After 777 customer discovery interviews for CLIN, I noticed healthcare practices weren't just different in size—they were different types of businesses. Each archetype has distinct growth patterns, operational needs, and financial requirements.
These segments determine everything from product roadmap to pricing strategy. Here's what I learned.
The Four Practice Archetypes
1. Enterprise Practices (2% of market, 40% of revenue)
Revenue: $10M+ annually Characteristics: Multiple locations, 50+ employees, institutional backing
These are the healthcare equivalent of Fortune 500 companies. Think HCA Healthcare, Aspen Dental, or large medical groups with PE backing. They have CFOs, procurement departments, and multi-year vendor evaluation cycles.
What they need:
- Enterprise-grade treasury management
- Multi-entity accounting capabilities
- Complex approval workflows
- Integration with existing enterprise systems
- White-glove customer support
Banking behavior: They park millions in checking accounts because moving money requires board approval. Their CFO cares more about operational efficiency than yield. They'll pay $50K+ annually for the right solution.
How to serve them: Don't compete on price. Build for their procurement process. Expect 12-month sales cycles but massive deal sizes.
2. Strategic Growth Practices (15% of market, 35% of revenue)
Revenue: $2-10M annually Characteristics: Aggressive expansion plans, sophisticated operations, growth-minded owners
These practices are in their scaling phase. They've figured out operations and are ready to expand. Think successful specialists opening second locations or primary care practices adding services.
What they need:
- Growth capital and lending products
- Multi-location cash management
- Sophisticated financial reporting
- Integration with practice management systems
- Performance benchmarking tools
Banking behavior: They actively manage cash flow and understand unit economics. They'll switch banks for better lending terms or operational efficiency. ROI-focused decision making.
How to serve them: Lead with data and analytics. Show them how your platform improves their unit economics. Price based on value delivery.
3. Scaling Practices (30% of market, 20% of revenue)
Revenue: $500K-2M annually Characteristics: Established but growing slowly, basic operations, time-constrained owners
These are your typical established practices. Been around 5+ years, profitable, but growth isn't the primary focus. The dentist who owns two offices, the dermatologist with a solid patient base.
What they need:
- Simple, reliable banking
- Basic financial reporting
- Easy-to-use interfaces
- Reasonable pricing
- Minimal time investment
Banking behavior: They want set-it-and-forget-it solutions. Hate complexity. Will pay reasonable premiums for simplicity but won't overpay for features they don't use.
How to serve them: Simplicity wins. Don't oversell features. Focus on reliability and ease of use. This is your highest-margin segment if you build right.
4. Lean Boutique Practices (53% of market, 5% of revenue)
Revenue: Under $500K annually Characteristics: Solo practitioners or small teams, cost-sensitive, basic needs
The majority of healthcare practices fall here. Solo practitioners, new practices, or small specialty clinics. They're bootstrapping growth and every dollar counts.
What they need:
- Low-cost or free basic banking
- Simple accounting integration
- Educational resources
- Transparent pricing
- Easy onboarding
Banking behavior: Extremely price-sensitive. Will switch for $10/month savings. Limited time for financial management. Often use personal banking for business needs.
How to serve them: This is a land-and-expand play. Capture them early with great pricing, then grow with them. Many will scale into higher segments.
The Critical Insight: Different Segments Need Different Products
Most healthcare fintech companies make the same mistake: they build one product and try to serve all segments. This never works. Geoffrey Moore's Crossing the Chasm shows us that different market segments adopt technology at different rates and with different requirements—early adopters (Strategic Growth practices) have vastly different needs than the early majority (Scaling practices) or late majority (Lean Boutique practices).
Enterprise practices need white-glove service and complex features. Lean boutique practices need simple, cheap solutions. You can't deliver both with the same product architecture.
How This Changed Our Strategy at CLIN
Initially, we tried to be everything to everyone. Bad idea.
Once we mapped our customer base to these segments, everything became clearer:
Product decisions: We built separate feature sets for different segments. Enterprise customers got advanced reporting. Lean practices got simplified interfaces.
Pricing strategy: We moved from flat-rate to segment-based pricing. Enterprise practices paid more but got more value. Lean practices got basic features at low cost.
Sales approach: Different segments, different sales motions. Enterprise required relationship selling. Lean practices preferred self-service onboarding.
Support model: Enterprise customers got dedicated account managers. Lean practices got excellent self-service resources and chat support.
The Revenue Distribution Reality
Here's the uncomfortable truth: 2% of practices generate 40% of revenue, while 53% generate only 5%.
This creates a strategic choice:
- Go upmarket: Chase the big accounts with complex, expensive solutions
- Go broad: Serve the masses with simple, scalable products
- Do both: Build a platform that can serve multiple segments (harder but more defensible)
Most successful healthcare fintech companies pick one and execute flawlessly. The companies that fail try to do everything.
Red Flags I Learned to Watch For
For Enterprise prospects:
- No clear procurement process
- Decision maker changes frequently
- "Let's start with a pilot" that never scales
For Strategic Growth prospects:
- Vague growth plans
- No understanding of unit economics
- Expects enterprise features at scaling prices
For Scaling prospects:
- Constantly price-shopping
- Wants features from other segments
- No clear value proposition understanding
For Lean Boutique prospects:
- Unrealistic feature expectations
- No budget allocated for tools
- Expects white-glove service at low prices
Implementation Framework
If you're building healthcare fintech, here's how to apply this:
- Segment your current customers using revenue and growth trajectory
- Analyze profitability by segment - you'll be surprised
- Map product features to segment needs - kill features that don't serve a clear segment
- Align pricing with segment value - don't leave money on the table
- Build different customer journeys - one size doesn't fit all
The Network Effect Opportunity
Here's the real opportunity: practices don't operate in isolation. Enterprise practices often refer patients to specialists. Strategic Growth practices acquire Lean Boutiques.
If you can serve multiple segments well, you become the infrastructure layer for entire healthcare ecosystems. That's how you build a moat.
What This Means for Healthcare Banking
Traditional banks fail at healthcare because they treat all practices the same. They either:
- Oversell Enterprise features to small practices (who churn)
- Undersell simple solutions to large practices (who leave for better service)
The winning strategy is segment-specific solutions with seamless transitions as practices grow.
For fintechs: Pick your segment and dominate it. Don't try to boil the ocean.
For incumbents: Your advantage is capital and compliance expertise. Use it to serve the Enterprise segment that startups can't reach.
For practices: Understand which segment you're in. Your banking needs are different from the practice down the street, even if you're both "healthcare."
The healthcare services market is $4.3T annually. These four segments represent different strategies to capture that opportunity. Choose wisely.
This analysis is based on 777 customer discovery interviews conducted while building CLIN's healthcare banking platform. The segment definitions and revenue distributions reflect our actual customer data from 2023-2024.