7 Go-to-Market Lessons From Building a $30B Healthcare Category

Torben Nielsen has scaled two healthcare companies. The second time, he knew exactly which mistakes not to repeat.

In a recent episode of Category Visionaries, Torben Nielsen, CEO and Co-Founder of Uptiv Health, shared hard-won lessons from building HealthSparks to number 196 on the Inc. 5000 list, then applying those insights to transform the infusion therapy market. These aren’t theoretical frameworks. They’re battle-tested principles from someone who’s lived through hypergrowth twice.

Lesson 1: Remove Structural Barriers Before Launch, Not After

Most healthcare founders launch first, prove demand, then negotiate with gatekeepers. Torben flipped this entirely at Uptiv Health.

“We decided very early on that it was important for us to get on contract with all the payers so we could see patients regardless of what insurance company they had,” he explained. “Actually, you know, six to seven months before us even opening up our first clinic, we started working with payers to get on contract.”

The result? When they opened their doors in Detroit, they could treat any patient. No insurance barriers. No coverage questions. Within 12 months, over 150 unique providers were referring patients.

This lesson applies beyond healthcare. In any market with structural gatekeepers—regulatory approval, platform partnerships, enterprise procurement requirements—tackling those barriers before launch creates exponentially faster growth after. That six-month pre-launch investment compressed what could have been years of momentum-building into months.

The counterintuitive truth: what looks like delay is actually acceleration.

Lesson 2: Culture Dilution Is Mathematical, Not Accidental

At HealthSparks, Torben learned this lesson the hard way. The company scaled from 11 people to over 100 as the second fastest growing digital healthcare company in 2016. Growth was intoxicating. Culture became a casualty.

“When you start with 11 or even 20, right? As we started hiring early on, you still had a really good sense of what is the culture, what is true north, you know, where do we want to go?” he reflected. “But as you start quickly getting from 20 to 50 to 70 to 100, all of a sudden that base of core people that know the culture of why you do certain things is getting smaller.”

The math is brutal: hire 30 people when you have 20, and you’ve diluted your cultural carriers by 60%. Each new hire needs context, not just instructions. They need to understand why you do things a certain way, not just what to do.

At Uptiv, Torben’s applying this lesson from day one through what he calls over-communication. “Over communicating and making sure that everybody is with you as you hire new people and they understand, you know, what true north is and why you do certain things. What your philosophy is, I think was a major learning for me.”

Over-communication isn’t more all-hands meetings. It’s obsessively articulating the why behind every decision, especially as headcount doubles.

Lesson 3: Operational Efficiency Comes From Philosophical Clarity

Most founders think better patient experience means higher costs. Torben proved the opposite by embedding philosophy into operations.

At Uptiv, there’s no reception counter. “We feel there are enough barriers in healthcare, we don’t need to create yet another one between us and the patient,” he explained. This isn’t aesthetics. It’s a philosophical statement that drives operational decisions.

No reception counter means no receptionist position. Tasks that typically happen at check-in move to the patient app—consent forms, insurance verification, medical history updates. Patients complete everything from home before arriving.

“All the consent forms they usually fill out, our patients do via the app from home prior to them coming in,” Torben noted. “And they will never see those consent forms again until the year after.”

The company also centralized operations with one phone number routing to a call center, so no phones ring in centers disrupting the patient experience. “That takes away some of the costs that we typically see infusion centers. It’s actually a very lean experience that we have.”

Their first center became cash flow positive in just over 12 months. The second is tracking faster. This only works because every team member understands the philosophy behind eliminating barriers, not just the tactical process changes.

When philosophy drives operations, efficiency and experience reinforce each other rather than compete.

Lesson 4: Enterprise Sales Requires Enterprise Optics

This lesson came from Torben’s experience at HealthSparks, where the company had to transition from SMB to enterprise customers. The product and operations matter, but so does how you present them.

At Uptiv, this meant building enterprise infrastructure from the start—robust data security, professional visual identity, systems that could pass credit committee reviews at major financial institutions. But it also meant understanding that enterprise buyers evaluate differently than SMBs.

The payer contract strategy served double duty here. Beyond removing patient barriers, it signaled to specialists and health systems that Uptiv was a serious, stable partner. Enterprise customers don’t pilot with companies that might not exist in six months or might not have their insurance covered.

The lesson: enterprise sales isn’t just about bigger deal sizes. It’s about meeting the buyer’s risk evaluation framework with proof points that matter to them.

Lesson 5: Technology Should Reduce Costs, Not Just Add Features

Most healthcare technology adds capabilities on top of existing processes, increasing costs. Uptiv’s technology replaces expensive processes with cheaper digital ones.

Every patient starts their journey in the Uptiv app, setting up profiles, photographing insurance cards, and communicating with care teams via secure SMS. They complete intake questionnaires about preferences—blanket choices, beverage preferences, entertainment options—before arriving.

“We also have our patients go through a small questionnaire where they can let us know how they want their infusion,” Torben explained. “Would they like one blanket with their infusion? Would they like an extra blanket? Are they bringing a friend? If so, what’s their name?”

This personalization isn’t expensive add-on service. It replaces manual intake processes that would require staff time. The app doesn’t just improve experience; it fundamentally reduces operational overhead while delivering premium service.

“You’ll be surprised that you know, how little effort it takes, you know, to add these additional elements to it and really just think about how do we create a much better experience,” he said.

The principle: technology that can’t replace expensive processes is just more overhead.

Lesson 6: Sales Velocity Comes From Removing Buyer Friction

Uptiv’s sales playbook works because they eliminated every possible source of friction before the first sales conversation. With all payer contracts secured, the pitch to specialists became remarkably simple: “Give us just one patient and we will show that we can deliver on that promise.”

But the real genius is what they remove from the specialist’s workflow. “We will do the prior auth, we will collect all patient information, medical information that’s needed for this infusion to take place,” Torben explained.

Specialists doing in-office infusion deal with payer contracts, wholesaler contracts for drugs, and prior authorization headaches. Uptiv absorbs all of that administrative burden. The specialist’s downside risk is zero. The upside is happier patients and less operational headache.

This resulted in 150 unique providers referring patients in 12 months, with a referring provider NPS of 87. That’s not satisfaction. That’s advocacy that compounds through word-of-mouth.

The lesson: sales velocity isn’t about better pitches. It’s about removing every reason the buyer would hesitate.

Lesson 7: Contrarian Positioning Requires Market Education

Uptiv is moving infusion from hospitals to retail locations next to Starbucks. This positioning is contrarian enough that it requires educating the market, not just targeting it.

“Nobody wants to go to a hospital, right?” Torben stated. “It’s very hard to find parking. It’s hard to find the building where you’re going to get the infusion. Once you find the building, maybe it’s up on the third floor. Once you get to that third floor, then it tends to be an open room where chairs are just lined up in a row, where you almost take a number, you take a seat.”

The hospital experience is objectively terrible—sterile, cold, noisy, with zero privacy. But it’s what patients and specialists know. Changing behavior requires articulating why the current model is broken, not just why your model is better.

Torben’s background at Lego taught him about latent consumer needs. “They pay attention to consumer needs like nobody else,” he said about Lego. “It’s incredible that they’re even around in today’s world. Right. Where most kids operate in a digital world. But Lego has never done better.”

The insight: some markets don’t know they have a problem. Your job is naming the problem before selling the solution.

The Playbook in Practice

These seven lessons compound. Removing structural barriers before launch (Lesson 1) enabled the sales velocity strategy (Lesson 6). Philosophical clarity about eliminating barriers (Lesson 3) made the technology investment (Lesson 5) deliver ROI faster. Culture work (Lesson 2) ensured the team could execute on all of it.

Looking ahead three to five years, Torben wants 50 to 60 clinics proving that hybrid in-person and virtual care models create better outcomes at lower costs. “I think that’s exactly what we are proving out in the Detroit market and taking that playbook across the nation would be very excited,” he said.

The playbook works because it’s built on principles, not tactics. Remove barriers early. Obsess over culture as you scale. Let philosophy drive operations. Meet enterprise buyers where they are. Make technology reduce costs. Eliminate buyer friction. Educate contrarian markets.

None of this is complicated. But doing it requires living through hypergrowth once, learning from the mistakes, then having the discipline to apply those lessons the second time around. That’s exactly what Torben is doing at Uptiv Health.