Odgers’ Chris Hamilton and Mike Drew explain what digital health boards should be looking for in commercial leaders
Reimbursement has quietly become one of the strongest predictors of commercial success in digital health.
Innovation is accelerating and remote care models are expanding, yet many organisations still struggle to convert great products into sustainable revenue.
The challenge rarely lies in technology. It lies in the complexity of reimbursement.
A recent scoping review across eight European countries and Israel showed that although most markets have introduced reimbursable digital solutions, the mechanisms remain fragmented and often rely on negotiated or ad hoc assessments rather than consistent value based frameworks.
In this environment, the organisations that succeed will be those with leaders who can translate evolving reimbursement rules into commercial engines.
Why Reimbursement Literacy Now Defines Commercial Performance
Reimbursement literacy now sits at the heart of commercial performance. Digital therapeutics, remote patient monitoring, hybrid care models, and virtual wards all depend on an accurate understanding of how funding flows through payers and providers.
Yet many organisations still operate with revenue strategies built for traditional fee for service models or standard SaaS pricing.
These models do not reflect the realities of digital health markets, where pricing, product design, contracting, and adoption are heavily shaped by policy and code based reimbursement.
The result is predictable. Companies over invest in technology and under invest in commercial strategy.
They build clinically compelling products but struggle to scale because they cannot align their service model with the way providers are incentivised and paid.
The New Breed of Commercial Leader in Digital Health
What is emerging is a new breed of executive leader.
These leaders combine commercial acumen with policy fluency and understand reimbursement as deeply as they understand product strategy.
They monitor regulatory shifts and immediately translate them into commercial implications.
They act as revenue architects, shaping service models around reimbursable pathways rather than around theoretical pricing logic.
Research into digital health implementation supports this shift. A 2024 European review found that financial barriers and unclear reimbursement structures remain among the most significant obstacles to adoption.
Technology is rarely the limiting factor. Funding models are.
These executives succeed because they can connect policy, payers, providers, and product strategy in a way that earlier generations of commercial leaders did not need to.
They speak the language of clinicians while also delivering compelling financial cases to provider CFOs and procurement teams.
They know how to generate the economic and outcomes evidence required to unlock new reimbursement codes. They also understand the operational realities that influence provider behaviour.
A case study from Dutch district nursing found that even with supportive policy in place, the payment model and the relationships between purchasers and providers were key determinants of whether digital health solutions were adopted.
The message is clear. Commercial leaders must understand not only the code but also the ecosystem it operates within.
From Frameworks to Revenue
These leaders translate complex frameworks into revenue.
They evaluate which elements of a service align with existing or emerging reimbursement pathways and design commercial models that providers can deploy at scale.
They do not allow innovation that cannot be billed. They influence product roadmaps to ensure that the solution can be documented, measured, and justified within a clinical workflow.
They navigate payers with confidence because they understand the incentives driving decision making.
They structure contracts that help providers minimise financial risk while maximising clinical benefit.
Their impact is visible in real world examples.
A study of United States hospitals showed that those with telehealth and remote monitoring capability before the pandemic experienced significantly smaller revenue losses during 2020 than those without.
Reimbursable digital services supported financial resilience during one of the most turbulent periods in modern healthcare.
The Capabilities Boards Should Be Hiring For
Healthcare and digital health boards now face a strategic question. Do their commercial leaders have the capability to build revenue lines that reflect reimbursement reality.
Executives must be able to interpret coding systems across local and international markets and understand how these systems evolve.
They need to innovate in commercial model design and understand that funding architecture determines adoption.
They must be credible with clinicians, payers, regulators, and investors. They must be financially strong leaders who can build economic cases that withstand scrutiny.
Most importantly, they must guide organisations through constant policy change and align teams behind a clear revenue strategy.
What Happens When Organisations Get This Wrong
When organisations get this wrong the consequences are severe. Products stall in pilots. P
roviders express interest but fail to adopt. Revenue forecasts collapse under the weight of unrealistic assumptions.
Some companies find that entire service lines never achieve viability because they do not integrate into reimbursable care pathways.
Evidence shows that financial and structural barriers consistently limit digital health scale up across Europe.
Without a leader who can address these barriers the commercial strategy will always remain incomplete.
Boards Must Treat Reimbursement as a Leadership Capability
Reimbursement is no longer a backend operational detail. It is a leadership capability.
Digital health companies that win the next decade will be those that hire executives who understand how to turn policy frameworks and reimbursement codes into sustainable, scalable revenue.
Boards must look closely at whether their current leadership has this capability.
The opportunity in digital health is significant, but only for organisations with leaders who can bridge policy, payers, and providers and turn codes into cash.
