Platform / Health / Home-Health Wedge
Strategy

The Home-Health Wedge
−30%, setup waived, margin intact.

The sales thesis for the healthcare business: walk into a Medicare home-health agency, undercut their current EMR bill by 30% and waive the setup fee entirely — and still run roughly 78% gross margin, because AI-assisted visit documentation costs cents where incumbents charge dollars.

● Active motion Costs measured in real use, not projected First migration connector built
What it attacks
Incumbent EMR pricing power$10–25K/month bills, per-clinician gouging Setup-fee lock-in$20K–$400K switching walls, waived here Months-long onboardinga migration connector instead of a services project
The insight

Agencies already want to leave — they're walled in

The field finding that anchors the whole strategy: home-health agencies aren't loyal to their EMRs. Nearly all of them want to switch. What stops them isn't reluctance — it's data continuity and the punitive economics of moving: incumbents gate exits behind setup fees that run from twenty thousand to hundreds of thousands of dollars, then price per clinician in a business where head-count is the whole operating model.

So the wedge attacks the wall, not the preference. "Minus 30% on your software bill, and we waive the setup fee" — which compounds to roughly 69% first-year savings once the avoided setup fee is counted. The offer removes the only two reasons an agency stays.

Data continuity gets the same treatment: the first migration tool targets Axxess, reading an agency's own data export and mapping it cleanly into the new system. OASIS (Medicare's required patient assessment) and EVV (electronic proof the visit happened) follow formats CMS standardized — precisely the data an incumbent can't lock in — and a read-only archive of the old records means nothing is ever lost in the move.

The offer, in one column

−30%off the agency's current software bill
$0setup fee — the incumbent's switching wall, waived
~69%typical year-one savings, setup fee included
The economics

Why −30% is a profitable price, not a promotion

The numbers underneath the discount are measured from real daily use of the live EMR — actual AI spend across tens of thousands of patient encounters — not a spreadsheet assumption.

🧾$0.17–0.20 per visit

The measured AI cost to fully document a home-health visit. That's the entire added cost of the intelligence layer incumbents don't have.

📊~6% of revenue

AI cost stays around six percent of revenue at every pricing tier — which leaves roughly 78% gross margin even after giving away 30%.

📈Margin widens with size

AI cost grows with visits; revenue grows with clinicians. Bigger agencies mean wider margins — so the plan targets small agencies for volume and references, larger ones for margin.

The market: roughly 11,900 Medicare home-health agencies, a software market on the order of $285M a year, and no modern AI-native entrant fighting for it. A thousand agencies is roughly $16.8M a year in recurring revenue — before the add-on services (referral capture, OASIS accuracy improvement) that ride on AI capacity the platform already pays for.

The map

Sequenced against the incumbents

The incumbent field is concentrated and complacent: two large players hold nearly half the market with long-locked enterprise contracts — those are deliberately skipped first. The near-term push aims at the price-sensitive small-agency segment, where the −30% offer bites hardest and the incumbent (Axxess, hence the first migration tool) is easiest to move away from.

  • Prospect list in hand: nearly 12,000 CMS-listed agencies nationwide, with a state-by-state territory plan starting in Illinois
  • The defensible claim: the only AI-native EMR built for home health — OASIS assessments, PDGM billing (how Medicare decides what an episode pays), the 485 plan of care, and electronic visit verification all built in — sharing its foundation with an EMR that runs a real clinic, certified e-prescribing included
  • The celebrated AI-documentation startups are note-taking layers on top of someone else's EMR; they don't own the record. This owns the record.

Incumbent share, roughly

~25%HCHB — large, locked contracts; skip first
~20%MatrixCare — same posture, same order of attack
1sttarget: the Axxess small-agency segment — price-sensitive, migration tool already built
The machine

Fed by the closed sales loop

The wedge isn't a slogan; it's the offer carried by an end-to-end sales machine already running on the platform's own tools: SynergyRoutes plans the agency territory and the door-to-door day, the demo happens on SynergyMeet, the meeting transcript prices the deal against the −30% rule, and the contract goes out through SynergySign — with a firm rule that a human confirms any number the AI merely heard on a call rather than verified.

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