure on a policy you didn't write and can't change.
6. **Reserves and hold-backs on your revenue.** OpenLoop explicitly manages "reserves/hold-backs" on the merchant account. Standard merchant practice, except it's *your patients' payments* being reserved, at a percentage and duration you don't control, by a counterparty you can't audit. Structurally, you are an unsecured creditor of OpenLoop for every dollar in transit.
7. **Your product can vanish overnight, and that's in writing.** "Availability of any given GLP-1 option may change at any time, *with no notice*." If a patient's medication disappears, OpenLoop will "attempt" to find an alternative, but "not all patients will qualify." Your core offering (the thing your marketing spend acquired patients for) exists at OpenLoop's pleasure, and they've pre-disclaimed any obligation when it doesn't.
8. **Pricing is a moving target with a signature deadline.** The proposal expires in 30 days and states pricing "will change immediately upon changes in FDA and state regulations." Combined with flag #7, you're asked to sign a 12-month commitment against pricing and product availability that OpenLoop reserves the right to change at any moment.
9. **You're asked to sign against blanks.** An upfront implementation fee is normal, and what's not normal is what's *behind* it. In OpenLoop's proposal, the provider quantities in Schedule A are literally "TBD," the staff start date is "tbd," and holiday coverage is explicitly excluded, yet $4,500 is due at signature and the 12-month clock starts anyway. You're committing to a year against a staffing plan that hasn't been written. And the scope you're buying is deliberately narrow: every future business line triggers "an addendum to the MSA and a separate implementation fee": expansion is a tollbooth, not a feature. (Contrast: Cuvo's $9,800 Launch setup buys a fully defined offering: the complete 05/01/2026 price list, the partner pharmacy network, the consult rate, and the managed LegitScript application, with no term, no per-line addendums, and no re-implementation fees to grow.)
10. **The margins on commodity products are indefensible.** On the sexual-health single-dose 10-pack, the patient pays $119 and you receive $50, and OpenLoop keeps **58%** on generic sildenafil/tadalafil that costs roughly a dollar a dose at compounding cost. The best example: the **biotin supplement**: patient pays $35/month, you receive $11, and OpenLoop keeps **$24 (69%) on an over-the-counter vitamin.** These aren't clinical-services margins; they're what a captive channel looks like.
11. **Coverage and eligibility carve-outs hide behind the "50-state" headline.** TRT with scheduled medications is available in only ~35 listed states ("subject to change at any time"). Weight loss is capped at ages 18–74, TRT at 25+, sexual health at 21+ with 75+ restricted to single-ingredient products. Staffing "does not include holiday coverage." OpenLoop defines your addressable market, and reserves the right to redefine it without notice.
12. **The proposal can't even keep its own numbers straight.** The microdosing table lists the 24-week option as "$159/mo (charged as $507)" and the 52-week option as "$149/mo (charged as $507)": the same $507 for both, when the stated monthly rates imply roughly $954 and $1,937 respectively. A pricing document with internally contradictory numbers is either careless or convenient; either way, it's what the contract will incorporate by reference, and *you'd* be the one discovering which figure OpenLoop honors after signing. (Note also: TRT care coaching is "$5 per patient per month **(waived)**," waived, not removed. The right to start charging is retained.)
13. **"Paid by OpenLoop" means deducted from you.** The tables tout "(labs paid by OpenLoop)" in Month 2, and in exactly that month your remittance drops $12 on semaglutide and $30 on tirzepatide. The "optional" Care Coaching works identically: the care-coaching-included tables carry a footnote confirming a "$10 per 4-week reduction in Admin Fee," and every figure in *your* column falls by precisely $10 while OpenLoop's retained share is untouched. Across the entire proposal, not one cost is ever absorbed on OpenLoop's side of the ledger.
14. **The termination clause is a loaded gun pointed one way.** "12-month initial term, 30 day notice to terminate for any reason." Read it from both sides. If *you* terminate, you leave behind your merchant account, card tokens, billing relationships, and patient records (all resident in OpenLoop's stack) and effectively restart from zero. If *OpenLoop* terminates, they lose one revenue-share client and keep everything. A mutual 30-day clause between parties with wildly asymmetric switching costs isn't mutual at all: it's a kill switch on your business that only one side can afford to pull.
15. **Even your legitimacy credential may be a tether.** Before considering the $3,000 "LegitScript Through OpenLoop Integration," ask in writing: if certification is obtained *through OpenLoop's integration*, does it survive your departure from the platform? The proposal is silent. (On Cuvo, the LegitScript application is prepared and managed by Cuvo for the brand, and the brand registers the certificate from its own ad accounts; expedited certification is included in the Grow setup.)

**The pattern across all fifteen:** OpenLoop holds the cash, the count, the policy, the product availability, the pricing, and the exit. The client holds the brand risk, the marketing cost, the refund exposure, and a 12-month obligation. Cuvo's flat-fee model doesn't just price better, it structurally *can't* do most of the above, because Cuvo never touches your money, your tokens, or your patient relationships in the first place.

## 09. Side-by-side scorecard

| Criterion | Cuvo | OpenLoop | Winner |
| --- | --- | --- | --- |
| Upfront cost (with LegitScript) | $9,800 (Launch, LegitScript application managed by Cuvo) | $12,000 | **Cuvo ($2,200 less)** |
| Monthly fee | $997 flat on Launch, month to month | $1,500 from first patient | **Cuvo** |
| Contract | Month-to-month | 12-month term | **Cuvo** |
| Medication pricing | Dated price list | Bundled into 42–59% revenue retention | **Cuvo** |
| Consultation pricing | $25 flat | Bundled into retention | **Cuvo** |
| Per-patient fees | None | Effectively 50–59% of maintenance revenue | **Cuvo** |
| Merchant account ownership | Clinic | OpenLoop | **Cuvo** |
| Card token ownership | Clinic | OpenLoop | **Cuvo** |
| Patient record ownership | Clinic | OpenLoop's systems | **Cuvo** |
| Cash flow | Direct to clinic, immediately | Weekly remittance from OpenLoop | **Cuvo** |
| Pharmacy flexibility | Licensed partner pharmacies or BYO | OpenLoop supply chain only | **Cuvo** |
| Provider flexibility | In-house network or BYO | OpenLoop providers only | **Cuvo** |
| Exit/migration | Trivial: you own everything | Effectively a business reset | **Cuvo** |
| Data breach history | None known | 716K patients, Jan 2026, HHS-confirmed | **Cuvo** |
| White-label integrity | Fully invisible to patients | Solicits reviews from clients' patients | **Cuvo** |
| Employer ratings (service-quality proxy) | n/a | Glassdoor 2.8, Indeed 2.4 | n/a |
| 50-state coverage | Yes (cold-chain injectables all 50; most others all states exc. DC, some exc. CA) | Yes (all 50 + DC) | Comparable |
| Amex acceptance | Your choice | Not accepted | **Cuvo** |
| Public API documentation | Yes, developers.cuvo.co (API on Grow and up) | None found (Oct 6, 2026) | **Cuvo** |
| Published price list | Yes, on /pricing | No; quoted by proposal | **Cuvo** |

## 10. Bottom line: follow the money

OpenLoop's proposal reads well until you follow the money. You pay $2,200 more upfront, sign for twelve months against pricing OpenLoop can change at any moment and product availability it can pull "with no notice," surrender your merchant account, your card tokens, and your patient data pipeline, and then hand over half or more of every maintenance patient's payment (a cut that *grows* as your patients stay longer) to a vendor with an HHS-confirmed 716,000-patient breach, bottom-quartile employee sentiment, a 69% margin on a drugstore vitamin, and a review practice that markets itself to your patients.

Cuvo's Launch program charges $9,800 once with the LegitScript application prepared and managed by Cuvo, then a flat $997 a month, binds you to nothing, takes no revenue share, and settles patient payments to your own merchant account. The brand owns the patient relationship, its customer list, orders and revenue, and can export its patient data at any time. Year one you spend $21,764 in fixed fees on Cuvo versus $30,000 locked in on OpenLoop. Per patient, on the proposal's own semaglutide injection figures, a maintenance patient leaves $49 to $82 more with the clinic each month on Cuvo at the same retail price.

One platform charges flat, published fees and takes no share of a patient's payment. The other keeps half or more of every maintenance payment. That's the choice.

**Best for**
- Supplement, nutrition or fitness brand adding GLP-1: Cuvo Grow
- DTC brand with its own storefront and engineers: Cuvo Grow (API, webhooks and MCP) or Cuvo Prescribe
- Med spa group adding telehealth programs: Cuvo Health
- Brand that wants revenue in its own merchant account: Cuvo Health
- Multi-brand operator: Cuvo Enterprise
- Founder testing a first offer: Cuvo Launch

> **Compare an OpenLoop proposal line by line** If you hold an OpenLoop proposal, bring it: Cuvo prices the same patient volume on its published fees and shows where the revenue lands. [Book a discovery call](/booking) · [See the analytics](/analytics)

## 11. Common questions about OpenLoop and Cuvo

**Q: How much does OpenLoop cost?**

A: Cuvo Health publishes its prices; OpenLoop prices by written proposal. OpenLoop's proposal prices implementation at $9,000, split $4,500 at signing and $4,500 at first patient, with expedited LegitScript certification as a $3,000 add-on and a $1,500 monthly fee from the first patient seen, all on a 12-month initial term. The larger cost is the revenue model: on maintenance patients OpenLoop retains roughly 50 to 59 percent of what the patient pays. Cuvo's equivalent figures, on its Launch program, are $9,800 once with the LegitScript application prepared and managed by Cuvo and $997 a month, month-to-month, with no per-patient cut. Cuvo also publishes a larger Grow program at $2,500 a month with a $15,000 setup, and a custom-priced Enterprise program, on the same terms.

**Q: Does OpenLoop take a revenue share?**

A: Cuvo Health takes no revenue share; OpenLoop, structurally, does. Patients pay into OpenLoop's merchant account, and OpenLoop remits a scheduled amount back to the clinic weekly, keeping the difference. On its own proposal's numbers, a maintenance tirzepatide patient pays $339 a month and the clinic receives $138, so OpenLoop retains $201, about 59 percent, every month the patient stays. On Cuvo, there is no revenue share: patient payments settle to the brand's own merchant account.

**Q: Who owns the patient data and billing on OpenLoop?**

A: Cuvo Health leaves both with the clinic; on OpenLoop, OpenLoop holds them. Patient payments run through OpenLoop's merchant account, the card tokens live in OpenLoop's systems, and patient records sit in OpenLoop's EHR. Leaving the platform means re-acquiring payment authorization from every patient and rebuilding billing from zero. On Cuvo, the merchant account, tokens, and records are the clinic's from the first transaction.

**Q: Did OpenLoop have a data breach?**

A: Cuvo Health keeps patient data on HIPAA-compliant infrastructure with a signed business associate agreement on every plan; OpenLoop did report a breach. On January 7, 2026, an unauthorized third party accessed OpenLoop's systems and exfiltrated files affecting up to 716,000 patients across the telehealth brands running on its infrastructure. The incident is confirmed on the HHS Office for Civil Rights breach portal and was reported to the California and Texas Attorneys General.

**Q: What is the best OpenLoop alternative?**

A: Cuvo Health is the best OpenLoop alternative for a clinic that wants flat published fees, a $25 consult rate, no long-term term, and ownership of its merchant account, card tokens, and patient records; the line-by-line math is above. OpenLoop bundles clinicians, billing, and fulfillment into a revenue-retention model with a 12-month term.

**Q: Does OpenLoop have a telehealth API for white label pharmacy and prescribing?**

A: Cuvo Health does, and OpenLoop does not publish one. Cuvo's Integrations API is documented publicly at developers.cuvo.co: an OpenAPI 3.1 contract with 65 operations covering patients, cases, prescriptions, orders and visits, with signed webhooks, a test-mode sandbox and an MCP server, included on Grow, Enterprise and Cuvo Prescribe. As of October 6, 2026, openloophealth.com published no API reference, sandbox or webhook guide; its technology page asks companies with their own stack to talk to OpenLoop about integration, and prescriptions route to OpenLoop's own pharmacy network.

**Q: How much does OpenLoop Health cost for its clinician network, pharmacy and API?**

A: Cuvo Health publishes its price and OpenLoop does not. Cuvo charges $25 per completed consult and takes no revenue share, on Launch at $997 a month after a $9,800 setup or on Grow, which adds the API, at $2,500 a month after a $15,000 setup, month to month. OpenLoop's site says cost varies by the services selected and directs buyers to sales (checked October 6, 2026); the proposal analyzed on this page priced a $9,000 implementation, a $1,500 monthly fee and a retained share of 50 to 59 percent of maintenance revenue on a 12-month term.

**Q: What are the best OpenLoop Health alternatives with an API, prescription fulfillment and a clinician network?**

A: Cuvo Health is the best OpenLoop alternative for a brand that needs all three in one contract at published prices: a public API with signed webhooks and a sandbox, e-prescribing to licensed partner pharmacies or the brand's own pharmacy, and 300+ board-certified MDs, NPs and PAs licensed across all 50 states, DC, Puerto Rico, Guam and the US territories. OpenLoop publishes no API documentation and no price list, and in the proposal reviewed here keeps 50 to 59 percent of maintenance revenue. Wheel and SteadyMD, also compared on cuvo.co, quote their pricing per engagement rather than publishing it.

**Q: Can I launch a white label GLP-1 brand on OpenLoop or Cuvo?**

A: Cuvo Health is built for it. Semaglutide and tirzepatide programs, where clinically appropriate, run on every Cuvo plan alongside testosterone and hormone therapy, peptides, sexual health, women's health and wellness, with providers in all 50 states, cold-chain delivery at 2 to 8 degrees C, provider-reviewed refills, labs through Labcorp and Quest, and a typical launch in under 30 days. OpenLoop also markets a white-label GLP-1 program, but its site says compounded GLP-1 availability varies by state, and the proposal reviewed here says any GLP-1 option may change at any time with no notice while the brand is held to a 12-month term.

**Q: Does OpenLoop offer analytics or a revenue dashboard?**

A: Cuvo Health gives owners real-time new patient, revenue, retention and LTV dashboards, with cohort and rebill forecasting and a custom report builder on Grow and Enterprise, all reporting revenue that has already settled to the brand's own merchant account. OpenLoop's technology platform page advertises an admin dashboard with live volume and revenue reporting (checked October 6, 2026), but in the proposal reviewed here the revenue it reports is collected into OpenLoop's merchant account and remitted weekly from OpenLoop's own count of active patients.

**Read next**
- [Cuvo vs Wheel](/compare/cuvo-vs-wheel): Enterprise care platform with a gated API
- [Cuvo vs SteadyMD](/compare/cuvo-vs-steadymd): Clinician workforce and APIs for your own stack
- [OpenLoop alternatives](/blog/openloop-alternatives)
- [Cuvo vs OpenLoop vs Wheel](/blog/cuvo-vs-openloop-vs-wheel)
- [Telehealth API for white-label brands](/telehealth-api)
- [White label pharmacy and e-prescribing](/pharmacy)
- [Revenue and analytics dashboards](/analytics)
- [White label GLP-1 weight loss programs](/solutions/glp-1-weight-loss)

**Primary sources cited in section 06**
- [FDA: concerns with unapproved GLP-1 drugs used for weight loss](https://www.fda.gov/drugs/drug-alerts-and-statements/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss): Refrigeration of injectable GLP-1 drugs and complaints of warm deliveries
- [Google Ads: Healthcare and medicines policy](https://support.google.com/adspolicy/answer/176031): United States: telemedicine providers accredited by LegitScript and certified with Google
- [LegitScript: Healthcare certification](https://www.legitscript.com/certification/healthcare-certification/): Certification for telemedicine providers that advertise on major ad platforms

*Sources and disclosures: Sources: OpenLoop "Summary of Proposed Services" (exp. 05/28/26); Cuvo/RxAve client price list dated 05/01/2026; Cuvo commercial terms; HHS OCR breach portal via SecurityWeek, HIPAA Journal, Security Affairs (May 2026); Glassdoor and Indeed company pages (screenshots, May 2026); OpenLoop's public site (homepage, technology platform, pharmacy and diagnostics, Launchpad, medical weight loss and licensing pages) as checked on October 6, 2026 for section 06. Cuvo fixed-fee figures quote the Launch program ($997 a month, $9,800 setup); Grow and Enterprise are published on Cuvo's pricing page and carry the same commercial terms. Per-patient figures exclude shipping on both platforms and assume identical retail pricing. OpenLoop is a trademark of its respective owner, which is not affiliated with Cuvo Health and does not endorse this comparison. Not legal or financial advice; verify contract terms against executed agreements.*

## Sources for this comparison

- [OpenLoop homepage (FAQ: pricing varies by service)](https://openloophealth.com/)
- [OpenLoop technology platform](https://openloophealth.com/technology-platform/)
- [OpenLoop pharmacy and diagnostics](https://openloophealth.com/pharmacy-and-diagnostics)
- [OpenLoop Launchpad](https://openloophealth.com/launchpad)
- [OpenLoop white-label GLP-1 program](https://openloophealth.com/medical-weight-loss/)
- [OpenLoop licensing and credentialing](https://openloophealth.com/licensing-credentialing)

*Competitor information comes from the public sources above as of Oct 6, 2026; unknowns are stated as not publicly listed rather than asserted. Cuvo claims restate what cuvo.co publishes elsewhere.*

Canonical page: https://cuvo.co/compare/cuvo-vs-openloop