Don't wait for a formal QBR to discuss expansion. The immediate post-sale period is a golden window for additional sales. The customer's excitement and trust are at their peak. With their most urgent need solved, they are highly receptive to addressing other business challenges.

A MedTech startup's initial go-to-market may be hospital-by-hospital sales. However, after building a robust evidence base of clinical and economic impact, the sales focus can shift to enterprise-level deals with regional or national healthcare systems, accelerating growth.

Startups consistently underestimate sales cycles with large hospital systems. Due to risk aversion and complex approval processes designed to ensure patient safety, what seems like a three-month process will likely take nine months. Founders must build this 3x buffer into their financial planning to survive.

A key expansion strategy is moving 'upper funnel' from treating specific, acute conditions to offering a holistic, preventative platform. For Hims & Hers, adding diagnostics ('Labs') created a new entry point for users to understand their overall health, not just solve one problem.

Don't force your sales team to learn and sell a completely new product. Instead, integrate the new capability into an existing, successful product, making it "first" or "default" for that channel. This reduces sales friction and complexity, leveraging established momentum for adoption.

Large enterprises don't buy point solutions; they invest in a long-term platform vision. To succeed, build an extensible platform from day one, but lead with a specific, high-value use case as the entry point. This foundational architecture cannot be retrofitted later.

To move upmarket and win six-figure contracts, Kadence discovered that simple desk and room booking was insufficient. They had to build a comprehensive "Space Ops" product to solve complex enterprise problems like move management and scenario planning. This product depth was necessary to justify the higher price point to enterprise buyers.

Commure uses targeted point solutions for quick adoption and short sales cycles. These act as a wedge to initiate a longer, more complex platform sale, which ultimately displaces the initial point solution competitor and captures much higher account value.

Enterprises are comfortable buying services. Sell a service engagement first, powered by your technology on the back end, to get your foot in the door. This builds trust and bypasses procurement hurdles associated with new software. Later, you can transition them to a SaaS product model.