Dr. Chris Stock, Managing Director of Medical Affairs at Health2047, speaks with Dr. Sachin Jain, President and CEO of SCAN Group and SCAN Health Plan, about how startups can succeed in enterprise healthcare sales. They also explore founder leadership styles, the underestimated value of talent, and the complex realities of innovating for underserved populations. This conversation has been edited for clarity and flow.

Chris Stock: Many of the founders we work with at Health2047 start by selling into independent practices or smaller healthcare organizations. But they often struggle when it comes to payers and large health systems. What advice would you give founders trying to sell into those larger enterprise environments?

Sachin Jain: I think one of the biggest challenges is that while our organizations may be large, we’re not always sophisticated buyers of healthcare services or solutions. So relationships become incredibly important. People lean on who they trust.

It’s frustrating, I know—most entrepreneurs want to be judged on the quality of their solution, not whether they happen to know someone. But there’s a lot of opacity in this industry, and a long history of poor implementations, especially with earlier-stage companies. So trust—and the people who bring that trust—become essential.

Another issue is that startups often haven’t done their homework on how our businesses actually work. For example, at SCAN, we delegate most of our cost of care management to providers. But I still get pitched solutions that assume we manage all of that internally. Those conversations could’ve been avoided entirely with a bit more prep.

CS: That seems like such a preventable gap—just understanding who owns the problem.

SJ: Exactly. And when I give feedback, some founders still try to convince me their solution is relevant—even when I’m telling them directly it’s not. I’ll say, “You should go talk to the provider groups who actually hold the risk,” and they just keep pitching.

Also, I think many founders assume they’re giving more than they’re getting in early partnerships. But the reality is, the startup often gains more—credibility, data, a reference account—than the health plan does. And that imbalance should be acknowledged. Whether that means going at risk for implementation, or providing added support, you’ve got to make the first few deals easy to say yes to.

CS: Should founders approach pitches differently depending on whether it’s a health system or a health plan?

SJ: Not really. The dynamics are pretty parallel across the industry. Every buyer has its own specific structure and problems. The best founders approach these conversations with real curiosity.

I was at dinner once with the chief AI officer of a major biopharma company. A founder sat across from her and spent the entire time talking—pitching. Never asked her a single question. Afterwards, the exec said, “I’d never work with someone who didn’t demonstrate curiosity about my role, my organization, or our challenges.”

The founders who succeed are the ones who are relentless about learning. They’re gathering information. They’re not just pitching—they’re listening and adjusting.

CS: You advise a lot of startups. What are some of the common mistakes that you’ve steered founders away from?

SJ: Shiny objects. People get fixated on big customers or big visions without paying attention to the nuance of who they’re selling to.

And VCs often push billion-dollar narratives, which encourages founders to try tackling ten things at once. But the path to big outcomes usually starts small. Nail one use case, then expand. Serial success beats parallel ambition.

Also, talent is massively underappreciated. We talk a lot about product-market fit but not enough about people. I believe CEOs should interview every new hire for as long as possible. Especially in healthcare—these are complex, mission-driven businesses. Delegating culture to HR too early can dilute what makes a company work.

CS: What about founders who come from clinical or technical backgrounds and may not be suited to being the CEO?

SJ: I don’t fully buy that. There’s more than one way to be a CEO. Some lead through product, others through clinical insight, others through business development. The key is building the right team around you.

If you’re a technical CEO, maybe your president handles ops and partnerships. But I push back on this idea that every CEO needs to be the fundraising, deal-making archetype. Vision and conviction matter more. And those often come from the founder.

CS: Can you support that vision through advisors, or do those people need to be full-time?

SJ: Both. Earlier in my career, I studied network organizations. The idea is that companies aren’t just made of org charts. They’re built around a mix of strong and weak ties—advisors, collaborators, employees—who move the mission forward.

Founders should think strategically about who’s in that network. What incentives are in place? Who’s aligned to help grow the business?

CS: Let’s shift to another area you care a lot about—serving underserved populations. What are the unique challenges in innovating for those communities?

SJ: The business model is harder. You’re doing more upfront, with the hope of doing less later. That takes time—and most business models want results fast.

At CareMore [now Carelon Health], the company I used to lead, our core idea was that if you intensively manage chronic disease early, long-term costs will drop. But that only works if you have stable cohorts and time to realize the impact. If you’re growing fast, it’s hard to prove outcomes year-over-year because your population keeps changing.

Nurse-Family Partnership [now Changent] is another example. It’s an 18-month program for high-risk mothers, and outcomes improve not just for them but for their kids, years later. Amazing public health results—but that’s hard to translate into startup economics. One company I advise, Cayaba Care, is working on this, and they’re doing a great job. But the challenge remains: how do you get paid today for value that shows up years later?

CS: And SCAN has specific divisions focused on these populations, right?

SJ: Yes. We have several. Healthcare in Action focuses on people experiencing homelessness. MyPlace Health is a PACE (Program of All-Inclusive Care for the Elderly) model. And Homebase Medical supports older adults with complex conditions. Each is tailored to a specific population and need.

CS: Do you serve younger populations at all?

SJ: Not generally. SCAN stands for Senior Care Action Network, so our focus is older adults. The exception is Healthcare in Action. We started by targeting older homeless individuals but quickly realized that in practice, we had to serve everyone in the encampments. It’s an ethical decision—you can’t just walk past someone who needs care because they don’t fit your target demo.