Next, Jamie Heywood points out the difficulty of breaking down the US healthtech opportunities geographically, since some of the states are very similar. However, there are clearly different markets you can target. This way, companies should look at innovation in terms of the structure of systems. According to Heywood, “a lot of innovation comes from Keizer or other integrated care provider systems, and these are not necessarily coast-based institutions. I like to think of it, specifically when it comes to transformative change, as a ‘doughnut-hole’ model.
The center of the doughnut hole encompasses the top institutions that do a lot of innovation. If you manage to become part of that system, then they often capture what you are providing rather than enabling you. They are also harder to work with, in general, as they have a lot of internal innovation and more opaque economics. Around that doughnut, there are those secondary healthcare institutions with very good talent, that desire innovation, but with fewer investments and grants provided by the government funding. Those institutions, if you provide a good solution, can combine and strengthen their offerings to try to compete with those from the center of the doughnut hole. This will drive your growth.
As for the rest, you will see fragmented health institutions in the US that have little structure, they scale slowly, are small, and have less economics to share.
I think for Europeans it’s hard to understand just how fractured the US healthcare system really is. Bluntly in the US if you are not making someone money, you are not doing business. And to understand that, you need to get a clear idea of how people are making money in the US.
It’s particularly important to know how the person/team you are targeting makes money, how they make profits, in order to be able to build solutions that will be adopted at a large scale. Many people will try innovation, but nobody is going to scale resources if your solution does not put a particular department in a favorable position compared to other systems.”
Some extra takeaways on this topic from the breakout discussions:
The US provides a massive single-language market potential. I don’t think it’s about regional variation but about where the leading research centers are. Boston, NYC, and Silicon Valley are big and hard-to-enter healthtech markets.