Selling Digital Health Technology to Commercial Payers
Updated: Sep 23
Selling to Commercial Payers Means Solving for Three Customers at Once
A commercial health plan does not buy digital health technology for one audience. It buys on behalf of employer customers, deploys to members, and operates the program inside its own clinical, financial, product, technology, and service systems. A solution can satisfy one group and still fail the sale.
The commercial strategy must therefore answer three questions at the same time. Why will an employer value the offering? Why will a member use it? Why can the payer operate and finance it? The strongest proposals connect these interests in one coherent model.
The payer’s customer changes the value proposition
Employers buy health benefits to manage cost, support employees, compete for talent, and meet workforce needs. The health plan must offer products that help those employers while differentiating itself in a competitive market.
That means a digital health solution may create value beyond its clinical outcome. It can help the plan win or retain an employer account, strengthen a product bundle, address a visible workforce concern, or improve the experience members associate with the health plan. Those benefits can matter even when the direct medical-cost effect is still developing.
The company should understand which employer segments the plan serves and what those customers are asking for. A solution designed for a geographically dispersed technology workforce may not fit a manufacturing population with shift work and limited smartphone access. A maternal-health benefit may resonate differently with an employer focused on talent retention than with one responding to avoidable neonatal costs.
Commercial research should therefore extend beyond the plan. The payer’s customer is an essential source of demand, and employer renewal cycles can determine whether a product reaches the market.
Member engagement is the mechanism, not a decorative metric
Digital health companies frequently place engagement beside clinical outcomes and ROI as a separate proof point. For commercial payers, engagement often explains whether those other results are possible.
A program cannot lower cost or improve quality if members do not enroll, activate, and continue using it. Low participation also weakens attribution because the plan cannot distinguish product failure from distribution failure. Engagement is therefore part of the causal model: outreach produces activation, activation produces use, and sufficient use creates the opportunity for outcomes.
The vendor should arrive with an activation strategy. What messages will be used? Which channels can the plan and employer provide? Who owns outreach? How will communications comply with plan and employer rules? What happens when members do not respond? How will engagement differ by language, age, geography, and health need?
The webinar suggests that engagement above roughly 30 percent can command attention, although the appropriate benchmark depends on eligibility, intervention intensity, and how engagement is defined. A credible proposal defines the denominator and the behavior being measured rather than offering an isolated percentage.
Product teams often connect the internal buyers
Inside a commercial plan, the product organization can serve as a bridge among clinical, finance, sales, marketing, operations, and customer teams. It considers how a solution fits the plan’s portfolio and whether employer customers will understand and value it.
That does not make product the only entry point. A clinical leader may sponsor a condition-specific program. A finance team may lead an affordability initiative. A customer-experience group may own navigation. The company should identify the business problem first and then map the stakeholders required to act.
Internal priorities can reveal attractive openings. A plan may be focused on a high-spend condition, an employer-requested benefit, or a digital funnel where members repeatedly abandon the process. A startup that can improve an existing priority is easier to fund than one asking the organization to create a new category.
The sales narrative should be legible across the committee. Clinical leaders need evidence. Finance needs a defensible economic model. Product needs differentiation. Marketing needs a member story. Technology and security need a safe integration. Operations needs a workable launch.
Security is a market-access requirement
Security review is not a late-stage procurement formality. For many commercial payers, it is a go-or-no-go condition. A product that handles protected or sensitive data may need mature controls, documented policies, independent assessments, and certifications aligned with the buyer’s expectations.
The webinar notes that HITRUST readiness can require 18 to 24 months. The precise timeline varies, but the strategic implication is clear: companies should understand target-customer requirements before a large deal reaches security review.
Overbuilding too early can consume scarce capital. Underbuilding can make a qualified opportunity impossible to close. The right sequence is to interview likely buyers, identify minimum and future-state requirements, create a phased compliance plan, and be transparent about current capabilities.
Security should also be incorporated into the product roadmap and pricing. Integrations, data storage, identity, subcontractors, incident response, and audit support create real costs. Treating them as part of the offering makes the commercial model more accurate.
Start conversations before the product becomes rigid
Founders sometimes wait for a finished product, a complete evidence package, and a polished price before approaching a payer. That reduces the buyer’s role to approval and misses the chance to learn what would make the solution usable.
Early payer conversations can test the problem, population, workflow, evidence, pricing unit, and pilot design. They can reveal whether the plan prefers a narrow high-risk population, a particular integration, or an at-risk contract. They also expose internal alternatives the startup may not see.
The goal is not to sell vapor. The company should be clear about what exists and what remains flexible. Collaborative design works when it is bounded by a specific problem and supported by a credible delivery plan.
A rigid offer can also create pricing friction. A plan may reject a broad per-member-per-month model but accept payment for engaged members, completed cases, or outcomes. Flexibility should allocate risk intentionally, not conceal weak economics.
Make implementation and marketing part of the offer
Commercial plans do not want a vendor that launches and leaves. Member-facing technology requires an operating partnership: eligibility, communications, onboarding, customer support, issue escalation, reporting, and continuous optimization.
The vendor should specify which activities it owns and what it needs from the payer and employer. If the model depends on employer emails, plan portal placement, care-manager referrals, or provider promotion, those dependencies belong in the implementation plan and the performance assumptions.
Marketing also needs an understandable value proposition. Virta’s early positioning around reversing type 2 diabetes offered a clear promise that members and buyers could repeat. A company does not need to mimic the claim, but it should reduce complexity to a problem and outcome that travel through the payer organization and reach the member intact.
Strong consumer experience can support that story. High satisfaction or recommendation scores show that the benefit may strengthen the plan’s relationship with members and employers. The evidence should use validated definitions and explain whose experience was measured
Prepare for a long cycle and a narrow first win
Commercial payer deals can require 12 to 18 months or longer. The company must finance the process, maintain momentum across personnel changes, and avoid treating every friendly meeting as progress.
A practical first contract is often narrow: one employer group, market, population, or product line. The pilot should produce a decision, not merely activity. Success criteria, data access, evaluation, renewal logic, and expansion conditions should be agreed upon before launch.
The most persuasive commercial-payer strategy connects the entire system. It starts with an employer need, creates a member experience people will use, and fits the payer’s internal economics and operations. Solving for all three customers turns a promising technology into a benefit the market can actually carry.
About the Speakers
Tiffany Martin, MPH
Vice President of Product & Partnerships at UnitedHealth Group
Tiffany leads product strategy and strategic partnerships serving more than 25 million commercial members. Her experience spans virtual care, e-commerce, affordability products, innovation, commercialization, and major consumer-brand partnerships. Connect with Tiffany on LinkedIn.
Demi Radeva, MSc
Founder and Chief Strategist at Akros Advisory
Demi has more than a decade of experience across Medicaid, Medicare, and Commercial health plans, including leadership roles at UnitedHealthcare and Optum. She now advises HealthTech companies on reimbursement, payer strategy, market access, and commercialization. Connect with Demi on LinkedIn.
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