Digital health companies sell the same product to vastly different buyers – a patient paying out of pocket, an employer purchasing a benefit for thousands of employees, or a payer negotiating a per-member-per-month rate. Pricing is usually set once, early on, then stretched to cover all three. We create segmented pricing models based on your actual unit economics, so every channel is priced according to how its buyer really buys.
The Pricing Challenge
Consumer, employer, and payer buyers assess price in entirely different ways, so one number cannot work for all three
A consumer compares your app subscription to a gym membership. An employer benefits leader compares your PMPM rate to the next vendor's PMPM rate across a spreadsheet with twenty other line items. A payer runs your pricing through an actuarial model against expected utilization and medical loss ratio impact. Pricing built for one of these buyers and applied to the others either scares off the consumer or looks naive to the payer. Without segmented pricing, sales ends up negotiating the number from scratch in every deal.
PMPM contracts are negotiated one deal at a time, leaving the company without visibility into its true blended unit economics
Per-member-per-month pricing to employers and payers is often set to win the specific logo in front of the team, not against a documented cost-to-serve model. A large early enrollment group gets a discount to prove market traction, that discounted rate becomes the reference point for the next negotiation, and margin erodes contract by contract. Two years in, finance cannot tell you what the company actually earns per enrolled member because every contract was priced individually under deal pressure.
Free trials and promotional consumer rates spill into enterprise and payer discussions where they were never intended to appear
A digital health product built consumer-first often launches with heavy trial discounting or a freemium tier to drive downloads, which is a reasonable acquisition tactic on its own. The problem shows up when an employer or payer procurement team finds that same product for free or near-free on the App Store and uses it as an anchor in enterprise negotiations. Consumer pricing and enterprise pricing need to be built as separate systems from the start, not reconciled after a deal stalls on it.
Lengthy, competitive RFP cycles lead growth teams to rely on discounting as the default closing tactic, without a framework for deciding when a discount is justified
Payer and health system procurement runs through formal RFPs with multiple vendors bidding against each other, often over many months. Under that pressure, account teams learn that the fastest way to move a stalled deal is to cut the price, and without documented discount guardrails, that becomes the default play in every negotiation. The result is a book of contracts with inconsistent pricing logic, a difficult renewal conversation on every one of them, and no clean way to raise prices later without losing the account.
How We Can Help
We begin by creating an honest unit economics model for each segment. This means separately mapping cost to serve, current realized pricing, and margin across consumer subscriptions, employer PMPM contracts, and payer arrangements, using your real billing and contract data instead of the list price shown on your website.
From there, we design the pricing architecture for each channel according to its own buying dynamics. Consumer pricing is organized around subscription tiers and trial mechanics that drive acquisition without creating an anchor that weakens enterprise deals.
We then establish the guardrails that preserve the model once the sales team begins using it. These include discount approval thresholds, a defined escalation route for exceptions, and packaging choices – what changes with price, such as implementation support or reporting depth, versus what is never negotiable.
We also determine how pricing should be presented to procurement and the buying committee. A payer actuarial team, an employer benefits broker, and a consumer reviewing a subscription page each require a different framing of the value case, even when the underlying economics remain consistent.
During execution, we work directly with your sales and account management team on active deals throughout the engagement, rather than limiting the work to a workshop. That includes reviewing current proposals, joining pricing discussions when helpful, and refining the model as real market objections emerge.
To measure progress, we monitor realized price versus list price by segment, the frequency and depth of discounts, and gross margin by channel before and after the engagement.
Unlike a generic pricing consultant, we create the model from your actual billing and contract data, then remain embedded through the next several deals to confirm that it holds.
What we deliver
- Segment-level unit economics model covering consumer, employer, and payer channels built from real billing and contract data
- PMPM and subscription pricing architecture with defined tiers, floors, and volume or engagement-based adjustments
- Discount and packaging guardrails – what can move with price, what cannot, and the approval path for exceptions
- Value-framing materials tailored to consumer, employer benefits, and payer actuarial audiences
- Realized price, discount, and margin tracking by channel to monitor whether the model holds after rollout
The most significant pricing mistake in digital health is not choosing a number that is too low. It is applying one number to four different buyers who assess price using completely different logic – then allowing the loudest deal that quarter to become the reference point for every deal that follows.
Our Methodology
We deliver pricing strategy through a 90-day sprint. The first 30 days focus on building the unit economics: gathering actual billing and contract data by segment, determining how current pricing compares with cost to serve, and identifying the deals or channels causing the greatest margin damage. Days 30 through 60 center on architecture – creating tiered PMPM and subscription structures, establishing pricing floors, and specifying what changes with price and what remains fixed. Days 60 through 90 shift to rollout: training the sales and account management team on the new framework, joining several live deals to test it against genuine objections, and implementing tracking to show whether realized pricing is truly improving.
This is not a pricing workshop that delivers a slide deck and walks away. Digital health pricing must withstand an actuarial review, a benefits broker comparison, and a consumer subscription page simultaneously, which means the model must be validated through real deals before it can be considered complete. We work from your actual figures, not industry benchmarks drawn from a different type of company, and remain involved through the first live negotiations to identify where the model must flex.
Our Working Approach
The opening 30 days are diagnostic. We extract realized pricing, discounts, and margin by segment from your billing and CRM data, speak with sales and account management about where pricing causes deals to stall, and establish the unit economics baseline for the remainder of the engagement. Before any new structure is recommended, you receive a clear view of which channels are healthy and which are being sold at a loss.
Days 30 through 60 focus on creating the pricing architecture – tiered models for every channel, discount guardrails, and packaging rules – in close collaboration with finance and sales leadership, because both teams must operate within the final structure. We need access to billing and contract history, along with input from whoever manages employer or payer relationships, to ensure the model mirrors how deals are actually negotiated.
Days 60 through 90 cover rollout and pressure-testing. We train your team on the new framework, participate in live pricing discussions when useful, and make adjustments based on the market's actual objections. Most engagements continue beyond the first 90 days in some capacity, either through ongoing deal support during a busy RFP season or quarterly reviews comparing realized pricing with the model.
Our cadence begins with a weekly working session involving sales and finance during the build, then shifts to a lighter monthly check-in after the structure goes live. We integrate with your current deal review process instead of layering on a separate pricing committee.
- Margin recovery on underpriced segments and contracts
- Fewer deal-by-deal pricing negotiations, more consistent structure across the sales team
- Cleaner path to price increases at renewal without renegotiating the whole account
- Pricing that holds up against payer actuarial review and employer benefits comparisons
If your digital health company needs pricing strategy leadership, we should talk.
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Frequently asked questions
What does a pricing strategy engagement cost for a digital health company?
We scope each pricing engagement according to the number of buyer segments you serve – consumer, employer, and payer all introduce additional complexity – and the depth of unit economics rebuilding required based on the quality of your existing billing and contract data. An engagement for a single-channel consumer subscription model is narrower than one for a company operating across all three.
When will we begin seeing results from a pricing strategy engagement?
The unit economics baseline and first version of the architecture are generally completed within the initial 60 days. The realized margin impact appears as new deals close using the new structure and existing contracts reach renewal, which can require a full sales cycle of several months in employer and payer channels.
How will the pricing team collaborate with our current sales and finance staff?
We develop the model with finance and sales leadership at the table because both teams must work within it afterward. Sales must know where genuine negotiating flexibility exists, while finance needs the model to align with how revenue is recognized and forecast.
How is Winston Francois different from a conventional pricing consultant?
A traditional pricing consultant will often use a standard SaaS pricing framework built around a single buyer type. Digital health pricing must serve consumer, employer, and payer buyers with distinct evaluation logic, procurement procedures, and budget cycles. We design the model for that reality, using your actual billing and contract data instead of generic benchmarks.
How is ROI measured for a pricing strategy engagement?
We measure realized price against list price for each segment, the frequency and depth of new-deal discounts, and gross margin by channel, all compared with the baseline established during the first 30 days. The objective is not simply a higher list price on paper – it is whether deals close nearer to the model and margins improve over the quarters that follow.
Which type of digital health company is best suited to this service?
This service is designed for digital health companies in roughly the 5M to 100M ARR range that sell through at least two separate buyer channels – usually a combination of consumer, employer, and payer – and have set pricing ad hoc or negotiated each deal without a documented model. If your company sells through one simple channel with straightforward subscription pricing, this engagement is likely more scope than you require.
