Enquirer Consulting Group

Reachable Buyer Map: the US

Prepared for Beth Rogozinski · Oncoustics · August 2026
Software that turns an existing ultrasound probe into a liver assessment has two buyers who almost never share a budget: the clinician who wants a better answer at the bedside, and the organization carrying the risk for a population that is being diagnosed too late. The clinical buyer is reachable through conferences and clinical networks. The risk owner is not. This map covers where both sit in the US market, who signs, and roughly how many there are. It describes the market rather than your business, and there is nothing to buy at the end of it.
Health systems and hospitals
The obvious segment and the slowest one, because the decision is made at the system rather than at the site, and a new diagnostic route has to pass a value analysis committee before a clinician can use it. Large when it lands, and it lands on a committee calendar rather than on a clinical one.
Who signs: the chief medical officer, the service line chief for gastroenterology or hepatology, the director of imaging, the VP of clinical operations, and the value analysis committee.
6,000 to 6,200
US hospitals, held inside roughly 400 to 700 systems; the system is the buying seat, not the hospital
Community health centers and safety net clinics
The largest concentration of undiagnosed liver disease in the country and the least imaging capacity to find it. Every one of these organizations is publicly listed with a named clinical leader, and almost none of them appear at the meetings where diagnostic partnerships get discussed. Underworked because it is unfashionable, not because it is unqualified.
Who signs: the chief medical officer, the chief operating officer, the quality or population health director, and the grants lead where the funding route matters.
1,300 to 1,500
grantee organizations operating roughly 15,000 delivery sites between them
Risk-bearing primary care and accountable care groups
The segment that buys earlier detection as a financial argument rather than a clinical one, because it holds the downstream cost of a late diagnosis. Faster to a decision than a hospital system and reached by a completely different message, aimed at a completely different job title.
Who signs: the chief medical officer, the population health director, the quality lead, the network medical director.
400 to 500
organizations in the national shared savings program, plus a wider private risk layer that no single public list covers
Gastroenterology and hepatology groups
The clinical champion layer. Independent groups and investor-backed platforms buy quickly when the clinical argument holds, and a platform decision carries dozens of sites at once. This is the segment a clinical network of any kind reaches first, which is exactly why the growth usually sits elsewhere.
Who signs: the managing partner, the medical director, the practice administrator, and at platform groups the chief medical officer.
15,000 to 18,000
practicing gastroenterologists nationally, concentrated into a few hundred large groups and platform practices
Outpatient imaging and mobile ultrasound operators
Volume businesses that already own the hardware and sell throughput, so the argument is capacity rather than capital. Consolidated ownership means a small number of decisions reach a large number of locations.
Who signs: the chief operating officer, the medical director, the head of clinical operations, the director of ultrasound services.
5,000 to 7,000
outpatient imaging locations under roughly 500 to 800 operators
Life sciences programs in liver disease
Small in count, unusually large in scope when one lands, and the segment where a screening route is worth more to the sponsor than to the site. Stated plainly: no public register lists which companies have an active liver program and who owns diagnostics inside it, so this group is identified program by program from trial listings and company disclosures.
Who signs: the head of clinical development, the medical affairs lead, the diagnostics partnering or business development lead.
No single public register
identified one program at a time; the difficulty is the reason the segment stays open

Where the openings are

1
The hardware is already in the room. Where a point of care probe already exists, the constraint is the read and the confidence in it, not capital. That turns the first conversation into a throughput question with a clinical leader rather than a capital request with a committee, and it means the reachable market is defined by who owns the workflow, not by who has budget for a device.
2
Two buyers, two arguments, two lists. The clinical champion argues from the patient in front of them. The risk owner argues from the population found late. Those are different seats, different words and different months, and typically only the first is reachable through a clinical channel. Building the second list is the gap.
3
The safety net is the largest version of the problem and the easiest to name. 1,300 to 1,500 organizations, publicly listed, each with a named clinical leader and a documented population. They are rarely competed for by anyone arriving through conference halls, which is precisely why they stay unreached.
Built from public registries covering hospitals and systems, federally supported health centers, shared savings participants and clinician counts, counts banded deliberately. Ownership and affiliation change faster than any register updates, sites are not organizations, and life sciences programs are not enumerated anywhere public, so that line is described rather than counted.
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