78: HealthTech Hour with Steve Roest and guest Demi Radeva78: HealthTech Hour with Steve Roest and guest Demi Radeva
UK Health Radio Podcast
Steve Roost talks with Demi Radeva about how UK health tech companies can enter the US market, focusing on payers, incentives and rapid return on investment. The conversation compares UK and US systems, highlights the role of evidence, and offers straightforward advice for founders aiming to scale internationally.
49:21•9 Jun 2026
From NHS to USA: How UK Health Tech Can Truly Take Off
Episode Overview
- There is no perfect health system; each country makes different trade-offs about cost, access and what is socially acceptable.
- US healthcare has over 1,100 decision-making bodies, creating huge complexity but also many routes to a ‘yes’ for new technology.
- Prevention is often underfunded because of the ‘wrong pocket problem’, so founders must show clear, rapid financial returns.
- UK health tech companies tend to have strong evidence, but they still need deep customer discovery and a clear path to payment to succeed.
- Technologies that help payers make or protect revenue are prioritised over those that focus only on cost savings.
“There’s really no perfect health system, and there’s no right health system or wrong health system, but there’s a series of trade-offs that we have to make as a society.”
Ever wondered what it takes to get a UK health tech idea off the ground in the United States? This conversation on HealthTech Hour lays it all out, with plenty of real-world stories and a few gentle reality checks. Host Steve Roost chats with Demi Radeva, CEO and Chief Strategist at Akros Advisory, who has spent almost 20 years working inside health systems in both Europe and the US.
Born in Bulgaria, educated in finance and health economics, and experienced at one of the largest US payers, she brings a rare, cross-border view of how healthcare actually gets paid for.
As she puts it, “there’s really no perfect health system… but there’s a series of trade-offs that we have to make as a society.” You’ll hear Demi unpack what a “payer” really is, why the US has “over 1,100 decision-making bodies”, and how that level of fragmentation is both a nightmare and a massive opportunity for digital health founders.
She explains concepts like the “wrong pocket problem”, why prevention can be such a hard sell, and why return on investment needs to show up in “three to six months” for many US buyers. A big chunk of the chat focuses on practical advice for UK health tech founders: how to think about billing codes, why “follow the money” is more than a cliché, and how programme budgets and pilots with payers can open doors.
Demi also praises UK companies for their strong evidence base and university partnerships, but nudges them to get far closer to customers and incentives before blaming slow adoption.
The episode ends on a personal note, with Demi sharing the simple mantra that keeps her going through uncertainty: “just keep swimming.” For anyone building health innovations, or just curious why healthcare feels so complex, this is a grounded, jargon-busting listen that might change how you see both the NHS and the US system. What might your own idea look like if you started by following the money?
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