» IDN

Integrated Delivery Networks (IDNs) as Buyers

Get inside how IDNs think—how they’re structured, what they reward, and how decisions actually get made.

The IDN Opportunity

If you’re building a startup that sells to providers, health plans, or value-based entities—chances are, you’ll run into a risk-bearing IDN (or “Payvidor”).

The top 40 alone generate hundreds of billions in annual premiums, employ hundreds of thousands of physicians, and increasingly control both care delivery and financing. They don’t just deliver care—they pay for it, too.

But not all IDNs are built the same.

Some are structurally integrated. Others are deeply siloed—between plan and provider, budget and value, buyer and beneficiary.

This guide helps you spot misalignment early— so you can navigate complexity with clarity.

What’s Inside

Too often, founders start selling into risk-bearing IDNs without first asking the hard questions that determine fit and viability.

These are the 60 questions to help you assess if your startup is a good fit for this segment & covers how to –

Spot which systems are structurally ready for transformation—and which are too siloed to move
Identify who actually controls decisions and budgets
Tailor your messaging to match the incentives, integration depth, and operating model of each IDN
Bonus videos: interviews with C-Suite executives from top performing risk-bearing IDNs

Digital Health Founder

“This ebook is an invaluable guide to help operators move beyond an over simplified balcony view and instead grasp the unique considerations of risk-bearing IDNs – knowledge that is essential to truly win the opportunity.”

Itamar Perlov

CEO & Co-Founder, ecton

Growth stage company Chief Business Officer

“The IDN landscape is complex & often misunderstood, but this guide cuts through the noise with a clear framework and the right questions to ask. It’s a practical tool that will help save time and sharpen go-to-market focus.”

Tamir Gotfried

Chief Business Officer, Tyto Care

IDN executive and startup founder

“Understanding the structure & culture of organizations that are both payers & providers can make or break your sales effort. The prep work outlined here is essential to ensuring shorter & more successful contract cycles.”

Kris Smith

President & Co-Founder, Ruby Health. Previously Chief Medical Officer, Optum at Home.

About the Authors

Jonathan Friedman

Jonathan is a Partner at LionBird, leading new investments in companies in the healthcare delivery segment and serving on the boards of Laguna Health, Mellie, OneStep, Heyday Health, Ditto and others.

Prior to co-founding LionBird, he previously worked for the CEO of Azzorti, a multi-national consumer products company, managing new product launches, sales operations and other cross-functional projects.

He is a member of The Kauffman Fellows Program (class 24), has been frequently featured in technology publications such as TechCrunch and VentureBeat, and also compiles the popular
LionBird Bites & Wings newsletters.

Dr. Jordan Asher

Dr. Jordan Asher is a seasoned physician-executive with over 20 years of leadership experience in large, matrixed healthcare systems. He currently advises a range of healthcare and healthtech companies focused on technology-enabled care delivery and innovation and serves as a Director at Brookdale Senior Living (NYSE: BKD).

Most recently, Dr. Asher was Executive Vice President and Chief Clinical Officer at Sentara Health, a leading Integrated Delivery Network. At Sentara, he led efforts to develop high-quality, equitable, and consumer-centered models of care. His portfolio included oversight of Clinical Quality and Safety, Clinical Effectiveness, Innovation, Research, the Clinically Integrated Network (Sentara Quality Care Network and ACO), Nursing, Academic partnerships, Residency Training, and the system’s High-Performance Design initiative.

Dr. Asher is a national thought leader on population health, value-based care, clinical integration, and payment model transformation. His work emphasizes cultural sensitivity, care equity, and delivering outcomes across the continuum—from individual care to community health. Before Sentara, Dr. Asher held multiple leadership roles at Ascension Health, including Chief Clinical Officer of Ascension Care Management, Chief Innovation Officer at MissionPoint Health Partners, and Chief Medical Officer and Chief Integration Officer. He also served as Assistant Dean at the University of Tennessee Health Sciences Center’s Nashville campus. He holds a B.S. in Biology from Emory University, an M.D. from Vanderbilt University School of Medicine, and an M.S. in Medical Management from the University of Texas at Dallas and Southwestern Medical Center.

LionBird is a venture capital firm investing exclusively
in pre-scale digital health companies.

Since its inception, the firm has invested in more than 35+ founding teams and now has over $150 million in AUM. Our focus is on helping founders lay the best foundations for their companies to scale and succeed.

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