Elizabeth Watson: This year, urology providers are under the same pressure as the rest of healthcare, but with your own unique set of challenges: tightening margins, shifting reimbursement and the increasing need for operational efficiency means that urology leaders aren’t just looking for the next innovation. They want proof. Proof of efficacy for their patients. Proof of ROI. Proof that your solution helps their practice or health system survive real financial pressure. And the companies that can make that case clearly will grow in this constrained environment. Welcome, I’m Elizabeth Watson, principal at the Alexander Group. I’m one of the leaders of our healthcare practice, and I’m here with Ola Pitcher to discuss the findings from our recent provider research as it relates to urology. Together, we will explore how organizations like yours can refine your go-to-market strategy to better meet customer needs and set yourself up for a successful year ahead. But first, Ola, please tell us a little bit about yourself.
Ola Pitcher: I’m Ola. As Elizabeth said, a director at the Alexander Group and I focus on healthcare, go-to-market strategies and structures.
Elizabeth Watson: Thank you. Let’s jump right in. So, the number one priority for 2026, according to our latest provider research was operational efficiency and that’s across all specialties. And providers are under pressure to do more with less. Overall, reimbursements are projected to decline while total expenses continue to increase. So what are some of the things, Ola, that you’re advising your urology clients to do in order to meet this challenge?
Ola Pitcher: Supporting urology providers in making their practices more efficient right now is no longer optional for our clients. It’s fundamental to survival. Reimbursement models such as value-based care and bundled payments are driving urology practices to enhance patient access, as well as manage costs more efficiently. These models incentivize urologists to improve health outcomes by adhering to evidence-based guidelines for conditions like prostate cancer and lower urinary tract symptoms, while navigating financial risks and Medicare reforms. Our clients see that it is imperative now to support their practices with market access, insurance coverage and reimbursement processes. Helping providers navigate these areas integrates treatments like prostate artery embolization into routine clinical practices despite varying clinical outcomes. The other thing to think about here is that while operational efficiency is key, and we’ve heard that, as you know, across the board, that doesn’t mean that all spending at practices, ASCs or hospitals is cut off entirely. Instead, investing in essential capital equipment such as ultrasound and automated robotic systems is crucial for establishing procedures to treat BPH. By focusing on placing this equipment, urology companies leverage the ongoing, profitable, consumable revenue tied to capital. The spend on this capital equipment can also be justified by increased net patient revenue and or the operational efficiencies we were just talking about.
Elizabeth Watson: One additional challenge to this, on top of this operational efficiency is around what their expectations are from their vendors. They’re constantly raising the bar for that vendor engagement. In fact, in the last survey we did 75% of providers cite deep product or clinical knowledge as the most important trait for their medical device representative, along with an understanding of reimbursement pathways and technical savvy. So now they have these very high and probably always expectations for their vendors, but even more today. So how does this translate to our clients?
Ola Pitcher: As you mentioned, providers expect reps to be clinically credible, technically proficient and knowledgeable about those reimbursement pathways. Lots of different things that we’re expecting sellers to do. The first two needs are particularly important when urologists are thinking about embracing new technologies. So they need help making sure that they’re really understanding the clinical piece of things. And then obviously, the technical aspects of those new technologies. Sacral neuromodulation and tibial nerve stimulation are examples of technologies that have emerged to treat UI and other primary urological conditions. These products require market development and expansion strategies that are different than core urology products like BPH and Stone. Given that the sales and marketing motions required to sell these products are also different, our clients should consider these implications when they’re deploying commercial teams to support these innovations, both on the marketing and on the sales side. For sacral neuromodulation and tibial nerve stimulation specifically, there are commercial model similarities to spinal cord stimulation technologies that have been in place for many years, which can help Medtech companies with new innovations think about how they want to implement or change their commercial team.
Elizabeth Watson: Innovation always comes with challenges. So what have you seen your urology clients do to address some of those perceived talent gaps? For example, for sellers who are supporting some of those existing technologies?
Ola Pitcher: Yeah. This first one is actually relevant to both new and existing innovations to make sure that reps are technically savvy and can help with reimbursement challenges. It’s imperative for our urology clients to align their resources appropriately, think clinical specialists, junior reps, and core sellers, to ensure proper account management and support. With more complex products or reimbursement challenges, you may want to have a more seasoned core seller rather than a junior rep, for example, in place to help more often than for a straightforward product or procedure. The same can be true for clinical specialists. Ultimately, the right resource mix depends on the complexity and maturity of the product, as well as what reimbursement challenges that sellers may need to address. Additionally, both IDNs and LUGPAs are critical channels for urology products. Despite IDNs not being quite as influential in this space as some of our other clients. Our clients are increasingly investing in tenured selling and account management resources to execute IDNs strategies to drive growth. Similar investments are happening to cover LUGPAs, with our clients developing dedicated coverage strategies for urology groups by allocating specialized resources. In any case, whether it be new or existing technology or particular customer segments, our clients are investing in training to address each buyer’s group’s unique needs. Training, along with ensuring you have the right role with the right experience and the right responsibilities in place, will allow your reps to meet what urologists are looking for in both the clinical and technical knowledge, as well as the reimbursement support.
Elizabeth Watson: Speaking of innovation, everybody’s favorite topic, how should we be thinking about AI in the urology space?
Ola Pitcher: Our research is showing that providers expect AI to help them in three main categories: completing administrative tasks, supporting them in clinical decision making, and three – actual clinical decision making. Obviously, the providers are more willing to start with number one and number two, where the AI either completes the administrative task or supports them in clinical decision making rather than actually making the decision for them. For example, helping them read MRI results more quickly. Actually, transitioning the onus of full clinical decision making to AI is obviously more sensitive. Providers are concerned about the liability associated with doing so and potentially missing something where the liability would sit. Whether that would be with the provider or the Medtech company is still a crucial question. On the flip side, there’s also a concern of potential overdiagnosis of certain conditions based on the use of AI. All that being said, our urology clients who are winning with the AI space are really focused, for now, at least on use case number two – helping providers with clinical decision making by helping them make decisions faster, translating to higher operational efficiencies. A key priority discussed at the beginning of our conversation.
Elizabeth Watson: Thank you. A lot of things to consider, but here’s the bottom line. Medtech leaders who align their commercial models, talent strategies, and messaging to provider priorities will outperform the market. If you want to understand how these provider priorities impact your commercial strategy talent model, go-to-market execution, we would love to continue the conversation.
Ola Pitcher: Visit AlexanderGroup.com or reach out to connect with our healthcare practice. Thank you for joining us and we look forward to helping you win in 2026 and beyond.
