The statistics are sobering. Despite billions in funding and countless innovative ideas, many women’s health startups struggle to achieve meaningful scale. They build compelling products, attract early users, even secure initial partnerships – but then hit a wall when trying to expand beyond pilot programs or niche markets.
The culprit isn’t usually the technology or the team. It’s a fundamental misunderstanding of how the U.S. healthcare system actually works.
Many femtech founders come from consumer tech, where user adoption can happen overnight and viral growth is possible. But healthcare operates by entirely different rules. Success depends on navigating complex reimbursement structures, lengthy procurement cycles, regulatory requirements, and entrenched institutional practices that can make or break even the most promising solutions.
Understanding these dynamics isn’t just helpful – it’s the difference between building a sustainable business and becoming another cautionary tale.
The Most Common Scaling Pitfalls
Mistaking Pilot Interest for Market Readiness Health systems love to pilot new solutions. It makes them appear innovative without committing real resources. But pilot programs rarely translate to enterprise contracts without a clear understanding of procurement processes, budget cycles, and decision-making hierarchies.
Underestimating the Reimbursement Maze “We’ll figure out payments later” is a startup death sentence in healthcare. The $4 trillion U.S. healthcare system has intricate funding flows between insurance companies, government programs, employers, and patients. Without understanding who pays for what – and when – sustainable business models become impossible.
Ignoring Provider Consolidation Hospital mergers and health system acquisitions have fundamentally changed the buyer landscape. What used to be hundreds of independent decision-makers is now dozens of large, bureaucratic organizations with complex approval processes. Scaling strategies that worked five years ago no longer apply.
Building for the Wrong User In women’s health, the person using your product often isn’t the person paying for it. A fertility tracking app might be used by patients but purchased by employers. A maternal health platform might serve pregnant women but get evaluated by hospital administrators. Misaligning your go-to-market strategy with these realities kills scale.
Why System Knowledge Changes Everything
Understanding how healthcare actually works doesn’t just help you avoid pitfalls – it reveals opportunities that others miss.
Follow the Money When you understand that U.S. healthcare spending has grown to over $13,000 per person annually, and where that money flows, you can identify sustainable revenue models. You know which conditions get reimbursed, which don’t, and how to structure solutions that align with existing payment incentives.
Understand the Players The healthcare workforce is vast and diverse – from hospital systems to urgent care centers to retail clinics. Each operates differently, makes decisions differently, and has different needs. Knowing how to navigate this landscape is essential for partnership success.
Anticipate Integration Challenges Healthcare technology doesn’t exist in isolation. It needs to work with existing electronic health records, clinical workflows, and operational systems. Understanding these integration requirements early prevents costly rebuilds later.
Leverage Consumer Trends Retail companies are entering healthcare precisely because traditional providers struggle with consumer experience. This creates openings for femtech companies that understand both clinical excellence and user-centered design.
A Foundation That Prevents Expensive Mistakes
For women’s health founders and operators who want to build this understanding systematically, “An Overview of the U.S. Healthcare System” by Northeastern University on Coursera provides exactly the foundation you need.
The course covers the critical knowledge areas that separate successful healthcare companies from failed ones:
Healthcare Financing and Economics
- How the $4 trillion gets allocated and why it matters for your business model
- Public vs. private funding structures and their implications
- Geographic variations in pricing and access that affect market strategy
Provider Landscape Evolution
- Hospital consolidation trends and what they mean for partnerships
- Emerging care delivery models and where opportunities exist
- Healthcare workforce changes and their impact on adoption
System Organization and Integration
- Why hospital-physician integration matters for femtech
- Care coordination models that actually work
- Quality metrics and outcome measurements that drive decisions
Consumer-Centered Healthcare Trends
- How retail healthcare companies are succeeding where others failed
- Patient decision-making patterns in different care settings
- Self-care trends and their business implications
The course is designed for both clinical and business professionals, requires no prior healthcare experience, and can be completed at your own pace. Most importantly, it provides the systems thinking that helps you make better strategic decisions from day one.
Scaling in women’s health is hard enough without fighting the system instead of working with it. Understanding how healthcare really operates won’t guarantee success – but it will help you avoid the predictable failures that derail most promising startups.
This piece is part of an ongoing series by Femtech Insider in partnership with Coursera, spotlighting educational resources that help make sense of healthcare’s complexity – and support those working to change it.
