Breaking Into the Healthcare Industry: A Guide for Entrepreneurs


As more people live longer, the number of patients with degenerative and chronic diseases continues to increase. On top of that, we are currently dealing with a pandemic that claimed the lives of millions. With COVID-19 and other chronic diseases still in existence, it’s no secret that medical infrastructures are often struggling to keep up.

To answer the challenge, entrepreneurs have taken the challenge by generating innovative and revolutionary healthcare solutions. From using automating processes and digitizing clinical records to using artificial intelligence to perform surgeries, entrepreneurs are stepping into the industry.

If you are interested in entering the healthcare industry, business opportunities abound. However, some steps are necessary to ensure you succeed in your endeavors.

Understand Your Market

Like any emerging market, here are some nuances to consider if you are interested in starting a business in the healthcare industry. Since the sector is a big part of the economy, identifying your target consumers matters. Otherwise, you might implement dead-end strategies.                                                                                         

Also, understand the layers of the business or the sequence of events that motivate a consumer’s decision to buy. How can you engage with them? How can you encourage loyalty to your products and services? By answering these questions, you can reach the right audience at the right time with the right materials.

Familiarize Yourself with Healthcare’s New Economics

The Affordable Care Act (ACT) is changing the way healthcare workers are paid and how they deliver their care. In the future, solutions will come from innovative entrepreneurs who can provide personalized, higher-quality medical care at more affordable costs.

At the same time, the expansion of private and public health insurance exchanges will lead to the development of more competitive insurance products. As a result, there is downward pressure on prices.

The Centers for Medicare and Medicaid Services (CMS) will continue regulating the Medicaid Advantage program’s reimbursement rates for popular insurance plans. This will lead to more affordable hospital and physician payments while rewarding health plans that deliver A+ services.

The combination of ACT, the Medicare Advantage and the Accountable Care Organizations resulted in a shift in the payment paradigm. From the old “fee-for-service” model, we are moving towards the “pay-for-value” system.

Form the Right Partnerships

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The healthcare industry is a delicate one. In one way or another, your decisions will affect the lives of others. While you don’t need a scientific or a medical degree to start a healthcare-centric business, it helps to work with someone who does.

Limit your clinical liability and financial risk by working with the right partners. At the same time, you reduce the likelihood of making costly mistakes.

Understand The Regulations

Healthcare is one of the most highly regulated industries in the world. It is a complicated and multi-faceted ecosystem riddled with the risks of making costly mistakes. Apart from being costly, these mistakes can also be fatal for both the patients and the business. A healthcare entrepreneur must understand these regulations and have the guidance of an expert if needed.

Create Technologies That Make Healthcare Affordable

Today, many patients enrolled in bronze or silver insurance plans deal with huge deductibles. For many health insurance holders, paying the first $5,000 out-of-pocket is not an option. On the other hand, patients with a more comprehensive coverage seek convenience from their healthcare experiences as they attempt to balance home life with work and other responsibilities.

Healthcare entrepreneurs now take advantage of technology to create easier alternatives to in-patient hospital stays and office visits. Many businesses have developed safe and reliable applications that are available on video and mobile platforms. These apps provide patients virtual access to care, which eliminates the need for in-person visits.

Understand That Startups Fail — And That’s NormalA person holding a paper with white board beside him

Like any business, there is a chance that not everything will go according to plan. Healthcare startups can still fail, especially since the industry is a complex one. In most cases, the patient isn’t the one paying for their care — the insurance company is. As a result, many physicians and hospitals still depend on the fee-for-service payment model. Even those who want to change cannot do so immediately due to the negative impact on their bottom line and the short-term revenue loss.

As a result, the healthcare industry is unlikely to embrace any type of solution that reduces utilizations. But entrepreneurs are challenging this practice by creating services that offer substantial value. This involves enabling hospitals and doctors to move away from the fee-for-service model.

Still, even the most experienced entrepreneur fails, especially when money becomes an issue. To prevent this, get to scale. Acquire the expertise and skill to maneuver through the industry’s complex requirements to acquire more clients, as well as adequate human and financial capital.

Equipped with the right framework and marketing strategies, breaking into the healthcare industry should be a straightforward venture. It won’t be easy but, in the process, you’ll still realize the best outcome possible: improving the lives of people.

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