LiquidSMARTS

Call Website

LiquidSMARTS Empowering MedTech & Healthcare sales teams with training & strategies to dominate the market. Unleash your team's full potential. Let’s chat.

LiquidSMARTS – turning surprise into strategy, challenges into opportunities, and potential into performance. We are the catalyst for your next-generation transformation. We equip your team with tools to overcome challenges, promoting individual agency that ensures they are driving their roles, not being driven by them. LiquidSMARTS is dedicated to revitalizing your team and supercharging their performance. Our team of experts is committed to providing the knowledge, tools, and support necessary for individuals to succeed. Our approach is unique - we cater to individual learning needs while ensuring collective growth. Experience increased pipeline velocity as we help you sell more, faster. Ready for the intangible to become tangible?

10/16/2026

The ghosts get the headlines. The workflows get the returns.

MIT's Project NANDA reviewed more than 300 public AI initiatives in 2025 and reported that 95% of organizations were getting zero return from generative AI. The authors traced most failures to "brittle workflows, lack of contextual learning, and misalignment with day-to-day operations."

McKinsey tested 25 organizational attributes against reported EBIT impact. Redesigning workflows had the biggest effect of all 25. Only 21% of organizations using generative AI had fundamentally redesigned even some of their workflows.

Meanwhile the AI story keeps telling ghost stories: machine consciousness, digital salvation, and superintelligence from elsewhere. Serious people write those essays. The trouble starts when that language lands in a vendor deck and then in a commercial budget.

Before Monday:

1. List the 15 recurring tasks in a typical commercial week across reps, managers, and sales operations.
2. Write today's time, error rate, and owner next to each one.
3. Mark the tasks a model can draft.
4. Count how many AI-assisted decisions in your deal reviews carry one human name.

Issue 44 of The Boomerang, my LiquidSMARTS℠ newsletter, lands Monday, October 19, at 8 AM ET: "Ghosts, Angels, and Alien Life in Business." Subscribe from Issue 43 so it reaches you:
https://www.linkedin.com/pulse/werewolves-medtech-gunter-wessels-phd-mba-2j33e/

10/16/2026

Your clinical specialist knows the account better than you do, and you have never asked them what they know.

They are in the room at 6:40 in the morning when the first case starts. They know which surgeon trusts the product and which one tolerates it. They know the charge nurse who quietly swaps in the competitor's kit when nobody is watching. They heard the department chair complain about the budget in the hallway two weeks before you heard it in a meeting.

All of that lives in their head and in a text thread you are not on. Your CRM has the notes you wrote after your last lunch with the director.

You see them at the quarterly meeting and thank them for their support. Then you go back to forecasting the account from those lunch notes.

It is a strange arrangement when you say it out loud. The person who sees the account every week reports to someone else, gets paid on something else, and is never asked. The person who sees it once a month owns the number.

Most clinical specialists stopped volunteering years ago. They told a rep once that a deal was softer than it looked, watched it go into commit anyway, and learned that the information was unwelcome.

The fix costs nothing and almost nobody does it. Before the forecast call, ask them one question about each big account: what would surprise me here? Then write down the answer, especially when you dislike it.

Which of your accounts would look different through the eyes of the person who is there every Tuesday?

10/15/2026

Your team can explain every deal it lost and almost none of the deals it won.

Losses get a post-mortem. Someone asks what the competitor offered, who changed their mind, and where the deal turned. It hurts, so people pay attention.

Wins get a bell and a forecast update. The rep says the relationship was strong and the product fit, the manager nods, and everyone moves on before anyone asks the obvious question. Why did this customer pick us?

So the organization learns from the deals that went wrong and guesses about the ones that went right. The story about why you win becomes whatever sounds best at the kickoff. Usually the product. Sometimes the rep's personality. Rarely the thing the buyer actually said.

Ask a recent customer and the answer is often humbling. The competitor's rep stopped calling. Your implementation date was two weeks earlier. The CFO already knew your finance team from another deal. Small, specific, repeatable reasons, and nobody wrote them down.

Pick your last three wins. Call the person who signed and ask what almost made them choose someone else.

Which of your wins do you understand well enough to repeat on purpose?

10/14/2026

Your quota calendar is not your coverage calendar. Stop forecasting as if they were the same document.

Quota calendars assume control. Coverage and payment-model calendars do not. If a close date assumes a payment or coverage outcome the rep does not control, the number is a wish.

CMS RAPID is the design evidence, not a countdown. Under the proposed pathway, a National Coverage Determination can post the same day as FDA market authorization, with a final NCD goal of about 60 days for Class II devices and 90 days for Class III. Those are CMS goals, not guarantees. The commercial lesson is speed and separation: coverage can aim to move in days after authorization while deal reviews still move in quarters.

That gap is a commercial design problem.

Teach two calendars. Quota is what the team manages. Coverage is what the team hitches. Confusing them is how forecasts die quietly.

Payment-model calendars compound the same risk. Mandatory models and disease-track starts land on their own clocks. The field does not own those dates. The forecast still has to name them.

What to do this week:

1. In the opportunity review, flag every deal whose close date assumes a coverage or payment outcome the rep does not control. Separate those rows from controllable quota math.

2. Add a coverage-status field to the review: proposed, pending, final, or not applicable. Force a named status before the close date stays.

3. Ask each regional leader for the three largest deals hitching a coverage or payment change this half. Write the pathway owner next to each.

4. Build a one-page two-calendar brief for first-line managers: quota milestones on the left, coverage and payment milestones on the right.

5. Put pathway literacy into the deal review agenda as a standing item. Keep deadline alerts out of the hook and inside the operating rhythm.

Does the forecast teach two calendars, or does it dress a coverage wish as a quota plan?

10/13/2026

When the product clears and the U.S. launch is the job, boards hire operators, not more science theater.

A CEO change at commercial scale is a forecast event. Decision rights, spending discipline, and field focus move within a quarter.

Nyxoah is the evidence. The company appointed Liam Kelly as CEO effective October 1, succeeding Olivier Taelman. The board put U.S. growth at the center of the strategy and cited Kelly for scaling organizations and driving commercial performance after FDA approval and into U.S. commercialization.

That framing is the signal. The science got far enough. The remaining constraint is commercial scale.

If a counterpart's new CEO was hired to scale U.S. commercial performance, the open enterprise deals need a fresh read. The economic buyer may still sit in the same chair. The decision rights, the spending pace, and the proof standard often move within 30 days.

A new operator CEO is a re-qualification trigger.

What to do this week:

1. List every open enterprise deal where the economic buyer or CEO changed in the last 90 days. Mark each for re-qualification before the next QBR.

2. Ask who now owns budget authority for the category, not who owned it last quarter. Write the name on the opportunity record.

3. Rebuild the first five minutes of the next executive call around the operator mandate: scale, spending discipline, and field focus, in that order.

4. Pull any forecast row that assumed the prior leadership's buying rhythm. Reset the close date to a re-qualified decision path.

5. Brief the regional leaders on one sentence: operator CEO means re-qualify decision rights within 30 days, then prosecute.

Is the team treating the new operator CEO as gossip, or as a re-qualification event with owners and dates?

10/12/2026

The ruling is the hitch. The story is the work. Build the reimbursement narrative before payment flips.

Reimbursement is a sales motion. Pass-through status is a week-one sales system test, not a press release for market access.

Lantheus is the evidence. CMS granted Transitional Pass-Through payment status for PYLARIFY TruVu, with permanent HCPCS code A9613, enabling separate reimbursement in the hospital outpatient setting. The company says more than 900,000 patients have received a PYLARIFY PSMA PET scan since FDA approval in May 2021. That figure is theirs. The commercial point is who owned the field story before payment changed.

Week one after a pass-through ruling is when the IDN conversation converts or stalls. The account still has to fund the scan, staff the pathway, and defend it in VAC. Separate outpatient payment changes the room from interesting diagnostic to budgeted pathway.

One team walks in with the HCPCS, the outpatient payment story, and the one-page field narrative already written. The other team is still explaining what pass-through means while the calendar moves.

Stop waiting for the ruling to write the field story. Pre-build the one-pager for every VAC-sensitive deal, then hitch the ruling when it lands.

What to do this week:

1. Pick one open deal whose close this quarter depends on a reimbursement decision. Write the one-page outpatient payment narrative before the next VAC.

2. Put the effective date, the HCPCS code, and the separate-payment claim on the first page of the field brief. No appendix burial.

3. Ask the market-access lead which three accounts already have a budgeted pathway story and which three are still waiting for clarity.

4. Role-play the first five minutes of the IDN call: payment pathway first, clinical claim second.

5. Put recent reimbursement decisions on this week's opportunity review. Flag any forecast that still assumes the old bundled conversation.

Did the team rehearse the payment narrative before the ruling, or is the story still being written after payment flipped?

10/05/2026

Medicare put a number on the lab cut: up to 15% per test, starting January 1. ACLA counts 775 tests at the full 15% in 2027.

CMS posted preliminary 2027 Clinical Laboratory Fee Schedule rates on September 21. It says Medicare has paid about 16% more for lab services than private payors, and it expects to save about $1 billion a year.

By law, a test's payment can drop at most 15% a year through 2029, so CMS will phase the cuts in.

ACLA, the lab trade group, counts cuts on almost 1,200 tests and says the rates rest on data from 2% of labs.

The dates are tight. Comments close October 21. Final rates come in November and take effect January 1. CMS says it will price tests that had no private-payor data in early October, with their own 30-day comment window.

Now the commercial read. A lab that earns less per test looks for savings in what it buys. I'd expect that pressure to reach reagent, instrument, and outreach lab contracts in Q1 budgets.

And the cuts may slip. TD Cowen, as reported by MedTech Dive, sees Congress as most likely to "punt" the 2027 cuts. The House is out until after the November midterms.

So plan for both outcomes. A team that bets on the delay gets surprised in January. A team that bets on the cut gives away price too early.

What to do this week:

1. List every open deal whose customer runs a Medicare-heavy outreach lab. Re-check each January 1 close assumption.

2. Build two Q1 forecasts: one where the cuts land January 1 and one where Congress delays them. Walk your CFO through the gap.

3. Write your price-defense story before the November final. Put cost per reportable result in the customer's own numbers.

4. Ask your top five lab customers which tests on their menu face the full 15% cut in 2027.

5. Put October 21 and the early October pricing notice on your account review calendar.

Is your Q1 forecast built on the cuts landing, or on Congress delaying them?

10/02/2026

Software now sits on both sides of the claim, and your rep sees the result first: a case that stalls with no clear reason.

Payers use it to review prior authorization. Providers use it to code and bill. Your device sits in the middle.

The regulator said so out loud. On September 23, CMS Administrator Mehmet Oz said, "Short term, AI is going to be inflationary because it's going to turbocharge the ability of the current billing systems to work more effectively."

Traditional Medicare now runs the review side too. Since January, CMS's WISeR model has used technology companies, with AI and clinician review, to screen prior authorization in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. CMS pays them a share of the spending they avert. The service list reads like a device catalog: nerve stimulator implants, vertebral augmentation, cervical fusion, and skin substitutes.

And the clock keeps running. Starting January 1, 2027, most payers under CMS's prior authorization rule, including Medicare Advantage plans, must answer requests through an electronic interface. Since this year, they already owe a specific reason for every denial.

You know the forecast call. A case slips three weeks, and the CRM note says "scheduling." Nobody asks whether a prior authorization sat in a queue.

So treat field reimbursement as part of selling. A denial is clinical, coverage, or administrative, and each one has a different owner and a different fix. The administrative kind is usually the fastest to fix, and it is the one your CRM files under "scheduling."

What to do this week:

Ask every rep to tag each case that stalled in the last 60 days as clinical, coverage, or administrative. Count the administrative ones.

If you sell in any of the six WISeR states, check your codes against the list in CMS's WISeR operational guide.

Ask the revenue cycle leader at each of your top five accounts which payers changed their review process this year.

Name the person who answers prior authorization questions on a new account's first cases, and give that person the tags from step 1.

Add a denial-type field to your forecast, so every stalled case carries a reason and an owner.

Two teams see the same stalled case. One writes "scheduling" and waits for the quarter to end. The other tags it administrative, fixes the paperwork, and books the case.

When a case stalls in your forecast, who on your team knows why?

MedTechSales

10/01/2026

You are paying for something you did not do, in accounts you did not lose, to people who have never met you.

The rep before you overpromised in three places. One install went sideways. Somebody sent an invoice that did not match what was said in the room. All of it happened before your badge worked.

Nobody tells you this on day one. You find it in the temperature. The scheduler who does not call back. The director who takes the meeting and keeps their coat on. The account that your CRM says is warm and your gut says is finished.

Your manager's version is that you get a clean slate. That is a generous thing to say and it is not true. The slate belongs to the customer, and they have not wiped it.

So you do the natural thing, which is to work harder and be more likeable, and it moves nothing. Charm does not settle a debt. It reads as the same charm they heard last time, which is the worst possible association.

The only move that has ever worked here is to name it before they do. Say the thing your predecessor said. Say what actually happened. Say what you will do differently and then be boring about doing it, for longer than feels necessary.

You will hate the first of those meetings. They are short and cold and you will drive away replaying it. That meeting is the whole repair.

Which account are you still treating as cold when it is actually holding a grudge?

WhatIsAlreadyInTheRoom

09/27/2026

BD and Wellstar put pharmacy-to-bedside medication management on one connected path: Pyxis Pro, Alaris, and Incada analytics.

That is not a cabinet announcement. It is a stack announcement.

Hospital buyers still sit through feature demos. The veto often shows up later as missing doses, waste they cannot explain, and labor spent hunting inventory instead of treating patients. A dispensing box that cannot talk to infusion and inventory truth loses to a system that can.

Sit with that. If your commercial story stops at "smart cabinet," you are selling last year's proof. The proof that clears pharmacy, nursing, and finance is availability you can see, waste you can name, and a workflow that survives a Tuesday night surge.

I have been in rooms where the clinical champion loved the UI and the pharmacy director asked one question: will this cut the calls about stockouts. The deal lived or died on that answer.

Connected medication management is an account strategy problem. Own the path from central pharmacy to the bedside, or watch a competitor own the narrative of "we made the floor calmer."

What to do this week:
Map one target health system as a med stack: dispensing, infusion, EMR handoffs, inventory visibility. Mark the broken joint.
Rewrite your proof slide around availability and waste language a pharmacy director already uses. Drop three feature bullets to make room.
Ask nursing and pharmacy the same question in separate meetings: what burns an hour on a bad day. Compare the answers before your next demo.
For installed-base accounts, write the switching-cost paragraph before a competitor arrives with a "connected" pitch.

Are you selling a cabinet, or selling a quieter floor?

MedTech

Address

9206 Crystal Brook Drive
Apison, TN
37302

Opening Hours

Monday 8am - 4:45pm
Tuesday 7am - 2pm
Wednesday 7am - 2pm
Thursday 9am - 4pm
Friday 9am - 4pm

Telephone

+14237024001

Website

Alerts

Be the first to know and let us send you an email when LiquidSMARTS posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Shortcuts

Sponsored

Share

Category