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Breakthrough MedTech Strategy

The round closed. Now the plan has to work.

I work with the investors and boards who put the money in, and the founders who have to spend it. I find the problem, define the fix, and stay for the part that needs an operator.

Most medtech and digital health companies don’t stall on the science. They stall in the gap between “this works” and “someone pays for this, repeatedly.” Investors and boards usually see it a quarter late. Founders often can’t see it at all. I’ve worked that gap from the payer’s side, the vendor’s side, the acquirer’s side and the CEO’s chair. Below are the six ways I work, each with a defined output.

$0 → $7.5M

NightWare revenue. The first $5M with no sales staff, $7.5M after a small sales force.

10 + 1

Premarket products advised through my firm, including one exit to Integra LifeSciences.

$172K → $1M

Highmark Health’s VITAL program, which validates medtech for a payer, in one year.

$275M

Acquisition whose commercial integration I ran at Baxter.

Who I work with

Four seats. Each has a different problem.

The engagement starts from where you sit and what you can see from there.

The board director on a fresh round

You took the seat on a round priced on commercial milestones. Nobody at the table has built the sales engine, and the founder may not have either. I tell you early, and specifically, whether the plan will hit what the round was priced on.

What keeps you upThe first hire is a VP Sales who’s supposed to arrive with the plan, and nine months and $3M later the milestones slip.

The platform or operating partner

Your reputation rides on whom you put in front of a founder. I’m an operator who has sat in the founder’s chair, not an adviser who studied it, available as a bench across the companies that need one.

What keeps you upSending someone who talks strategy, leaves a deck and disappears.

The strategic, payer or provider-backed investor

Your companies were backed partly because the parent might deploy them. Most have no idea how to get through procurement and medical policy. I’ve been the gatekeeper and the applicant.

What keeps you upA pilot that stalls at the parent, when the fund’s thesis was strategic fit.

The growth or PE investor

You have a thesis, a 100-day plan and a founder-led asset. I pressure-test the commercial plan in the memo, before the close or in the first 100 days, and give you an honest read on whether the team can run it.

What keeps you upActing on the founder six months too late, after the numbers in the memo have slipped.

Six ways to work together

What I do, and what you get.

Counsel, coaching, strategy, diagnosis and, where it’s the right answer, operating leadership. Project-based or retained.

01
The first
two weeks

Business assessment

Two weeks inside the business, working with the founder, measuring where it stands against what the round was priced on. Commercial plan first, because that’s the milestone that moves the next raise. You see the size of the gap before you decide anything else.

What you get

  • A one-page board read: where the business is, where it needs to go, and what it will take to get there
  • The commercial plan tested against the model: pricing, channel, sales compensation and launch sequence
  • The reimbursement and payer path: who pays, how, and who inside the company owns it
  • An honest read on whether the team in place has the capacity to execute the plan
02
Scaling

Strategy and scaling counsel

Coaching and counsel for the CEO, strategy for the board. I identify the problem, define the fix and work through it with the team, either on a defined question or retained for a founder who needs someone in their corner who has run a company at that stage.

What you get

  • CEO and founder coaching from an operator who has held the seat
  • Strategy development across market, pricing, channel, evidence and reimbursement
  • Board counsel: what to ask, what to watch, and which decision to force and when
  • Problems named plainly, solutions designed and the fixes sequenced in the order that protects the next raise
03
Before you
sign

Operator diligence

The data room shows you the first layer. The capital gap, the product debt, the channel that can’t pay and whether the team can run the fixes usually sit one or two layers down, and they surface when someone has to run the company. I inherited one, so I know where to look. The point isn’t only to avoid companies with hidden problems. It’s to give the ones with a real shot a map through them.

What you get in three weeks

  1. The hidden problems, each with its evidence and the layer where it was hiding
  2. The solve for each, with its real cost in money, time and people
  3. Whether current leadership can run those solves and, where it can’t, what the gap is
  4. A one-page read for the investment committee or board: proceed, proceed with conditions, or don’t, in your terms
Declared up frontIf the read says the leadership gap is the CEO, I’ll say so, and you should assume I’d be interested in the seat. If that makes the read less useful to you, I’ll give you the read and step out of the search.
04
On
retainer

The fund’s operator bench

A platform team is judged by whom it puts in front of a founder. I serve as an operator-CEO on your bench: one relationship, applied across the portfolio companies that need it, without a new search or a new vendor each time. I’ve run the function at a company of that size, and more than once.

What you get

  • Founder coaching and board counsel on the portfolio companies you choose
  • Assessments across three to six companies, using one scorecard so the findings are comparable
  • A pattern read for the fund: the gaps that repeat across companies, such as no reimbursement owner, a sales comp plan built before the pricing model, or a launch plan with no payer step
  • An operator your platform team can introduce with confidence, because the record is the proof
05
Pilot to
contract

Getting a portfolio company through the parent

For strategic, payer and provider-backed funds. A pilot that stalls at the parent is a portfolio problem and a career problem. In my experience it’s usually stuck in procurement or medical policy, not in the product. I treat every pilot as a procurement case from day one, not a clinical demonstration.

What you get

  • A pilot-to-contract assessment on one company: who owns the path, where it’s stuck, and what the buyer’s policy requires
  • A fit-for-parent read: whether the company belongs inside the parent’s channel at all, and on what terms
  • The payer and health-system pathway mapped end to end: coverage, medical policy, contracting and committee review
  • An evidence plan built to what a medical policy needs, not to what the company already has
Both sides of the tableAt Highmark Health I ran VITAL, the program that validates medtech for a Blues plan and its health system, and grew it from $172K to $1M in a year. At NightWare I was the applicant: a VA innovation pilot and the commercial-payer medical-necessity process.
06
The next
chapter

Operating leadership

Sometimes the read says the business doesn’t need better advice. It needs a different operator for the next leg. Where there’s capital to scale and the founder isn’t the operator for what comes next, I can step in as interim or long-term CEO. I’ve done it: I stepped in as CEO at NightWare when the board needed an operator, after taking the company from $0 to $7.5M as chief commercial officer.

What you get

  • Interim or permanent CEO or commercial leadership for a company funded to execute the plan
  • A transition handled with the founder, not around them: a redesigned role, or a board-led change done cleanly
  • A 100-day plan that already exists, because the assessment was the groundwork
Only where the capital is thereI take a seat only at companies capitalized to pay for the plan. This is the second conversation, not the first, and it comes out of the work, not a pitch.
Also for
founders

Commercialization planning, fractional commercial leadership and positioning for acquisition. The work I’ve done for founders directly, before launch, in market and ahead of an exit: customer and market insight, evidence planning, launch strategy, sales build-out, payer access and a commercial story that survives diligence. I’ve advised ten premarket products, including a client exit to Integra LifeSciences, and integrated acquisitions from the buy side.

How an engagement runs

Small first step. Clear decision after.

You see what I find before you commit to anything larger.

01

A 20-minute conversation

No pitch. We compare notes on the business, where it’s stuck and whether what worked for me applies to it.

02

The diagnostic

Fixed fee, two to three weeks, scoped before kickoff. Inside the business, with the founder.

03

The read

One page, in your terms: where it is, where it needs to go, what it takes and who can run it.

04

The decision

A follow-on project or retainer, a different next step, or nothing at all. The diagnostic fee is credited in full against a follow-on signed within 30 days.

Fit

Who this is for, and who it isn’t.

I’d rather tell you in the first conversation than in the third.

Good fit

  • Companies that closed a meaningful round and are funded to act on what the work finds
  • Investors and boards who want a read in their own terms, not a deck
  • Founders who want the problem named plainly and a plan to fix it
  • Funds with several companies at the same stage and the same gaps repeating

Not a fit

  • Companies without the capital to act on the findings
  • Free assessments, discounted discovery or open-ended “pick my brain” sessions. The work is priced because the answers are specific
  • Marketing agency, media or lead-generation work
  • A second opinion meant to confirm the first

Start here

Start with 20 minutes.

Tell me the company, the round and the question you most want answered. If what worked for me applies, we’ll scope the first step. If it doesn’t, I’ll say so and point you to who might help.

Book a conversation Read Nobody Wants to Say It first, free Written for investors and boards when a company isn’t going right.

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