Krista Bragg Interview Published on: 05, Mar 2026

I’ve worked with companies at all stages of maturity trying to enter or scale within healthcare, many of them originating outside the U.S. Over time, clear themes emerged, particularly a lack of understanding of the mechanics of the system and the perspectives of those operating within it. Leading both payer and provider organizations has given me insider experience into how decisions are actually made, and I wanted to share that insight into practical guidance others could use.

In reality, incentives drive behavior, even when they don’t always align with what feels best for the patient. Once people understand how insurers manage financial risk, how care is incentivized through payment models, and how outcomes are measured, the system becomes much easier to navigate.

I encounter this often with companies trying to sell to the wrong customer. For example, a health insurance company is often motivated to invest in services that keep patients healthier and reduce emergency room visits. At the same time, under current payment models, some cash-strapped health systems rely on emergency department volume to sustain revenue. That difference matters if the product you’re selling is designed to reduce ER visits, because the health system may not be the right customer for your solution.

I included topics based on real mistakes I’ve seen throughout my career. This book is a culmination of the mistakes and wins I’ve seen over my career, including my own, and the lessons that came from helping founders, executives, and clinicians navigate the same challenges. It’s a comprehensive reference packed with insider insight, with deliberate avoidance of metaphors, acronyms, and jargon so anyone, including those outside the U.S., can clearly understand how the system works.

The healthcare industry relies heavily on jargon and acronyms that often overcomplicate important concepts. I wanted to make the information accessible and practical, so readers could gain a different perspective on how healthcare and insurance works. Feedback from both students and professionals has been positive, and one chief nursing officer shared that even though she thought she understood insurance, she learned a great deal from the payer chapters.

They build a solution before fully understanding the problem they’re trying to solve and what healthcare organizations or industry already have in place. For example, AI is a popular focus right now, but many health system leaders are less interested in adding disparate technology and more focused on solutions that address a real operational problem and integrate with existing systems.

Stakeholder alignment sounds straightforward, but it often takes significant effort to identify the true decision makers within an organization. Healthcare is highly regulated and frequently matrixed, and most solutions impact multiple teams, all of whom want input. When you add ongoing regulatory changes, margin pressure, and leadership turnover across health systems and insurance companies, achieving stakeholder alignment becomes very difficult but is necessary.v Your book includes pricing worksheets and market entry strategies. Why is pricing such a critical and misunderstood element in healthcare startups?

Pricing is important because it forces alignment with how buyers already think about their problem. Most buyers understand what an issue is costing them. What they need to see is how your solution fits into that financial reality. Pricing models should align with how money actually moves through the healthcare system. I see founders struggle when they don't understand those dynamics, and I see companies succeed when they learn how to position pricing in a way that clearly connects value to the buyer’s existing cost structure.

Healthcare and health insurance often move more slowly because the consequences of mistakes are much higher. I work closely with technology companies and health systems and help them navigate regulation, patient safety, data and privacy, and trust at the same time. In healthcare, success depends less on speed and more on credibility and execution.

Traditional education often focuses on high-level concepts, simulated scenarios and overarching theories. This book explains how healthcare functions day to day, based on real world experiences. It shares what motivates many leaders, how decisions are really made, and insider considerations that are rarely discussed. It covers a wide range of topics, including contracting, internal decision making, procurement, and why good ideas sometimes fail to scale.

I hope it helps with a better understanding of healthcare and health insurance. When people have context and practical application knowledge, they can innovate and collaborate more effectively.

The traditional payment model in the U.S. has been fee for service (FFS), meaning physicians, other clinicians, and healthcare organizations are paid for each service, visit, or hospital stay.

At its core, value-based care aligns financial incentives with keeping people healthier, which reduces the need for services, visits, and hospital stays.

I was surprised by how much critical knowledge in healthcare is informal and rarely written down. Writing the book made me realize how many lessons people are expected to learn through trial and error, slowing innovation.

Startup Guide to U.S. Healthcare was designed as a comprehensive reference, not a book readers are expected to read cover to cover. Thank goodness, since it’s over 700 pages!

Most readers who simply want to understand how healthcare works are skimming sections, moving between chapters, and using it as a reference tool.

I’ve heard from founding teams that they use the book differently at various stages of their company and return to it over time. For some, the paperback is more useful because they prefer to mark up pages and take notes, while others are comfortable doing the same in a digital format and value the ability to search and navigate quickly.

Success in healthcare depends on fit and articulating your solution's value proposition. When solutions align with incentives, workflows, and risk structures, they scale. When they don’t, even strong ideas struggle. Understanding that early can save years of effort.

AllAuthor brings authors and readers together in a way that feels natural rather than promotional. Readers can easily discover books, follow authors, and engage in real conversations, and for authors, it offers practical tools that make marketing feel approachable instead of intimidating. It feels like a platform built around connection and discovery, which is refreshing.