Independent Payer Diligence

for Health Technology Investors

We assess whether a portfolio company’s evidence strategy can actually support coverage, pricing, and adoption, then surface the reimbursement gaps most likely to affect growth, valuation, and exit timing.

BUILT FOR

Series A-C investors in devices, diagnostics, digital therapeutics, and AI-enabled tools

POSITIONING

Independent validation that extends beyond regulatory and clinical diligence

OUTCOME

Board-ready findings that sharpen decisions and strengthen exit positioning

Payer readiness

Moderate

Independent read on current coverage strength

top evidence gaps

3-5

Highest-impact issues likely to block adoption

risk exposure

Elevated

Potential revenue and pricing pressure

action plan

6 weeks

Clear roadmap with owners and priorities

Clinical endpoints aligned

Assess whether endpoints and comparators match payer expectation.

Economic support for coverage

Pressure-test assumptions around cost offsets and budget impact.

Revenue assumptions validated

Show where adoption forcast may depend on unconfirmed coverage.

What traditional diligence misses

1

Has payer acceptance been independently tested, or is the investment case still relying on management assumptions?

2

Do clinical endpoints and comparators align with what payers need to see to support coverage?

3

Do revenue projects assume coverage that has not yet been validated with actual payer expectations?

4

Which evidence gaps are most likely to delay adoption, trigger pricing concessions, or weaken the exit story?

How the assessment works

Weeks 1-2

Evidence Review

Current-state payer readiness summarized for rapid investor review and internal discussion.

Weeks 3-4

Gap Analysis

Pinpoint the 3-5 highest-impact evidence gaps that could delay or block coverage.

Weeks 5-6

Action Plan

Translate findings into an Evidence Snapshot, Gap & Risk Map, and prioritized de-risking roadamap.

Three outputs investors can use immediately

1

Evidence Snapshot

Current-state payer readiness summarized for rapid invetor review and internal discussion.

2

Gap & Risk Map

Scored risks ranked by likely revenue impact so the most material exposure is visible fast.

3

De-Risking Roadmap

Prioritized actions, owners, and deadlines that move reimbursement strategy from aspirational to actionable.

Why investors use it

Independent validation

Pressure-test coverage risk before the check is written

Board-ready findings

Sharper framing of reimbursement exposure, priortiy gaps, and next steps for stakeholders

Stengthen the story

Reduce avoidable friction when buyers start probing payer readiness

Built for every deal stage

pre-close

Validate assumptions