The US healthcare market rewards companies that understand how it actually pays.
Crosswalk Health Advisory helps international health companies make sense of the US healthcare system as a whole — how federal and state governments split control, how CMS, Medicare, and the fifty-plus state Medicaid programs operate, and how products actually get covered, coded, and paid. We turn an opaque system into a workable plan.
Market entry is a sequence, and each stage has its own gatekeepers.
- 1Regulatory FDA clearance or exemption. Necessary, and widely mistaken for the finish line.
- 2Coding CPT, HCPCS, and ICD-10 codes that let providers bill for your product at all.
- 3Coverage Medicare policy, state Medicaid plans, and commercial payers each decide separately.
- 4Payment Fee schedules and rates that determine whether coverage is worth having.
- 5Contracts & scale Procurement, managed care organizations, and health systems — where revenue happens.
The system
Who controls what: federal, state, and the private market
The single biggest source of confusion for international teams is that no one is in charge of US healthcare. Authority is deliberately split three ways, and every product strategy has to answer to all three at once.
The federal government
Sets the national frame
- Runs Medicare — coverage for people 65+ and with disabilities — through CMS
- Authorizes products for sale through the FDA
- Sets Medicaid's ground rules and funds roughly half of it
- Writes the national compliance regime: HIPAA, fraud-and-abuse law, the ACA framework
The fifty states
Run the programs day to day
- Administer their own Medicaid programs — eligibility, benefits, rates, and managed-care contracts
- Regulate the insurance sold inside their borders
- License providers and facilities, and define scope of practice
- Set telehealth, privacy, and consumer-protection rules on top of federal law
The private market
Moves most of the money
- Commercial insurers and self-insured employers cover most working-age Americans
- Health systems, MCOs, and PBMs each negotiate their own prices and terms
- No national price list — payment is contract by contract
- Purchasing decisions sit with thousands of independent organizations
Why it's hard
There is no single US healthcare market. There are hundreds.
Companies that succeed in single-payer or national systems often stall in the US because the assumptions that worked at home don't transfer. These are the barriers we help clients get ahead of.
Services
Three ways to work with us
Market Readiness Consultation
For companies deciding whether and how to enter
- Structured working session with your leadership team
- Honest read on product–market fit for US payment models
- Likely reimbursement pathway and its gatekeepers
- The gaps to close before spending on US expansion
US Market Bootcamp
For teams committed to entering, and for VC portfolios
- Six working sessions covering the full entry sequence
- How CMS, Medicare, and state Medicaid actually operate
- Coding, coverage, and payment strategy for your product
- Ends with a written US entry roadmap you own
Ongoing Advisory & Referrals
For companies executing a US entry
- Retained guidance as regulatory and payer questions arise
- Introductions to regulatory counsel, billing and market-access specialists
- State-by-state Medicaid prioritization
- Support through payer and procurement conversations
The bootcamp
Six sessions from system basics to a written entry plan
Delivered live to a single company or a VC's cohort of portfolio companies. Each session pairs how the system works with what it means for your product.
How the US system is wired
The federal–state split, who pays and who provides — Medicare, Medicaid, commercial insurance, and employers, and where the money actually flows.
CMS and Medicare
How CMS sets national policy, how Medicare coverage decisions are made, and what NCDs, LCDs, and fee schedules mean for you.
Medicaid, state by state
State plans, waivers, managed care organizations, and rate setting — and how to prioritize which states to enter first.
Coding, coverage, and payment
The reimbursement pathway for your specific product category: codes to pursue, evidence payers expect, and realistic timelines.
Compliance and market structure
HIPAA, fraud-and-abuse rules, licensure, and procurement — the constraints that shape which business models work in the US.
Your US entry roadmap
A working session that turns the previous five into a written, sequenced plan: target segments, states, evidence, and first hires or partners.
Who this is for
Built for international companies — and the investors behind them
International health companies
Digital health, medical devices, diagnostics, and care-delivery companies with traction at home and ambitions in the US. If your product works in a national or single-payer system, we help you understand what changes — and what it will take — before you commit capital.
Venture funds & accelerators
A standing referral path for your portfolio. Send companies through the consultation or a cohort bootcamp so they arrive at US expansion decisions with clear eyes, realistic timelines, and a plan your partners can underwrite.
About
Advisory grounded in how the system really works
Crosswalk Health Advisory is led by [FOUNDER NAME], an expert in US healthcare products, CMS and state Medicaid systems, and the practical work of bringing health products to the American market.
[2–3 sentences of bio: prior roles, systems worked in, notable market entries supported. This paragraph is where credibility is won — specifics beat adjectives.]
Where we go deep
- How the US system is structured: federal vs. state authority, public vs. private payers
- CMS policy and Medicare coverage pathways
- State Medicaid programs, waivers, and managed care
- Reimbursement strategy: coding, coverage, payment
- US go-to-market for international health products
Get started
Tell us where you are, and where you're trying to sell.
Email a short note about your company, your product, and your home market. We'll reply within two business days with next steps — usually a brief intro call to see whether a consultation or the bootcamp is the right starting point.