From Sick Care to Health Ecosystems: What Must Change

Most healthtech solutions are still funded, built, and measured around sick care.

Let’s break it down:

• Hospitals generate revenue from procedures, not prevention. 
• Startups measure success by user growth, not reduction in ER visits. 
• Payers reimburse treatment codes—not longitudinal health outcomes. 

That means founders who design for wellness often struggle to prove value within legacy models. But the pressure is building. U.S. Medicaid spending is approaching one-third of state budgets in some regions. Chronic disease continues to climb. And workforce shortages demand more efficient, scalable solutions—not more patchwork fixes.

As Beckett shared in Episode 165 of The Provider’s Edge, the true breakthrough won’t come from digitizing old systems. It will come from economic models that reward what actually improves lives—and reduces cost.

The SimCity Model for Public Health

One of the most compelling ideas we discussed was this:

What if every city planner, policymaker, or health system executive could model their community’s health future—like a game?

Beckett’s team in Texas is exploring predictive AI simulations that allow communities to test various investments: What happens if we add five more community health workers? Build more parks instead of more hospital beds? Improve food access in specific zip codes?

This approach blends public health, data science, and fiscal modeling into one unified tool. And for investors, it offers something rare: foresight.

Instead of hoping a startup’s metrics line up over time, these models show real-time impact projections, enabling smarter funding decisions and better-aligned capital deployment.

Why Founders Need to Start Thinking Like Urban Planners

The best founders are already thinking this way—even if they don’t call it that.

They’re asking:

• Who are the hidden decision-makers that control budget flow? 
• What systemic cost am I preventing—not just what feature am I adding? 
• Can my product deliver ROI at a population level, not just an individual one? 

Whether you're building in remote monitoring, behavioral health, agetech, or diagnostics, the question isn’t just “Does this work?” It’s “Does this create savings that stakeholders will pay for—and sustain?”

Founders who can tie their innovation to Medicaid savings, ER diversion, or workforce optimization aren’t just more scalable. They’re more investable.

Aligning Capital with Upstream Impact

This is where the funding strategy must evolve.

Today’s investors have the opportunity to move beyond binary metrics (CAC vs. LTV, revenue vs. burn) and begin underwriting based on systems-level impact:

• Does this solution reduce total cost of care in vulnerable populations? 
• Does it integrate into workflows with minimal retraining? 
• Does it generate consistent usage without behavior reinforcement campaigns? 

When tech is designed with alignment in mind—from reimbursement models to frontline workflows—it gets used. And when it gets used, it creates measurable impact.

That’s what Beckett and teams like his in Texas are pushing for: a future where data isn’t just interoperable, but actionable. Where AI doesn’t just diagnose, but forecasts. And where community health becomes a fundable, repeatable outcome.

Where This Leaves You (Investor or Founder)

If you’re an investor:

• Start asking for metrics beyond MRR. Ask about avoided ER visits, increased primary care engagement, or workforce retention improvements. 
• Prioritize companies that understand public-sector funding mechanisms and can work within Medicaid frameworks. 
• Look for platforms that can serve both commercial and vulnerable populations—without requiring separate infrastructures. 

If you’re a founder:

• Design for sustainability, not subsidy. Grants can start a pilot, but you need a repeatable model to stay in-market. 
• Learn the language of budget holders—hospital CFOs, city health planners, payers. What do they want reduced, not just improved? 
• Model your impact not only per patient, but per community served. 

Because the companies that can do this will be the ones shaping—not just surviving—the next generation of healthcare.

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If you're an investor focused on upstream value, long-term outcomes, and system-wide scalability—Phil Beckett’s work in Texas shows what’s possible when economics align with impact.

And if your portfolio includes healthtech founders building for community health, PulsePoint Path can help those companies grow with less risk and more strategic clarity:

• Leadership Maximizer: Align executive teams, reduce vision drift, and make the right strategic hires before it's too late.
• Pathfinder: Conduct SWOT-driven evaluations to help founders double down on traction—not distractions.
• Capital Readiness Scorecard: Catch burn risks early, streamline operations, and prepare for investor-grade due diligence.
• HealthTech Showdown: Give your strongest ventures the mic—our stage puts them in front of decision-makers who write checks, not just clap.

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About Sabrina Runbeck

Sabrina Runbeck, MPH, MHS, PA-C helps healthcare technology companies scale sustainably—without burning out their teams or running out of cash. She is the Co-Founder of PulsePoint Path and works alongside a 12-integrated board of advisors to help founders make strategic decisions that multiply impact and protect capital. Her signature 5D Integrated System helps companies move beyond one-dimensional problem solving—what they think the issue is—and instead, builds an Empowered Ecosystem across leadership, team dynamics, and systems alignment. This is how founders evolve from early traction to 10x growth. Sabrina is also a TEDx speaker, former Cardiothoracic Surgery PA, and trusted advisor with over 15 years of experience in public health, neuroscience, and business acceleration.