What’s Missing from Most Medtech Innovation Growth Strategies

By Ryan McGuinness, Chief Growth Officer, Triple Ring

The challenge facing medtech and life sciences leaders today isn’t a lack of innovation ambition — it’s a structural gap in how innovation portfolios are designed and resourced. Despite unprecedented technological opportunity, many organizations struggle to translate promising ideas into sustained medtech innovation growth.

I recently had the opportunity to moderate a panel discussion with a group of experienced operators and advisors spanning corporate innovation, venture creation, finance, and law: Joe Heanue, Co-Founder & CEO of Triple Ring; Francois Valencony, Chief Investment & Business Officer at General Inception; John Pennett, Partner-in-Charge of the Technology & Life Sciences Practice at Eisner Advisory Group LLC; and Stephen Thau, Partner and Co-Head of Life Sciences at Orrick.

What stood out most from the conversation was not disagreement, but alignment. Across very different vantage points, a consistent theme emerged: many medtech organizations are unintentionally underinvesting in the part of the innovation lifecycle that matters most for durable growth.

The structural drag on medtech innovation growth

Short-term pressure is often framed as a cultural or leadership problem. In reality, it is largely structural.

Quarterly reporting expectations, annual budgeting cycles, and P&L accountability all create powerful incentives to favor initiatives with near-term impact. These incentives are rational — but they shape innovation behavior in ways that are increasingly misaligned with how value is created in modern medtech.
External research reinforces this dynamic. Organizations such as FCLTGlobal have shown that companies overly focused on short-term performance tend to underperform over time in revenue growth, innovation output, and shareholder value compared with peers that balance near- and long-term investment horizons.

In innovation-intensive sectors like medtech, this imbalance is especially costly.

The hollowed-out middle of innovation portfolios

Most innovation portfolios today are weighted toward two extremes:
Near-term programs (12–18 months) that extend existing platforms, defend share, or meet immediate customer needs.
Long-term bets often pursued through large acquisitions or moonshot internal programs, aimed at 5–10 year horizons.

What gets squeezed out is the mid-term window — typically 2–5 years — where technologies mature from early feasibility into scalable, commercially relevant platforms.

As Joe Heanue, Co-Founder & CEO of Triple Ring, observed during the discussion, publicly traded medtech companies face intense pressure to sustain growth, yet have limited freedom to invest capital outside the P&L. The result is that mid-term innovation, while strategically critical, is often the first to be deferred. This is a problem not of intent, but of portfolio design.

Why the venture ecosystem no longer fills the gap

Historically, many corporates relied on venture-backed startups to populate this mid-term layer. That assumption is becoming less reliable.
Venture capital has shifted meaningfully over the past several years. Larger funds increasingly deploy capital later in company lifecycles, requiring more validation and larger checks. At the same time, early-stage capital is often concentrated in venture creation and studio models, where opportunities are incubated internally rather than broadly distributed.

From his vantage point building companies, Francois Valencony of General Inception highlighted that early teams frequently need not just financing, but hands-on operational support to reach meaningful inflection points. The traditional venture pipeline does not consistently provide that support at the scale or timing corporates require. The consequence is a widening gap between what corporates need to acquire and what the market is producing.

Patterns that help counterbalance the gap

Despite these headwinds, the panel surfaced several recurring patterns that have proven effective in restoring balance to innovation portfolios.

Semi-autonomous innovation programs

Programs that are structurally separated from core business units — with dedicated governance, milestones, and funding — are better able to sustain mid-term focus without being constantly pulled back into near-term priorities.

Build-to-buy and option-to-acquire structures

Rather than waiting for fully mature assets or shouldering all risk internally, some organizations are co-developing technologies with the option to acquire upon predefined success milestones. These structures allow risk to be shared while preserving strategic alignment.

Shared-risk financing approaches

Blended models that incorporate third-party capital, structured debt, or non-dilutive funding can advance programs without placing disproportionate strain on operating budgets.

As Stephen Thau, Partner and Co-Head of Life Sciences at Orrick, noted, these shared-risk arrangements are becoming more prevalent as corporates seek flexibility in uncertain regulatory and market environments.

One practical pattern in action

One pattern that reflects many of these principles is the use of semi-autonomous innovation labs designed explicitly to address mid-term growth challenges.

In this approach, innovation programs are intentionally shielded from quarterly P&L pressure while remaining closely aligned with corporate strategy. Success criteria are defined upfront, governance is structured to avoid unintended control consequences, and capital is deployed in a way that preserves optionality.

Models like this — including the Corporate Growth Lab approach practiced at Triple Ring — demonstrate that it is possible to counteract short-term structural pressure without sacrificing discipline or accountability. Importantly, this is not a single prescribed solution, but an example of how thoughtful operating design can unlock stalled innovation horizons.

Execution risks leaders must address

While these models are promising, they introduce real complexity that must be managed deliberately.

Governance:

Joint steering committees and oversight structures must be designed carefully to avoid unintended control, accounting, or disclosure implications.
Accounting and tax:

As John Pennett of Eisner Advisory Group emphasized, collaboration, equity, and financing arrangements each carry distinct balance sheet and tax consequences — particularly for public companies.

Unwind scenarios:
Not all programs result in acquisition. Clear agreements around IP ownership, data rights, talent, and residual value are essential from the outset.
Successful management of these risks is often the determining factor in creating a true strategic asset and avoiding a stalled program.   

Questions innovation leaders should be asking now

For leaders responsible for shaping innovation strategy, a few questions are worth pressure-testing:

-Does our innovation portfolio meaningfully invest in the 2–5 year horizon?
-Are mid-term programs protected from short-term performance pressures?
-Do our success metrics reflect commercial readiness, not just technical or regulatory milestones?
-Have we planned explicitly for governance and unwind scenarios?
-Are incentives aligned across internal teams and external partners?
-Do we have the right resources, network, and talent to consider creative approaches?

Answering these questions honestly often reveals that the biggest constraints on medtech innovation growth are not technological, but structural.

The bottom line

Medtech is entering a period of extraordinary technological convergence — across software, data, biology, and devices. Organizations that succeed will be those that design innovation systems capable of absorbing this complexity over time.

What’s missing from many innovation strategies is not vision, but a deliberate commitment to the mid-term horizon where differentiation is built. Addressing that gap requires intentional portfolio design, thoughtful operating models, and a willingness to challenge structures that prioritize short-term certainty over long-term advantage.

Get in touch with us to learn more about how Triple Ring can help with your mid-term innovation strategy.