Why Health Plan Buyers Are Scrutinizing Every Vendor's Financial Health
What's really behind the new questions about funding, acquisition risk, and long-term viability
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If you’ve been selling to health plans over the past 18 months, you’ve probably noticed the questions have changed.
Not the clinical questions or the integration questions. Those are the same grind as always. What’s changed more recently is how often buyers are scrutinizing your financial health. Your funding. Your investor backing. Whether you’ve been acquired or might be. Whether you’ll still be around in two years.
These questions were once reserved for early-stage companies with clear risk profiles. Now they’re showing up in nearly every serious evaluation, regardless of how long you’ve been in business or how strong your track record is. Health plan buyers have reason to be cautious. MA plans collectively lost $5.7 billion in 2024, and many are cutting vendor relationships as they restructure. Vendors with years of revenue, long customer tenure, and healthy retention are fielding the same scrutiny as companies that launched 18 months ago.
This is one of five trends I’m watching closely in 2026, and it’s the one creating the most immediate friction in sales cycles. However, most vendors are responding incorrectly.
The reasonable instinct is to treat this as an objection-handling problem and to prep better answers about financial stability. Or perhaps coach the team to proactively address concerns. That’s not wrong, but it misses what’s really behind the behavior.
Because these questions about funding, acquisition risk, and long-term viability aren’t really about those things. They’re about something else entirely, and until you understand what that is, you’re going to keep running into friction you can’t explain.
What Buyers Are Actually Trying to Figure Out
When a health plan VP or CMO champions a vendor internally, they’re not just recommending a solution. They’re putting their judgment on the line. They’ll have to explain the choice to their CFO, the CEO, and the board if the contract is large enough. They need a reason that, well… sounds like a darn good reason.
When they pick a large incumbent, the story is easy: “We went with the safe choice. They’re not going anywhere.”
When they pick an exciting early-stage company, the story is also easy: “We made a bet on innovation. They’re doing something nobody else can do.”
When they pick a mid-sized company with a solid track record, the story is harder to tell. I mean, what is it? “We picked the vendor that seemed pretty good”? “They’ve been around for a while and haven’t screwed up”?
That’s not a very compelling story.
So, no, the stability questions aren’t really about whether you’ll survive. They’re a symptom of something else: the buyer can’t articulate a compelling reason to choose you over the alternatives. So they start probing for risks, because risk is something concrete to evaluate when the upside story isn’t clear.
Which raises the question: why is this happening now, and why is the middle getting hit hardest?
Why the Middle Gets Hit Hardest
The answer is in how capital has been moving.
Capital in health tech has been flowing to the extremes. Series B deal flow has dropped by half compared to recent years, while mega-rounds over $100 million now account for nearly 40% of total funding. Meanwhile, early-stage companies are getting funded as bets on potential, many of them AI-native, most of them unproven but exciting. And large incumbents are consolidating, acquiring capabilities and customers, and getting bigger and harder to displace.
The middle, companies with real revenue, real customers, and years of operating history, are getting squeezed. Not because these companies are failing. Because they’re harder to tell a story about.
Early-stage companies have a built-in narrative: we’re building the future. That narrative carries risk, and buyers know it, but at least it’s a story. A buyer who chooses an early-stage vendor is making a bet, and bets are defensible. “We took a calculated risk on a company that could give us a real advantage” is something you can say in a meeting.
Large incumbents have a built-in narrative too: we’re the safe choice. Nobody gets fired for buying IBM, as the old saying goes. A buyer who chooses the biggest player doesn’t have to explain much. The choice explains itself.
Mid-sized companies have to manufacture their narrative. It doesn’t come automatically. And most of them don’t. They assume their track record speaks for itself, that being solid and reliable is enough. It isn’t. "Solid and reliable" doesn’t give a VP enough to say anymore when their CFO asks why this contract landed on their desk.
“The companies with the strongest track records often face the most friction because they’re not shiny enough to bet on and yet not big enough to feel safe.”
The companies with the strongest track records often face the most friction because they're not shiny enough to bet on and yet not big enough to feel safe. And so these stability questions arise when there’s no story to grab onto.
So what are the vendors still closing deals doing differently?
The Vendors Still Winning Have Figured This Out
The companies closing deals in this environment aren’t just better at addressing questions about stability. They’re giving buyers a story that makes those questions secondary.
That story takes different forms across companies, but it always does the same thing: it gives the buyer something to say.
1. The Specialist. “They’re the only vendor that really understands our specific situation. They’ve worked with plans like ours for years. They know things the generalists don’t.” A buyer can walk into a room and say, “We’re going with the specialists,” and everyone agrees.
2. The Trusted Partner. “They’ve been with us for five years. They’ve never let us down. We trust them.” A buyer who says “we’re staying with the partner who’s earned it” doesn’t have to defend much.
3. The Insurgent. “Everyone else is going with the big incumbent, but we found a company that moves faster and treats us like we matter.” A certain kind of buyer wants to tell this story, the one who sees themselves as smarter than the crowd.
4. The Bet. “This is the company that’s going to change how this works. We got in early.” Not every buyer wants to tell that story, but the ones who do are your buyers if you’re early-stage.
And then there’s what happens when you don’t have a story at all.
5. The Non-Story. “They seemed competent, and their pricing was reasonable.” Nobody wants to say this out loud. It’s a default, not a choice. Defaults get second-guessed. Defaults invite questions about risk, because there’s nothing else to talk about.
Knowing which story is yours is the first step; the next is ensuring buyers can tell it.
The Story That Makes Scrutiny Irrelevant
Knowing your story matters, but only if you’re honest about whether you actually have one.
If you’re getting stuck on stability questions, the fix isn’t to give a better answer. The fix is giving buyers a story that makes those questions feel beside the point. That starts with clarity about what your story actually is.
Not your positioning statement. Not your value proposition. The actual story a buyer would tell to justify choosing you. If you can’t articulate that in a sentence, you have a problem that no amount of stability messaging will solve. You’re asking buyers to defend a choice they can’t easily explain.
Some questions to pressure-test whether you have a real story:
What would a buyer say when their boss asks, “Why this vendor?” If the answer is some version of “they checked all the boxes,” you don’t have a story. If the answer is “they’re the only ones who really get X” or “they’ve been our partner for Y years, and they’ve earned our trust” or “they’re building something nobody else is building,” that’s a story.
What’s the risk of not choosing you? If there’s no clear downside to going with someone else, your story isn’t compelling enough. The best stories have stakes. “If we don’t go with the specialists, we’re going to struggle with X.” “If we don’t bet on this now, we’ll be three years behind when it becomes standard.”
Who’s the buyer that wants to choose you? Not every buyer is your buyer. Some want the safe choice. Some want the innovative bet. Some want the deep specialist. Some want the proven relationship. If you’re trying to be acceptable to all of them, you’re not compelling to any of them.
Once you’re clear on your story, the work becomes making it easy to repeat. This is more literal than most vendors realize. You need to give buyers the actual words they’ll use when they’re justifying the decision internally. The best salespeople do this instinctively. They say things like “The way most of our customers explain it to their leadership is...” and then they hand the buyer a sentence. They make it easy. The buyer doesn’t have to invent the story, they just have to repeat it.
This shows up in how you talk about your company. Not features and benefits, but the narrative wrapper around them. “We’re the company that X,” (where X is something a buyer would actually say out loud).
It shows up in your materials too. Case studies that aren’t just about outcomes but about why the customer chose you. Quotes that articulate the story, not just the satisfaction.
And finally, it shows up in how you position against alternatives. Not “we’re better than them” but “here’s why a certain kind of buyer chooses us instead of them.” You’re helping the buyer see where they fit.
And yes, it shows up in how you address stability. But when you have a real story, stability becomes a supporting detail, not the main event. “We’ve been doing this for eight years, and our first customers are still with us” lands differently when it’s reinforcing a story about deep expertise or trusted partnership than when it’s the only thing you have to say.
Building Your Story Based on Where You Sit
The specifics depend on whether you're a middle-stage or early-stage company.
If you’re in the middle and feeling the squeeze: The strategic question isn’t how to answer stability questions better. It’s how to build a story that’s worth telling.
Narrow your focus. Become the obvious choice for a specific buyer segment rather than a reasonable option for everyone. The more specific your story, the easier it is to tell. Get detailed.
Lean into longevity. Not just “we’ve been around” but “we’ve been your partner, we’ve earned your trust, we’re not going anywhere.” That’s a real story for buyers who value continuity over novelty.
Go on offense against the incumbents. “The legacy companies are slow, they don’t care about you, they’re resting on their reputation. We’re the company that still shows up and is highly attentive.” You need to put that in your own words and show how you’re different, but it’s a story that resonates with buyers who feel underserved by larger vendors.
Double down on existing customers. Expansion revenue, deeper relationships, proof points that compound over time. All of these help build the story (with evidence) as you pursue new logos.
The wrong move is trying to be a little bit of everything: Safe enough to not seem risky, innovative enough to seem current, specialized enough to seem expert, flexible enough to serve anyone. That’s not a story, that’s a hedge. And hedges don’t give buyers anything to say.
If you’re early-stage: Your story is the bet. That’s not a weakness to hide, it’s the whole point.
The mistake early-stage companies make is trying to seem safer than they are. They play up their funding, their advisors, their enterprise-ready features. They try to compete with larger vendors on stability. That’s the wrong game as you won’t “out-safe” the safe choice. The buyer who wants safety isn’t your buyer.
Your buyer is the one who wants to tell the story of making a smart bet. “We found this company before everyone else did. We got access to innovation that the big vendors can’t match. We took a calculated risk, and it’s paying off.”
That’s a story certain buyers want to tell about themselves. Your job is to find those buyers and make the bet feel worth taking. That means being clear about what they get by betting on you: speed, access, influence over the product, and a team that needs this to work as much as they do. And being honest about the risk while showing you’ve thought it through.
The stability questions will still come. But when the story is “we made a bet,” the stability conversation becomes “is this bet reasonable?” rather than “is this vendor risky?” That’s a much better conversation.
Be selective about where you make this case. If a buyer is clearly looking for the safest possible choice, you’re probably not going to win them over. Focus on buyers who are frustrated with incumbents, willing to move faster than their peers, or facing a problem that larger players aren’t solving well.
If you don’t have a good story yet: If that’s you, here’s the hard truth: the solution isn’t better messaging or more polished decks. The solution is strategic clarity about what you’re actually for and who you’re actually for.
That might mean making choices you’ve been avoiding. Picking a segment and letting others go. Taking a position that not everyone will like. Becoming known for something specific rather than being available for everything.
The stability question is a gift in that sense. It’s a signal that your story isn’t clear enough. It’s the market telling you that “pretty good at a lot of things” isn’t enough anymore.
The vendors who figure out their story will close more deals. Those who keep trying to answer the stability question without a story will keep getting stuck on it.
The paid section below is the execution layer. I’ll walk through what to say when buyers probe your financial health and how to recover when those concerns arise mid-deal, and you’re on the defensive.
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