How to Build a Medtech Company That Gets Acquired
A successful exit isn't a last-minute move — it’s the result of intentional strategy baked into how you run the company from day one.
Great businesses get bought, not sold: Focus on building real value. When buyers see something worth acquiring, they’ll come to you.
Pick the right market and show your value: A high-growth market is essential, but what really attracts investors and acquirers is a progressively de-risked startup. Time your fundraising and M&A conversations when your momentum is strongest.
Build to stand on your own: M&A may be the goal, but you need a company strong enough to thrive independently.
Ask the smart questions early: Talk to potential acquirers from the start — not to pitch, but to learn. What are they watching? Where are the inflection points? This helps shape your strategy and builds credibility.
Timing matters: The best exits happen when your value aligns with their timing. Keep them close, communicate progress, and make sure they see you coming.
The Smartest M&A Move? Don’t Sell — Get Bought
Over his 35-year career, Joe DeVivo has acquired and integrated eight companies, turned around four, and delivered five exits. After playing a role in expanding US Surgical and Teladoc Health, he’s now the President and CEO of Butterfly Network, leading the charge on an AI-powered handheld ultrasound device designed for accessibility — even in the most remote locations.
If there’s one thing DeVivo’s certain about, it’s this: “Any successful M&A transaction is one where you're purchased, not sold.” The moment a company starts trying to sell itself, buyers grow wary. “That’s when people wonder what’s wrong. The best businesses are bought.”
So, how do you get bought? “Sometimes, the best strategy is to do nothing but build value,” DeVivo says. Focus on delivering real results — and make sure the right people notice. When that’s not enough, take a longer view: build relationships, not deal flow.
Start by identifying potential acquirers early — especially competitors — and stay visible.“What I do is I simply befriend them,” DeVivo says. No pitching, no pressure. “At trade shows, be very open with them. Communicate what you’re doing. Of course, don’t give them your secret sauce, but keep the dialog going,” he advises. Over two or three years, these connections help potential buyers understand your business, how it fits in their world, and why it’s worth acquiring.
Founders often assume their impact is obvious — but it’s not. “You’d be surprised how much acquirers don’t know about you.” It’s your job to educate them, so they’re aware of your company and recognize synergies. The key is to keep them informed without pushing an agenda. Education builds recognition, and recognition builds credibility.
Trust matters, too. “Due diligence only goes so far — buyers need to feel confident there are no hidden risks. “If they ask you questions, don’t deal with them adversarially. Protect yourself, but be trustworthy, open, and transparent,” DeVivo notes.
The takeaway? If you’re trying hard to get acquired, you’re likely going about it the wrong way. Build something great, cultivate the right relationships, and let buyers come to you.
Market Growth Gets You in the Game. Milestones Move You Forward
James Reinstein knows how to build and exit medtech companies. He helped scale Cyberonics’s market cap from $200 million to $3 billion and led Aptus from a startup to a $120 million acquisition by Medtronic. Now, as President and CEO of Conformal Medical, he’s steering the company’s left atrial appendage occlusion (LAAO) technology toward clinical success and commercial launch.
“Find a market that’s growing fast, has few competitors, and is one that investors want to be in,” Reinstein says. LAAO is one of the fastest-growing medical device sectors today, with a 20% CAGR. The market, currently at $1.5 billion, is expected to double in the next two to three years—and double again by 2030. “Today, about 100,000 patients are treated annually. By 2030, that number should reach 400,000,” Reinstein notes. Boston Scientific’s Watchman dominates with 90% U.S. market share, while Abbott’s Amulet is the primary competitor. Still, the opportunity is expanding quickly.
Getting positioned in a growing pie is smart. A market like this gives Conformal multiple paths forward, whether it’s an IPO or an acquisition. But growth alone doesn’t guarantee a golden ticket to an exit. New entrants still need to prove their worth to acquirers and investors long before entering the commercial stage. And so for Reinstein, the question becomes, “What can significantly derisk this as an investment opportunity?”
To do that, he emphasizes the importance of hitting key milestones, such as regulatory approvals, early commercial traction, or pivotal clinical data. For example, Conformal is still a couple of years away from commercialization in Europe, but it’s approaching a critical moment: its first look at unblinded trial data.
Clinical trials are typically blinded to ensure unbiased results, meaning that investigators and sponsors don’t know which group of patients received the experimental device versus the control. However, FDA allows sponsors to unblind data under specific conditions. This kind of disclosure is a powerful signal to prove to investors and acquirers the company is a strong bet.
For companies like Conformal, this kind of data disclosure isn’t just a regulatory nuance. It’s a strategic step that gives investors and potential acquirers a clearer picture of the company’s performance and potential. That window is exactly when Reinstein is targeting to close their funding round. “Large investors and strategics are already tracking that timeline,” he shares. Once the data is in, Conformal should be in a stronger position to secure funding, push toward commercialization, or consider acquisition discussions.
To summarize, a fast-growing market with limited competition makes fundraising and exits easier, but growth alone isn’t enough. Investors and acquirers need clear reasons to bet on you. Strong data, regulatory approvals, and commercial traction all help de-risk the company. Above all, align your capital raise and M&A conversations with your critical milestones.
Build Wisely, But Don’t Rely on an Acquisition to Save You
Cary Vance has spent the last 11 years as CEO of six different startups, leading commercialization, fundraising, and M&A deals in surgical robotics, diagnostics, and pain management. While serving as CEO of PhotoniCare — a role he held until stepping down in January 2025 — he tackled ear infections with a handheld imaging device that sees beyond the eardrum.
Startups progress through different phases, and its leadership needs shift along the way. A strong medtech resume doesn’t always mean someone’s right for every stage of growth. As Vance puts it, “First question is, should you be the leader? And if so, what do you need to learn, to know, or become? If not, then who and when will you bring in someone else?” In PhotoniCare’s case, the founding CEO, Ryan Shelton, asked Vance to step into the chief executive seat when the company needed to focus more heavily on commercialization, partnerships, and M&A discussions — which were better suited for Vance’s skill set.
Vance knows how to navigate commercial conversations. “It’s like Shark Tank — they ask the same 8 to 10 questions every time. If you’ve ever watched the show, you should already know what they care about,” he says.
Strategics and investors will always look for:
Market size and opportunity: Is this a big enough space?
Risk profile: What hurdles need to be cleared?
Traction: What progress have you made and what gaps remain?
Competitive edge: Why buy you instead of building their own?
Founders should keep these points in mind from day one.“Run your business in a way that, when they start peeling back the layers in due diligence, everything stands up,” Vance advises.
If you’re eyeing an exit in two or three years, start conversations with strategics now. Don’t just pitch — learn about their challenges and priorities. Understand how they think, how their business units operate, and where your product fits in.
Ultimately, strategic leaders are risk-averse.“If acquiring your company makes their core business suffer, they won’t do it, no matter how great your technology is.”
And remember, even if you do everything right, a deal might not happen. “A lot of times, acquisitions don’t happen because of what’s going on with the strategic in other areas. It has nothing to do with the value of your company,” Vance explains.
That’s why it’s smart to cultivate multiple strategic relationships. Cary says, “The company that eventually buys you may not be the one you expected when you started the process.” This approach creates competitive tension and strengthens your position.
But don’t count on acquisition as your rescue plan. “You have to run your company as if you’re going to have to make a go of it alone,” Vance warns. That means, strong financials, commercial traction, and a product that is easy to sell.
The best exits happen as a result of building a great business. Prepare early, run lean and strong and keep lines open with strategics to create multiple paths forward—whether that’s acquisition, IPO, or sustainable growth.
Plan for M&A Early and Often
Jennifer Fried started her career as a healthcare venture capitalist and consultant at Bain & Company before co-founding ExplORer Surgical, a digital surgical workflow platform. Under her leadership, the company went from a university spin-out to a global product with major medtech partnerships, culminating in its acquisition by GHX in 2021.
Now, as co-founder and CEO of Flow Medical, she’s tackling pulmonary embolism treatment.
Before Fried joined Flow Medical, she called potential acquirers — not to pitch them, but to listen and learn. “I asked them, ‘What do you really think about the PE space? What do you see happening? What will be the big inflection points?’” she shares. These early conversations helped her understand market dynamics, shape Flow’s strategy, and build relationships well before ever having serious M&A talks.
Even if an acquisition is not your goal, Fried recommends keeping the M&A door open. “In medtech, most of the time you’re going to be thinking about M&A. Even if you believe you’re building a standalone business, have those conversations early,” she advises.
This means making M&A planning part of your company’s rhythm. Fried suggests a tactic from Mert Iseri’s book Exit Right: Every year, review your top five to ten potential acquirers. Ask:
Have I spoken to them this year?
Do I know their current strategy in my space?
Do they know who I am?
That way, when the time is right, you’re not starting from scratch — they are already know you and trust has been established.
Engaging early also gives you a chance to build a trend line. “At first, I say, ‘Hey, here’s the idea.’ Next, I show them our device. Then, I tell them about our first patient. Later, I share pivotal trial results,” Fried explains. This keeps acquirers engaged and gives them a front-row seat to your momentum.
The key takeaway: M&A doesn’t happen overnight. Make planning for it a part of your routine. Start conversations early, keep potential acquirers updated, and show steady progress. That way, when the time comes, you’ll already be on their radar.
Understand How Strategics Approach Acquisitions
Nitin Salunke has held leadership roles at Medtronic Neurovascular, Altura Medical, and Cordis (then a Johnson & Johnson company), where he helped shape breakthrough technologies in neurovascular and cardiovascular care.
Now, as President and CEO of Supira Medical, he’s leading the development of a next-generation catheter-based heart pump to provide hemodynamic support during high-risk procedures and severe heart failure. Under his leadership, Supira has secured FDA Breakthrough Device Designation, raised a $120 million Series E, and launched clinical evaluations in the U.S. and South America.
When it comes to M&A, “Don’t go on a fishing expedition,” Salunke says. In other words, don’t chase deals, but have an end goal as early as possible. Ask yourself: What value will you create for strategics, investors, and physicians? That kind of clarity guides your company’s trajectory and ensures each milestone builds toward making the business acquisition-worthy.
“All strategics have their targets to watch,” Salunke explains. “You need to make incremental progress on that list, starting from the bottom and rising to the top.” To do that, he suggests:
Identifying the right strategic players early and keeping a running list
Regularly updating them on your progress — don’t wait until you’re ready to sell
Demonstrating execution confidence by consistently hitting milestones
By the time you’re ready for an acquisition, strategics should already know your story and believe in your trajectory.
Being ready for an acquisition isn’t just about your company — it’s about timing and alignment. “Just because you think you’re ready doesn’t mean the strategic is ready — and vice versa,” Salunke warns. That’s why he emphasizes calibration. Keep an open dialogue with potential acquirers to understand their priorities, product roadmaps, and acquisition strategies. “That way, they anticipate where you’re heading, you know what they’re expecting, and hopefully, there is synchronization,” he explains.