You Landed the Account. Here’s How You Grow It.
Expansion works when it’s treated like a second sale, not a byproduct of delivery.
I spoke with a CRO at a health tech company last week, who had secured a regional Medicaid plan earlier this year. They’d cleared contracting, launched on time, and were getting decent engagement. But the contract value hadn’t changed since signing.
I asked where they saw the next wave of growth coming from and whether they had a specific expansion strategy in place.
She said, “Right now we’re hoping we get pulled into their Stars planning. That seems like the logical next step, but we’re not pushing it too hard yet.”
That line stuck with me. Not because it was unusual, but because it wasn’t.
Too many vendors treat expansion like gravity. Deliver good work, stay close to the sponsor, and assume the next opportunity will pull you in when the time is right.
But inside a health plan, value doesn’t create momentum on its own. Budget cycles are rigid. Stakeholders change. And your best-case scenario is usually being forgotten, not replaced.
If you’re not running expansion as a defined motion with targets, ownership, and structure, it quietly stalls. And when new logo sales start to slow, you feel it.
Here’s a five-part framework for turning early wins into real revenue.
A 5-Part Framework for Driving Expansion Inside Health Plans
1. Forecast It Like Real Revenue
In most growth-stage vendors, expansion lives somewhere between aspiration and afterthought. It’s discussed in team meetings. AEs mention it in pipeline calls. Some accounts even have expansion opportunities logged in Salesforce with rough timelines and placeholder values.
There’s intent. But it’s loosely held.
Pipeline reviews tend to focus on net-new. Expansion gets airtime, but not urgency. It’s usually owned by someone in Customer Success or Account Executives, but often without the necessary resources or pressure to move deals forward. Close dates drift. Deal strategy is hazy. And expansion projections often don’t make it into board-level models or hiring plans.
Good teams have expansion opportunities tracked in CRM, reviewed in meetings, and reflected in topline revenue goals, but often without committed timelines or defined next steps.
Great teams go further:
They treat expansion opportunities as real revenue inputs, forecasted, modeled, and prioritized alongside net-new
They build internal pressure through named deal owners, clear criteria, and milestone tracking
They anchor expansion scenarios to real plan activity: budgeting cycles, performance reviews, RFP planning, stakeholder shifts
They translate expansion projections into concrete planning inputs like sales coverage, capacity modeling, and hiring needs
It’s not a question of whether expansion matters. It’s whether your forecast treats it like something that has to happen, or something that might.
2. Build a Real Motion Around Growth
In most vendors, expansion is nominally owned by Customer Success or account management teams. They maintain the relationship, monitor performance, and identify new opportunities as they arise. The role is often defined as retention-first, with growth expected but loosely structured.
The issue isn’t that no one’s responsible. Rather, it’s that the system isn’t built to support proactive commercial development. Sales assumes they’ll be pulled back in when something real materializes. Customer Success is focused on delivery and outcomes. And without a clear motion behind it, expansion ends up reactive.
Good teams make a real effort to grow existing accounts. Customer Success stays close to sponsor sentiment, tracks emerging needs, and identifies areas where there may be room for expansion. AEs may re-engage when something promising surfaces. There’s forward motion, but it relies heavily on timing and individual judgment.
Great teams do more:
They designate a clear commercial lead on every strategic account, separate from delivery oversight
They give that person defined targets for growth, not just retention or satisfaction
They make expansion pipeline part of the regular sales forecast, not a separate thread
They treat expansion strategy as part of account planning, not just renewal preparation
The goal isn’t to take expansion away from Customer Success. It’s to give the commercial side of growth enough structure, ownership, and accountability to move on its own.
3. Build the Expansion Map Early
Most vendors understand that expansion needs a plan. They’ll sketch out where growth might come from, such as more members, an added module, or perhaps a second line of business. That thinking usually lives in an account deck or QBR slide. It’s directional, but not maintained. And it is rarely integrated into the way the pipeline is worked.
I’m not challenging intent. I’m emphasizing precision and repetition. Health Plans don’t expand just because the opportunity exists. They expand when timing, budget, need, and stakeholder alignment all converge. Without a map that reflects those constraints, growth stays theoretical.
Good teams identify logical areas for growth, such as additional lives, product extensions, or use cases that align with their buyers’ goals. They often track these ideas loosely across notes, decks, or call recaps.
Great teams treat expansion mapping like a commercial input:
They document total addressable lives by line of business across each active client
They align use cases with specific internal initiatives, not just features (Stars readiness, behavioral health integration, utilization management, etc.)
They layer in timing signals like planning cycles, contract renewals, or new budget windows
They track known and potential buyers across those paths and revisit them quarterly
This is a shift from strategic account theory into strategic account action. The best teams treat it like part of the revenue plan, rather than simply an upside bonus for an Account Manager’s annual KPIs.
4. Help Your Sponsor Sell the Next Deal
Most vendors assume that good performance will lead to more business (and sure, sometimes it does). But more often than not, that’s if you’re lucky enough to have a champion who’s well-positioned, articulate, and motivated to advocate on your behalf.
In reality, health plans are complex and constantly evolving. Even when your results are strong, they rarely make it past your day-to-day contact unless you carry them. If you’re not equipping your buyer with something they can forward, repeat, or say in a meeting, they’re not selling for you.
Good teams track outcomes internally and mention them in check-ins or steering meetings. They may send dashboards or status emails, but they rely on the assumption that the right people will see them and that results speak for themselves.
Great teams operationalize how impact gets shared:
They create lightweight summaries that link performance to plan-level priorities (Stars improvement, utilization reduction, member engagement targets)
They offer single slides or talking points that internal champions can drop into their own meetings
They know the difference between reporting and selling, and they design materials to do both
They make it easy for others to socialize the program without needing to interpret what’s in the dashboard
Here’s an Example:
Scenario: A population health vendor had strong engagement across a regional plan’s Medicaid population, with 80 percent of targeted members completing an onboarding call within 30 days. The Customer Success team included it in their QBR slide deck, but it didn’t lead to expansion.
What changed? The vendor created a two-slide brief, linking that same stat to the plan’s QIP targets and showing how it might reduce readmissions tied to performance incentives. The sponsor used it in a meeting with the Quality Improvement team. That’s what unlocked the next conversation around scaling the program.
Most teams stop at the performance report. The ones that grow figure out how to make it move.
5. Stay Relevant Inside the Health Plan
The easiest way to stall expansion is to go quiet. The second-easiest is to keep showing up without anything useful to say.
Health plan buyers are flooded with vendor outreach. Most of it is reactive. “Just checking in,” “Let me know if you have any updates,” or “We’d love to hear how things are going.” It’s well-intentioned, but low-value. Over time, it gets ignored.
Staying visible only matters if you do it in a way that remains relevant to the buyer’s priorities.
Good teams try to stay on the radar. They send periodic updates, share a case study, and offer to hop on a call. It’s well-intentioned, but often generic and disconnected from what the plan is actually focused on.
Great teams stay visible in a way that keeps the commercial conversation moving:
They surface new signals in the data (think utilization shifts, member patterns, gaps in current workflows, etc.) and bring them forward with a clear point of view
They share specific, actionable context that ties to current plan activity (e.g., enrollment planning, vendor budget reviews, audit cycles)
They time outreach to meaningful moments inside the account, not generic cadences
They avoid pushing roadmap features unless they solve something already on the plan’s plate
Here’s an Example:
Scenario: One vendor supporting transitional care management identified a spike in 30-day readmissions tied to their discharge cohort.
What changed? Instead of waiting for the client to raise it, they flagged the data, offered to rerun the risk model, and suggested an expansion into the duals population. The outreach wasn’t a check-in. It became a next step.
Expansion conversations don’t get ignored when they’re grounded in something the buyer already cares about. One of the biggest factors in whether a plan expands with you? Member usage.
If your solution isn’t getting traction with the people it’s built for, the next deal dies before it starts. Here’s how to fix that: Selling to Health Plans Isn’t Enough. Members Also Have to Use It.
Final Thought
Expansion isn’t a reward for doing a good job. It’s a second sale with different timing, different politics, and different constraints. Treat it as such and map it thoroughly.
Unfortunately, many vendors treat expansion as something that happens after performance is proven, after implementation settles, after the buyer brings it up.
But by then, it’s already late.
The teams that are built for expansion are mapping it from Day 1. They assign someone (or a small cross-functional team) to work on it. And finally, they continue to proactively share with their buyers solutions to problems that make their jobs easier.
That’s the difference between delivering value and turning it into revenue.
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