Hi Reader,

I’m a broken record about this, but I make no apologies: If you can't speak in the specific terms, metrics, and outcomes your customer is graded on, you’re in for a rough ride... and your health tech solution, regardless how earth-shattering and impactful it might be, will struggle with adoption.

The health tech founders who close deals with health plans and health systems are the ones who are fluent in the metrics their buyer's exec team lives and dies by, and who can show (with data and credible examples) exactly how much their solution moves those numbers.

Being hyper-specific does a few things: it gets the right people to listen, it gets you taken seriously and establishes your expertise, it prompts the sort of productive conversation that gets things moving, and it gives your champion the compelling story and details needed to sell the deal internally when you can’t be in the room..

I'm prepping one of my talks with the Techstars Baltimore AI in Healthcare cohort (and I walked a client through the same exercise last week), so I thought it might be useful to work through an illustrative example: selling a chronic care solution to a Medicare Advantage plan. The various circumstances, market, metrics and drivers will likely differ for your offer, but the overall approach should still apply.

Medicare Advantage now covers more than half of all Medicare beneficiaries, over 35 million people. It's arguably the largest market most health tech companies sell into. And one of the hardest to break into if your story is to promise "better health outcomes" instead of the specific outcomes CMS pays for.

So let’s jump in. Here are a few critical ingredients to any successful health tech sales strategy.

Know who you're talking to. Ideally, a Stars/Quality lead or Director of Care Management. Their bonus is likely tied to Star Ratings (and the plan’s success and profitability hinge on it.) Plus, their budget is tied to medical cost trend for their chronic population. Which is a good place to start the conversation.

Lead with the metric that matters (and that your solution can impact.) For example, can you increase medication adherence? That measure has been historically triple-weighted in Star Ratings, among the most heavily weighted measures in the whole program. (Note: CMS is phasing in a temporary reduction for 2026 before returning to triple weight in 2027.) CMS measures it using PDC: Proportion of Days Covered. It tracks the percentage of days in a year a patient actually has their medication on hand, based on pharmacy fill data. Below 80% PDC, a patient is considered non-adherent, and that drags the plan's Star Rating down. Your objective is to figure out which metrics matter to your prospective customers and then craft a story that resonates.

Do the homework before the call. CMS publishes Star Ratings technical notes and measure-level cut points every year here. Look up your prospect's current rating. Which measures can you move up (or help them keep from dropping?) Knowing where they're bleeding points or have the potential to improve is how you establish credibility and earn their attention.

Translate your value into their language. Don't say "we improve outcomes." Say "we move PDC rates on statin therapy by X points" or "we can help you close the gap on your lowest-performing HEDIS measure." Tie your contribution to the measures they're tracking and managing.

Show your math. A half-star swing up or down in the health plans Star Ratings equals real bonus dollars per member. If you can convincingly connect your solution to that math, your wellness solution is revenue and market share to your customer.

Prepare your champion. Anticipate the inevitable and plan accordingly. Your customer, now onboard and motivated, will want to share this opportunity internally. To do that effectively, you need to give them the numbers, sources, and the language their own execs use. Ideally, in a format your champion can claim as her own. Because as much as you want to control the deal, you can’t always be in the room. But you can craft the story.

Here’s the thing... Health plans and health systems are big, complicated, risk-averse, busy and often somewhat dysfunctional enterprises. But they probably do need what you have. The challenge isn't so much about proving your solution works. It's about communicating the contribution you can make to their operations in the terms, metrics, workflow, etc., etc. they care about.
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Again, your circumstances will likely be different, and the evidence you need to present will likely come from other sources and require a different story, but the fundamentals are the same.

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B.