The Forgotten Customer: Why Health Tech Startups Overlook the VA

By Robert Wegner - Chief Revenue Officer

When doing business with the government, most biotech, medtech, and health tech companies focus on one place: the Department of Defense.

If they don’t have something that directly supports the active warfighter, they usually move on. They assume government work is not for them.

That’s a mistake.

What most founders forget is that the Department of Veterans Affairs operates 170 medical centers and more than 1,000 outpatient sites. It serves over 9 million enrolled veterans each year. It is one of the largest integrated healthcare systems in the country.

If you are building technology for chronic disease, aging, mental health, oncology, or rehabilitation, the VA is not a side option. It is a major healthcare customer.

Ignoring it leaves opportunity on the table.

The VA Is a Real Healthcare System — Not a Side Program

The VA is not just a benefits administrator.

It delivers care every day. It runs specialty clinics. It manages long-term chronic conditions. It treats middle-aged and geriatric populations at scale. It funds research. It buys equipment. It runs clinical studies.

If your product is built for hospitals, health systems, or aging populations, there is a strong chance it applies to the VA.

The key is alignment.

Not “we improve healthcare.”

But “we solve this specific problem the VA has publicly said it cares about.”

Health Priority Areas: Where Alignment Often Exists

The VA maintains a wide range of research and clinical priority areas. These are tied directly to patient needs across its system.

Several common areas of interest include:

Alzheimer’s disease and related dementias.
Arthritis and musculoskeletal disorders.
Brain health, including mental health and PTSD.
Cancer, including prostate and ovarian cancer.
Cardiovascular disease.
Diabetes, obesity, and kidney disease.

These are not niche categories. They reflect the real disease burden inside the veteran population.

If you are building diagnostics for early dementia detection, remote cardiac monitoring, oncology tools, metabolic disease platforms, AI-enabled mental health support, or rehabilitation technologies, there may be direct overlap.

The question is not whether the VA “funds innovation.”

The question is whether your product addresses a defined health priority within its system.

If you can clearly connect your solution to one of these areas, you are in a stronger position than most startups who approach government work.

Securing Internal Advocates

Alignment on paper is not enough.

You need a human inside the system who believes in what you are building.

Once you identify a relevant health topic, your next step is to find an internal advocate. This is someone working within or closely affiliated with the VA who understands the disease state and sees how your solution could help veterans.

This could be at the local level, such as a clinician at the VA Palo Alto Health Care System. It could also be at the national level, such as someone connected to the VA Office of Research & Development (ORD).

These advocates matter for three reasons.

First, they help you refine your value proposition so it actually fits VA workflows and patient populations.

Second, they guide you toward the right funding mechanisms or pilot pathways.

Third, they provide credibility when you pursue formal studies, grants, or procurement vehicles.

Without internal support, most companies stall. They submit cold applications. They wait for responses. They burn time.

With internal support, conversations move faster and become more focused.

Funding and Procurement Pathways

Once you have meaningful engagement from an internal advocate, you can begin evaluating funding and procurement options.

There are multiple pathways depending on your stage.

If you are still in pre-clinical or early clinical development, research-focused mechanisms may be appropriate. In some cases, programs like CDMRP can provide significant funding for assets that align with veteran health priorities.

If your product is further along and ready for deployment, there may be procurement pathways within the VA itself. This can include structured pilot programs, clinical studies, or direct purchasing mechanisms for solutions that address defined needs.

The mistake many startups make is chasing mechanisms first.

They search for open calls. They draft proposals. They try to “fit” themselves into whatever funding vehicle is available.

That rarely works.

The more effective approach is this:

1. Confirm alignment with a VA health priority.

2. Secure internal support.

3. Then identify the right mechanism.

When done in that order, funding becomes a tool — not a gamble.

The Practical Takeaway

If you are a biotech, medtech, or health tech founder, do not assume government work equals defense contracts.

The VA is a massive healthcare provider. It treats millions of patients across many of the exact disease areas commercial startups target.

Before you dismiss government engagement, ask:

Does our product clearly align with a VA health priority?
Can we identify a specific patient population within the system?
Do we have a plan to secure an internal advocate?

If the answer is no, you need refinement.

If the answer is yes, you may have a serious opportunity.

If you are considering the VA as a co-development partner or procurement customer, book a call with our team. We’ll help you assess alignment, identify realistic entry points, and determine whether pursuing the VA makes strategic sense for your stage.

The VA is often the forgotten customer.

For the right company, it shouldn’t be.

Stop Wasting Time on Low-Probability Grant Opportunities

by Narges Tafreshi - Grant Consultant

For many founders, researchers, and small business teams, grant funding is supposed to be a catalyst, not a distraction. Yet too often, teams find themselves pouring months of effort into applications that were never realistically competitive in the first place.

The result? Burned time, exhausted teams, and stalled momentum.

The Hidden Cost of “Shot-in-the-Dark” Applications

Grant writing isn’t just about filling out forms. It requires:

• Strategic planning

• Scientific and technical alignment

• Budget modeling

• Internal coordination and reviews

When an opportunity has a very low probability of success, the real cost isn’t just the submission fee or consultant time; it’s the opportunity cost. Those months could have gone toward product development, customer discovery, partnerships, or higher-probability funding paths.

Why So Many Grant Opportunities Are Low Probability

Many grant solicitations look promising on the surface, but hide structural challenges that drastically reduce competitiveness:

• Overly broad solicitations that attract hundreds of applications

• Unpublished or shifting paylines, especially in SBIR/STTR programs

• Institute-specific preferences that aren’t obvious from the FOA

• Portfolio-balancing decisions that have little to do with scientific quality

Without insight into how funding decisions are actually made, teams often assume that a “decent” application is good enough. In reality, competitiveness is relative, and often far more selective than it appears.

Scoring Alone Doesn’t Tell the Whole Story

NIH and other agencies rely on impact scores and review outcomes, but funding decisions are rarely mechanical.

A technically strong application can still fall short if:

• It doesn’t align tightly with current program priorities

• The institute’s budget is constrained in that cycle

• Similar projects were recently funded

• The application lands just outside a practical zone of consideration

This is why many applicants receive solid reviews, and still no award.

A Smarter Question to Ask Before Applying

Instead of asking, “Can we apply?”, more teams are now asking:

“Is this opportunity actually worth our time?”

High-probability opportunities tend to share a few characteristics:

• Clear alignment with institute or program priorities

• Realistic competitiveness based on recent funding patterns

• A defined scoring or selection pathway

• A credible strategy to address reviewer risk

If those elements aren’t present, even a well-written application may be a long shot.

Fewer Applications, Better Outcomes

The most successful grant-funded teams are not applying to everything. They are:

• Selective about where they invest effort

• Strategic in how they use prior scores and reviewer feedback

• Focused on opportunities where marginal improvements can meaningfully change outcomes

This approach doesn’t reduce ambition, it increases efficiency.

Moving From Hope-Based to Strategy-Based

Grant funding will always involve uncertainty. That’s inherent to competitive, peer-reviewed systems. But uncertainty does not have to mean guesswork, and it doesn’t have to mean going it alone.

A strategy-based approach replaces blind optimism with informed confidence. It allows teams to make deliberate decisions about where to invest their time, energy, and scientific effort before months are spent writing.

By prioritizing fit, probability, and timing, organizations can move away from low-yield opportunities and toward a funding roadmap that is both realistic and forward-looking. This includes understanding which programs are actively funding work like yours, how competitiveness is assessed, and when small adjustments can meaningfully improve outcomes.

Importantly, this approach doesn’t limit opportunity, it focuses it. Many strong ideas fail to secure funding not because they lack merit, but because they were submitted to the wrong mechanism, the wrong institute, or at the wrong moment. Strategy turns those uncertainties into informed choices.

When teams apply selectively and intentionally:

• Applications become clearer and more compelling

• Reviewer feedback becomes more actionable

• Resubmissions are more efficient and targeted

• Funding outcomes feel repeatable, not random

The goal isn’t to submit more applications. It’s to win the right ones, at the right time, with the right positioning. With a strategy-driven approach, grant funding becomes not just possible, but increasingly predictable.

Need help with crafting your grant strategy? Contact our team today.