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An evidence-informed guide to patient-pathway value, reimbursement, strategic fit and acquisition readiness

Most healthcare-app founders believe they are building a product.

A future buyer may be looking for something entirely different.

The buyer may want a reimbursed clinical pathway, access to NHS organisations, a regulated European operation, specialist patient data, a trusted clinical network or a capability that would take years to develop internally.

The application matters. But it is rarely the whole acquisition.

The decisive question is not:

Is our technology impressive?

It is:

What does our company own that a larger healthcare organisation cannot reproduce quickly, safely or credibly?

That question changes how a digital-health company should think about evidence, reimbursement, hospital adoption, data, partnerships and growth.

It also explains why some apparently modest healthcare applications become strategically valuable, while better-funded and more technically sophisticated companies struggle to attract serious buyers.

A necessary scientific qualification

There is no validated formula that predicts whether an individual healthcare company will be acquired.

Nor does the academic literature prove that obtaining reimbursement will automatically increase a company’s acquisition price.

The framework below is therefore a strategic synthesis, drawing on research into:

• digital-health company growth;
• clinical validation;
• digital mergers and acquisitions;
• organisational integration;
• platform economics;
• and recent healthcare transactions.

The evidence helps us identify attributes associated with stronger companies and more credible acquisitions. Applying those findings to a particular digital-health business still requires careful commercial judgement.

Three levels of value

Healthcare-app founders should distinguish three different kinds of value.

1. Product value

Does the technology work?

Can patients and clinicians use it? Is the software reliable? Does the algorithm perform as intended?

This is essential, but it is only the beginning.

2. Healthcare-system value

Does the application improve a sufficiently important part of care to justify adoption and payment?

This requires evidence about the patient pathway, comparator, outcomes, implementation and economic consequences.

3. Acquisition value

Does ownership of the company give a specific buyer a capability, market position or competitive advantage that the buyer could not obtain efficiently through internal development or an ordinary partnership?

Many applications establish product value.

Some establish healthcare-system value.

A persuasive acquisition thesis requires all three.

Technology alone is rarely the scarce asset

A large healthcare company can employ software developers.

It can licence an algorithm, redesign an interface or reproduce individual features.

What it cannot quickly recreate may include:

• trusted relationships with dozens of NHS organisations;
• an established reimbursement mechanism;
• regulated clinical operations in several countries;
• years of implementation knowledge;
• a specialist clinical and technical team;
• longitudinal data linked to meaningful outcomes;
• repeatable access to a difficult patient population;
• or integration into routine clinical decisions.

Research supports this broader view of digital-health success.

A 2024 systematic review by Pfitzer and colleagues screened 2,972 publications and identified 36 relevant studies containing 52 success factors for growth-stage digital companies. These extended beyond products and technology into operations, business models, teams, customers, healthcare systems, regulators, investors, partners and competitors. Factors such as interoperability, data security and regulatory alignment were particularly important in digital health. (JMIR)

That matters because an acquisition is not simply the purchase of software. It is the purchase of a functioning combination of assets, relationships and capabilities.

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What recent acquisitions actually bought

Three transactions illustrate three distinct forms of healthcare acquisition value.

Transaction	The apparent product	The deeper strategic asset
T-Pro–BigHand Healthcare	Clinical documentation and workflow software	NHS relationships, installed workflows and implementation capability
Hims & Hers–ZAVA	Online medical consultation and treatment services	Regulated multi-country European operating infrastructure
Tempus AI–Personalis	Cancer genomic and MRD testing	Diagnostic ownership, longitudinal oncology data and clinical-decision infrastructure

UK: T-Pro and BigHand Healthcare

In July 2026, T-Pro acquired BigHand Healthcare. T-Pro’s announcement stated that the combined organisation now works with approximately 120 NHS trusts and that BigHand Healthcare brought a 15-year history and long-standing relationships with NHS trusts, private hospitals and GP practices. BigHand Healthcare’s employees and customers transferred into the T-Pro group. (blog.tpro.io)

The narrow description is that T-Pro acquired another clinical-workflow software business.

The more important interpretation is that it acquired elapsed time.

T-Pro obtained relationships, installed workflows, implementation experience, customer confidence and a route through which its wider ambient documentation technology could be deployed.

Those assets cannot be replicated merely by allocating a larger software-development budget.

The UK lesson is:

Do not merely build a feature for the NHS. Build a trusted position inside NHS care that a buyer would struggle to reproduce or displace.

Europe: Hims & Hers and ZAVA

In June 2025, Hims & Hers announced its plan to acquire ZAVA. The transaction expanded its UK footprint and provided entry into Germany, France and Ireland. (investors.hims.com)

Hims & Hers could have translated a website, recruited doctors and launched European advertising.

That would not have immediately recreated:

• local clinical-governance arrangements;
• prescribing and dispensing pathways;
• country-specific operational knowledge;
• established patient relationships;
• regulated service delivery;
• and experience working across several European healthcare environments.

ZAVA’s strategic value was therefore larger than its digital interface.

It provided a bridge between Hims & Hers’ European ambition and operational execution.

The European lesson is:

Regulatory and market fragmentation can become a valuable asset once a company has learned to navigate it repeatedly.

USA: Tempus AI and Personalis

In July 2026, Tempus AI announced an agreement to acquire Personalis for a total enterprise value of approximately US$1.5 billion, net of Tempus’s existing ownership interest.

Tempus stated that the transaction would combine Personalis’s tumour-informed molecular residual-disease technology with Tempus’s multimodal data, AI capabilities and precision-oncology platform. The stated objective was to extend support across diagnosis, treatment selection, recurrence and monitoring. (Tempus Investors)

This is strategically important because it brings more of the clinical chain under common ownership:

tumour profiling → diagnostic testing → longitudinal monitoring → data generation → AI-supported interpretation → clinical use.

Tempus is not simply purchasing another analytical algorithm. It is acquiring an underlying diagnostic capability that repeatedly generates clinically relevant data.

The US lesson is:

Digital value becomes more defensible when it is attached to a specific diagnostic, therapeutic or monitoring decision.

The Odelle Healthcare Acquisition-Readiness Framework

A digital-health company can assess its strategic maturity through seven connected areas:

1. Pathway

Own a clearly defined and valuable position in the patient pathway.

2. Proof

Build evidence connecting the intervention to clinical, operational and economic consequences.

3. Payment

Demonstrate who pays, from which budget and through which repeatable mechanism.

4. Position

Create relationships, workflow integration and data advantages that competitors cannot easily reproduce.

5. Purchaser

Identify the specific strategic buyer whose existing assets become more valuable after acquiring the company.

6. Portability

Ensure that contracts, technology, evidence, intellectual property and data rights can transfer to a buyer.

7. Preservation

Show how the team, clinical mission, customers and patient services can survive integration.

The seven elements are connected. Strong technology cannot compensate indefinitely for the absence of payment. Reimbursement cannot rescue an undifferentiated product. Deep integration may lose value if contracts cannot transfer after a change of control.

1. Pathway: own a problem worth acquiring

The first task is not to describe what the app does.

It is to map what happens to the patient before and after its introduction.

A credible patient-pathway analysis identifies:

• the intended patient population;
• the point of entry into care;
• the important clinical decision;
• the current standard of care;
• the relevant comparator;
• existing delays, costs and failures;
• the precise change created by the technology;
• and the clinical and operational consequences that may follow.

Compare these two statements:

“Our application uses AI to monitor people with heart failure.”

and:

“Our platform identifies deterioration between scheduled reviews, directs higher-risk patients to clinical assessment and supports lower-risk patients to remain safely at home.”

The second is more valuable because it identifies the population, decision, comparator and potential resource effect.

A buyer can see where the capability might fit within its portfolio.

A payer can assess whether it changes an identifiable cost or outcome.

A clinician can judge whether it improves a meaningful decision.

An investor can begin to understand whether the model is repeatable.

An acquirer does not buy an abstract claim that an application improves healthcare. It buys a defined ability to change a valuable part of care.

2. Proof: build an evidence ladder

Digital-health evidence remains uneven.

Day and colleagues examined 224 venture-funded US digital-health companies. Using clinical trials and regulatory filings as their operational measure of clinical robustness, they found that 44% scored zero, while only 20% scored five or more. They also found little correlation between clinical robustness and company funding, age or the number of public clinical claims. (ScienceDirect)

The measure has limitations. Not every valuable digital-health intervention requires regulatory clearance, and clinical robustness may also include peer-reviewed observational studies, health-economic analyses, accreditation and validated implementation evidence.

Nevertheless, the commercial message is important:

Investment, publicity and user numbers do not automatically constitute evidence.

An acquisition-ready evidence programme should develop logically.

Technical and usability evidence

Can the intended users operate the technology reliably?

Implementation evidence

Will patients and clinicians use it in real clinical settings?

Behavioural or workflow evidence

Does it change adherence, escalation, documentation, referral or decision-making?

Clinical evidence

Does it improve a meaningful endpoint in the intended population?

Resource-use evidence

Does it affect appointments, staff time, investigations, admissions, length of stay or treatment use?

Economic evidence

Does it represent good value, produce a defensible budget impact or create measurable provider capacity?

Generalisability

Can the result be reproduced in different organisations, populations and countries?

The company should also maintain a formal claims-to-evidence register.

Every important claim should be linked to its source, study population, comparator, endpoint, limitations and permitted wording.

This reduces risk for regulators, payers, investors and buyers.

Weak evidence does not merely threaten reimbursement. It creates acquisition liabilities because the buyer inherits the claims, contractual promises and regulatory exposure.

3. Payment: prove that somebody will pay repeatedly

A healthcare application becomes materially more attractive when payment is no longer hypothetical.

Payment does not necessarily require national reimbursement. It may come through:

• NHS or hospital licences;
• insurer coverage;
• employer health benefits;
• pharmaceutical service agreements;
• per-member-per-month arrangements;
• national digital-therapeutic reimbursement;
• regional commissioning;
• or inclusion in a broader funded clinical service.

The company must answer six questions:

1. Who pays?
2. From which budget?
3. What is the paid unit: patient, licence, consultation, outcome or covered population?
4. Which reimbursement or procurement mechanism is used?
5. What evidence supports payment?
6. Can the mechanism scale or survive a change of ownership?

A pilot proves that somebody was interested.

A renewed contract proves that an organisation found continuing value.

A repeatable reimbursement or procurement pathway demonstrates that the company is becoming part of the healthcare economy rather than remaining an externally funded experiment.

However, reimbursement must be interpreted correctly.

It is not simply a revenue line. It can also represent external validation that a healthcare decision-maker recognises:

• a defined intervention;
• an intended population;
• an acceptable evidence package;
• and a legitimate basis for funding.

That lowers uncertainty for a prospective buyer.

4. Position: become difficult to replace

The strongest digital-health assets are often embedded in:

• referral;
• prescribing;
• clinical documentation;
• diagnostic testing;
• scheduling;
• discharge;
• remote monitoring;
• escalation;
• or multidisciplinary decision-making.

This embeddedness creates value because removal would require the customer to redesign processes, rebuild interfaces and retrain staff.

But embeddedness should not mean dependence on one hospital or one bespoke configuration.

The objective is to become:

difficult to replace, but straightforward to scale.

A prospective buyer will examine:

• the number and quality of integrations;
• use of recognised interoperability standards;
• deployment time;
• implementation cost;
• customer resources required;
• technical debt;
• cybersecurity;
• support requirements;
• and dependence on specific employees.

A company that has solved implementation repeatedly across fragmented healthcare environments owns more than software.

It owns organisational knowledge.

Data can strengthen that position, but volume is not enough

Calvano and Polo’s review of digital-market economics highlights how data, network effects, innovation and competition can reinforce platform concentration. It also considers entry motivated by future acquisition and the risk of “killer acquisitions.” (EconPapers)

In healthcare, valuable data should be:

• lawfully obtained;
• accurately defined;
• longitudinal where relevant;
• representative of the intended population;
• linked to meaningful outcomes;
• interoperable;
• and usable for a specific clinical, economic or operational purpose.

Ten million unstructured interactions may be less valuable than 20,000 consistently collected episodes linked to treatment, outcomes and resource use.

The buyer will ask:

• Who controls the data?
• What legal basis or consent applies?
• Can the data continue to be used following a change of ownership?
• Does it support research, product improvement or reimbursement?
• Is it biased or incomplete?
• Could the same information be obtained elsewhere?

The most valuable dataset is not necessarily the largest. It is the one that answers a question the buyer cannot readily answer without acquiring the company.

5. Purchaser: identify who gains most from owning you

The most obvious buyer is not always the best buyer.

Recent research by Maisenhelder and colleagues examined digital acquisitions by S&P 500 firms. It found a positive market-value effect around digital-acquisition announcements by traditionally non-digital acquirers, with no equivalent effect identified for already-digital acquirers. The authors interpret this partly through signalling: acquiring digital capabilities can show investors that a traditional company is responding to technological change. The effect was stronger for non-digital buyers when the transaction price was disclosed. (WU Wirtschaftsuniversität Wien)

This does not demonstrate that every acquisition creates long-term operational value. Market reactions measure investor expectations, and the study examined a specific population and period.

It does suggest that the strongest buyer may be an organisation that urgently lacks the target’s capabilities.

Potential buyers include:

• pharmaceutical companies seeking adherence or real-world data;
• medical-device manufacturers seeking monitoring around a device;
• diagnostics companies seeking longitudinal patient engagement;
• hospital-technology suppliers seeking clinical workflows;
• insurers seeking interventions that affect claims costs;
• EHR businesses seeking specialist pathways;
• pharmacy platforms seeking patient access;
• and private-equity-backed healthcare groups seeking complementary assets.

For every serious buyer, the founders should develop a specific acquisition thesis:

• What does this buyer already own?
• What capability is missing?
• Which of its customers could use our technology?
• Which new market could it enter?
• What development or implementation time would it avoid?
• What risk would ownership remove?
• Why would an ordinary partnership be insufficient?
• What becomes possible after combining the two businesses?

This is strategic complementarity.

The target should not merely provide more of what the buyer already has. It should make the buyer’s existing assets more valuable.

6. Portability: make the value transferable

A company may be attractive but still difficult to buy.

The acquirer must be confident that the value can legally and operationally transfer.

Portability includes:

• clean ownership of source code;
• documented intellectual-property assignments;
• clear contractor and employee agreements;
• transferable customer contracts;
• appropriate change-of-control provisions;
• defensible data rights;
• regulatory and quality documentation;
• cybersecurity controls;
• validated clinical claims;
• and limited dependence on one founder or individual customer.

The company should maintain a buyer-ready evidence room before a buyer appears.

This should cover four areas.

Clinical and regulatory

Intended use, patient population, regulatory status, quality systems, clinical evidence, safety records and claims substantiation.

Economic and payer

Patient-pathway analysis, comparator selection, health-economic evidence, reimbursement routes, procurement mechanisms and renewal history.

Commercial

Recurring revenue, pilot revenue, customer concentration, implementation cost, retention, sales cycle and country scalability.

Technology and organisation

Source-code ownership, integrations, hosting, subcontractors, cybersecurity, data governance, key employees and founder dependency.

Due diligence should not reveal the company’s value to its own management for the first time.

7. Preservation: prepare to survive the acquisition

Completion of an acquisition is not the same as creation of value.

Gomes and colleagues reviewed more than 500 M&A articles published across 27 management journals over 27 years. They found growing attention to both strategic factors and the human dimension of acquisitions. (Edinburgh Research)

King, Bauer and Schriber describe acquisition as a multi-year organisational-change process extending from target identification and negotiation through post-acquisition integration. They emphasise that acquisition performance is multidimensional and cannot be understood solely through an announcement-day share price or a single accounting measure. (Routledge)

For digital health, the assets most responsible for value may be fragile:

• trusted clinicians;
• specialist employees;
• hospital relationships;
• patient communities;
• clinical-governance arrangements;
• and tacit implementation knowledge.

The founders should therefore define:

• which people must remain;
• which systems should be combined;
• which functions should remain independent;
• how customers and patients will be informed;
• how regulatory responsibilities will transfer;
• and how continuity of care will be protected.

The critical integration question is:

What must be combined, what must be protected and what must not be disturbed?

Acquisition does not guarantee that the product will survive

Gautier and Lamesch examined 175 acquisitions made by Google, Amazon, Facebook, Apple and Microsoft between 2015 and 2017. They found that acquired products were discontinued under their original brands in a majority of cases, particularly among younger companies.

They identify several possible explanations: product underperformance, acquisition of assets or research capability rather than the product itself, and elimination of a possible competitive threat. Their data could not reliably distinguish between these explanations in every case. (research.dial.uclouvain.be)

Healthcare founders must therefore decide what outcome they actually want.

Is the aim to:

• preserve and scale the independent product;
• integrate the technology into a larger platform;
• sell the team and expertise;
• retain the clinical mission under new ownership;
• or simply provide a financial exit?

These outcomes are not equivalent.

In healthcare, discontinuing an application may affect patients, clinical records, monitoring, commissioned services, ongoing research and continuity of care.

The founders should know why a buyer wants the company—and what that buyer is likely to do with it.

The payer, investor and acquirer are asking different questions

Decision-maker	Principal question
Patient	Will this improve my care, experience or independence?
Clinician	Will it improve a decision or reduce avoidable workload?
Provider	Will it improve quality, capacity or workflow?
Payer	Is the outcome or resource effect worth funding?
Investor	Can the model scale and generate a return?
Acquirer	What valuable capability or advantage do we gain by owning it?

The same evidence will not always satisfy all six.

A clinical trial may persuade a payer but say little about implementation cost.

Rapid revenue growth may interest an investor without establishing clinical benefit.

NHS adoption may attract a buyer, but only if the contracts, integrations and customer relationships are transferable.

The strategic task is to connect these different value propositions without pretending they are identical.

Ten questions every digital-health founder should answer

1. Which specific patient pathway or clinical decision do we change?
2. Which patient group benefits most?
3. What is the correct comparator?
4. Which of our claims are supported by credible evidence?
5. Who pays, from which budget and through which mechanism?
6. What recurring revenue exists beyond grants and pilots?
7. Which relationships, integrations or datasets are genuinely defensible?
8. Which particular buyer gains the greatest advantage from owning us?
9. Can our contracts, technology, data rights and regulatory systems transfer?
10. What must survive the acquisition for patients, customers and the buyer to receive the intended value?

A business unable to answer these questions is not necessarily a bad company.

It is simply not yet acquisition-ready.

Where Odelle fits

At Odelle, we begin with the patient pathway rather than the transaction.

We identify:

• where the technology changes care;
• which patient population should be prioritised;
• what the relevant comparator is;
• who receives the clinical and economic value;
• which organisation bears the cost;
• and what evidence each stakeholder requires.

That work can then be translated into:

• evidence strategy;
• reimbursement and coding pathways;
• hospital and payer value analysis;
• health-economic modelling;
• real-world-evidence planning;
• investor positioning;
• market prioritisation;
• and buyer-specific acquisition logic.

The purpose is not to make a healthcare application merely appear attractive.

It is to make its value:

clinically credible, economically demonstrable, commercially repeatable, legally transferable and capable of surviving scrutiny.

The final acquisition test

Eventually, the buyer will ask:

Why should we acquire this company instead of building the same capability ourselves?

A weak answer describes the algorithm.

A stronger answer explains:

We have identified the correct patient population, demonstrated the clinical use, established the payer value, integrated the workflow, secured recurring customers, generated governed longitudinal data and developed the regulatory and implementation capability required to operate in the markets you want to enter.

A buyer can employ software developers.

It can licence an algorithm.

It can redesign an interface.

What it cannot quickly recreate is a clinically validated position in the patient pathway, trusted healthcare-system adoption, recurring payment, governed data and years of implementation knowledge.

That is what makes a digital-health company strategically valuable.

Do not build merely to be acquired. Build something whose clinical and commercial value is easier to buy than to recreate and robust enough to survive the acquisition.

References

1. Pfitzer E, Bitomsky L, Nißen M, Kausch C, Kowatsch T. Success Factors of Growth-Stage Digital Health Companies: Systematic Literature Review. Journal of Medical Internet Research. 2024;26:e60473. Full article and DOI. (JMIR)
2. Day S, Shah V, Kaganoff S, Powelson S, Mathews SC. Assessing the Clinical Robustness of Digital Health Startups: Cross-sectional Observational Analysis. Journal of Medical Internet Research. 2022;24(6):e37677. Full article and DOI. (JMIR)
3. Maisenhelder F, Baccarella C, Maier L, Müller J, Voigt K-I. Digital Mergers and Acquisitions: Creating or Destructing Value? European Management Journal. Published online 2025. DOI: 10.1016/j.emj.2025.08.002. (WU Wirtschaftsuniversität Wien)
4. Gomes E, Alam S, Tarba SY, Vendrell-Herrero F. A 27-year review of mergers and acquisitions research in 27 leading management journals. Strategic Change. 2020;29(2):179–193. DOI: 10.1002/jsc.2320. (Edinburgh Research)
5. King DR, Bauer F, Schriber S. Mergers and Acquisitions: A Research Overview. Routledge; 2019. Publisher’s book page. (Routledge)
6. Calvano E, Polo M. Market Power, Competition and Innovation in Digital Markets: A Survey. Information Economics and Policy. 2021;54:100853. DOI: 10.1016/j.infoecopol.2020.100853. (EconPapers)
7. Gautier A, Lamesch J. Mergers in the Digital Economy. Information Economics and Policy. 2021;54:100890. DOI: 10.1016/j.infoecopol.2020.100890. (research.dial.uclouvain.be)
8. T-Pro. T-Pro acquires BigHand Healthcare. July 2026. Official transaction announcement. (blog.tpro.io)
9. Hims & Hers Health. Hims & Hers Announces Plans to Acquire ZAVA, Accelerating Major European Growth Across the UK, Germany, France and Ireland. 3 June 2025. Official transaction announcement. (investors.hims.com)
10. Tempus AI. Tempus to Acquire Personalis, More Tightly Integrating Molecular Residual Disease into Its AI-Enabled Precision Oncology Platform. 20 July 2026. Official transaction announcement. (Tempus Investors)