You have said it before. “We are looking at the US in the next 12 to 18 months.” Your board has heard it. Your investors have heard it. And every year, something gets in the way. A new NHS contract. A funding round. A hiring freeze. A general election. But here is the thing: the US market is not waiting for you to feel ready. And in 2026, the cost of that delay is no longer abstract.
We work with UK and European HealthTech companies every day, and the pattern is remarkably consistent. The ambition is there. The product is strong. The clinical evidence is real. What keeps companies stuck is not capability. It is the belief that there is a better moment coming. There is not. The better moment is now, and here is why.
This is not just a big market. It is a different kind of market.
When UK HealthTech leaders talk about the US, they usually know it is large. What they often underestimate is the structural difference in how money moves through it. The US does not have one buyer. It has thousands. Private health systems, insurers, employer-funded plans, and federal programmes all operate independently, all with their own budgets, and all actively seeking technology that helps them deliver care more efficiently and at lower cost.
US healthcare spending hit $5.3 trillion in 2024, growing 7.2% year on year, and is projected to reach $5.9 trillion in 2026. That is not a static pool of money waiting to be allocated. It is a system under enormous pressure, spending aggressively on solutions. For a UK HealthTech company with a proven product, that pressure is your commercial opportunity.
The problems you have been solving inside the NHS, workforce strain, administrative overload, clinical burnout, the need to do more with less, are the same problems US health systems are paying significant sums to fix right now. The difference is that in the US, they pay considerably more, the sales cycle for the right solution can be faster, and a single health system contract can be worth multiples of what a comparable NHS deal would generate. That is not an exaggeration. That is the reality of a privatised healthcare market of 340 million people.
The money is already moving. The question is whether you are in the room.
The timing matters because the US digital health investment environment has shifted meaningfully over the past 12 months. US digital health startups raised $14.2 billion in 2025, the highest total since 2022 and a 35% jump on the prior year, according to Rock Health. AI-enabled companies captured 54% of all that funding. The companies raising the largest rounds are not the ones with the most polished decks. They are the ones already in the US, already building relationships with health systems, and already generating real-world data.
That last point matters more than most people realise. Investors in this space are not funding potential. They are funding traction. And US traction, even early-stage, carries disproportionate weight in a fundraise. If you are planning to raise your next round and the US is on your roadmap, being able to show you are already there, even with one hire and one customer conversation underway, changes the entire conversation with investors.
Your peers are not waiting for the perfect moment. Neither should you.
This is not a trend that is coming. It is already happening, and it is happening with UK companies not unlike yours.
ABHI’s US Accelerator has helped over 150 UK HealthTech companies enter the US market across eight cohort years. Companies like Skin Analytics, Peppy, and Radar Healthcare did not wait until they felt completely ready. They started, learned the market with support around them, and built from there. None of them would tell you the timing was perfect. All of them would tell you it was worth it.
At the investor level, the signal is equally clear. In 2025, Meridian Health Ventures launched the world’s first transatlantic HealthTech fund, backed by UCLH, Guy’s and St Thomas’, and Cedars-Sinai in the US, with the explicit goal of ensuring UK innovations scale into the US rather than just get invented here. That is a structural acknowledgement, at the highest level, that the transatlantic opportunity for UK HealthTech is real and that the time to act on it is now.
Let the numbers speak for themselves.
Sometimes it helps to see it laid out plainly. Here is the state of the US healthcare and digital health market right now:
- US healthcare spending reached $5.3 trillion in 2024, growing 7.2% year on year, and accounts for 18% of the entire US economy
- The US digital health market is projected to grow from $106 billion in 2026 to $266 billion by 2035, at an 11% compound annual growth rate
- US digital health startups raised $14.2 billion in 2025, a 35% increase on 2024 and the highest total since 2022
- AI-enabled digital health companies captured 54% of all US digital health funding in 2025, raising 19% larger rounds on average than non-AI companies
- UK HealthTech investment hit $1.8 billion in Q1 2025 alone, making it the UK’s fastest-growing venture capital sector
- Over 150 UK HealthTech companies have already entered the US market through ABHI’s accelerator programme alone
The opportunity is not theoretical. The capital is not theoretical. The only thing that remains theoretical is your US expansion, and 2026 is the year to change that.
Your NHS track record travels. But not the way you think.
Here is something we see consistently with the UK companies we work with. They arrive in the US with genuinely impressive clinical evidence, often built across multiple NHS trusts, and they expect it to do the same work it does at home. It does not. Not because it is not impressive, but because US buyers speak a different commercial language.
A US value analysis committee does not want to know how many NHS trusts you work with. They want to know your ROI per bed, your reduction in clinician hours per week, and whether you have a reimbursement pathway. That translation, from NHS validation to US commercial proof, is one of the most important things to get right before you start knocking on doors. The companies that get it right move quickly. The ones that do not end up spending 18 months in pilots that go nowhere, wondering what went wrong.
This is not a criticism of UK companies. It is a reality of operating in a market built on different commercial logic. And it is entirely navigable, with the right guidance around you.
You do not need to boil the ocean to get started.
This is where most companies overthink it. You do not need a US office. You do not need a full sales team in place. You do not even need a US legal entity to hire your first person on the ground.
Through an Employer of Record service, you can hire a US-based employee compliantly, with local payroll, benefits, and tax obligations fully handled, without setting up a US entity at all. For many international HealthTech companies, this is the smartest first move: get someone with market knowledge on the ground, start building relationships, and learn what US buyers actually respond to before committing to a full infrastructure. When the business justifies it, setting up a US entity is a straightforward next step.
The right partner makes the difference between getting stuck and getting it right.
US expansion has a lot of moving parts. Employment law that varies by state. Payroll obligations that look nothing like the UK. Benefits expectations that will surprise you. Banking, tax registration, entity structure choices that have long-term implications. Most HealthTech founders are experts in their product and their market. They are not experts in US HR compliance, and they should not have to be.
This is exactly where Foothold America comes in. We are not a generic international expansion firm. We are specialists in helping UK and European companies build a compliant, operational US presence from the ground up.
We handle entity setup, Employer of Record hiring, payroll, HR compliance, bookkeeping, and talent acquisition, so that your leadership team can stay focused on the commercial opportunity rather than the administrative complexity of entering a new market.
We have done this with hundreds of international companies. We know where things go wrong, we know how to move quickly, and we know the difference between the advice that sounds right and the advice that actually works in practice.
If you are serious about the US in 2026, having a partner who has been there before is not a luxury. It is the thing that determines whether you gain traction or spend two years and significant money finding out what we could have told you on day one.
2026 is not early. But it is not too late.
The window is open. The capital is there. The appetite from US health systems for what UK HealthTech is building is genuine. What changes in 2026 is not the opportunity. It is how many of your competitors will have already walked through the door.
The most common thing we hear from UK HealthTech founders who have successfully launched in the US is not that it was harder than expected. It is that they wish they had started sooner.
If you are ready to have a real conversation about what this looks like for your company, visit footholdamerica.com or get in touch with our UK team directly.
Foothold America is a UK-based US expansion specialist helping international businesses, primarily from the UK and Europe, hire, operate and grow in the United States. Services include US entity setup, Employer of Record, PEO+ Cross-Border Support, talent acquisition, and Cultural Intelligence Advisory.
