Running a Value Review When No Baseline Was Set

A strategic account manager gets asked to run a value review for a health system that never agreed on a baseline before the device went live. The finance lead wants a single number that proves the program paid for itself. That number does not exist, because nobody defined what to measure before the rollout started. You can still hold a useful meeting. You just cannot let it turn into a fabricated return on investment claim.

Why this conversation goes wrong

This conversation goes wrong for a simple reason. Everyone in the room wants a verdict, and a verdict without a baseline is not available. The meeting usually gets scheduled months after the device went live, often because an executive at the health system needs a value story for their own leadership review. You feel pressure to deliver something clean, partly because the deal team promised value at close and partly because the meeting is labeled a value review, so silence feels like failure.

Two bad instincts show up here. The first is refusing to hold the meeting at all, or filling it with disclaimers until nobody learns anything. That reads as avoidance and stalls the account. The second is worse. You stretch thin or unverified data into a confident number because the room wants one. That number becomes the customer's reference point. When their own analyst checks it against a system you never had access to, the mismatch lands on you, not on the whoever skipped the baseline months earlier.

This pattern shows up often enough in medical device accounts that it is worth rehearsing before you walk into a real one. DealSpeak's Medical Devices practice conversations cover this scenario alongside others tied to committee reviews and capital cycles, so you can find your footing before a finance lead is asking you the question live.

How to prepare

Preparation determines whether this meeting produces something useful or turns into an argument about an unanswerable question. Before you sit down with the finance lead, build a simple data map for yourself. Write down the specific question leadership needs answered, not a general one like whether the program paid off, but something narrower like whether average procedure time changed on this device line in the third quarter. For each question, note which system would hold the answer, who owns access to that system, whether that owner has approved use of the data for this review, and what limitation applies if the data is incomplete or was never collected in a structured way.

This exercise usually reveals that finance and clinical operations are not tracking the same things, and that neither team can hand you what you need on their own. If clinical workflow data sits in a system finance cannot see, bring the clinical analytics lead or the service line owner into the meeting rather than relaying secondhand numbers you cannot stand behind. That one move keeps you from interpreting someone else's data without the authority to do so, and it puts the actual owner in the room when questions get specific.

The same discipline matters earlier in the deal too, back when a capital purchase is still moving through committee and nobody has agreed yet on what evidence will count later. Read Keeping a Capital Evaluation Moving Across a Budget Cycle for a fuller look at holding that structure across a long approval cycle, so the value review does not become the first time anyone talked about measurement.

What to say

The finance lead opens with the direct version of this question. She says, "Can you show me that this program has paid for itself."

You do not hedge, and you do not answer with a number you made up to fill the silence. You say, "I cannot make that claim without data the customer has approved and a measure we agreed on ahead of time. What I can do is help us figure out what we actually know right now. Can you tell me the specific question your leadership is asking, so we know what evidence would actually answer it."

She says leadership wants a number by the end of the quarter, something that shows the device reduced cost per case. You say, "That is answerable if the right data exists and someone has approved us using it. Procedure time and supply cost per case usually live in different systems, one your team owns and one that sits with clinical operations or the service line. Let's identify the owner of each, confirm what period they can actually validate, and agree on what we can responsibly report by that deadline. If the full comparison is not available yet, we can still tell leadership what we found, what we are missing, and how to close that gap starting now."

She pushes once more. "That is not the strong story I was hoping to bring back." You say, "I understand that, and I would rather give you something smaller that holds up than a big number that falls apart the first time someone checks it. A partial answer with a clear plan protects your credibility with your own leadership more than an unverified claim does. Let's give them both pieces together."

Mistakes to avoid

A few mistakes show up again and again in this conversation.

1. Agreeing to a return on investment number before confirming a named data owner has approved the underlying data. A verbal nod from one contact is not the same as an approved data set.
2. Treating an observed workflow change, such as staff saying a task feels faster, as a financial conclusion. That observation might be true and still not be evidence you can put a number behind.
3. Letting the meeting end without naming who owns each data source. If you leave without a name attached to each system, the follow up work has no owner and it stalls within a week.
4. Promising a full baseline retroactively. You cannot manufacture historical data that nobody collected. Say that plainly, then pivot to what a baseline could look like going forward.
5. Softening the message so much that the customer walks away thinking you have nothing useful to offer. A limited but honest assessment, with named owners and a next step, is still a real deliverable.

How to practice and score it

This conversation is worth rehearsing before the real meeting, because the moment someone asks for a number, it is tempting to give them one just to keep things moving. Run through it with your manager or with DealSpeak, and have them play a finance lead who keeps pushing for a clean figure by a fixed deadline. Score yourself on three things. Did you name the missing baseline plainly instead of talking around it. Did you land on a specific next step, such as a named data owner or a defined period to validate, before the meeting ended. Did you avoid stating any number or conclusion the customer had not approved.

A manager reviewing this practice should watch closely for the moment you feel pressure to fill silence with a guess. That is where deals get into trouble later, when a number said informally in a review gets repeated in an internal email and then treated as settled fact. Once you have a rhythm for holding this line, look at how the same discipline applies in committee settings, where several stakeholders track different pieces of evidence over months. Using a Decision Log During a Capital Equipment Evaluation shows how to keep that evidence organized so a future value review does not start from zero again.

A value review without a baseline is not a failed meeting. It is a chance to set up the real one. Handle it by naming what is missing, assigning an owner to each gap, and agreeing on what can actually be measured from here.

You can rehearse this exact conversation in the Medical Devices practice conversations library before it happens for real. When you have this one down, read Keeping a Capital Evaluation Moving Across a Budget Cycle next.