Negotiating Radiation Oncology Capital With the Vendor

 

How capital and service negotiations are structured before the program arrives at the table.

 

Medsolve Dynamics prepares oncology programs for capital and service negotiations, built on twenty years spent structuring those agreements from the vendor side.

 

Short field notes, recorded as they came up. Newest first.

 

 

Sixteen Months of Ordinary Course

August 12, 2026 · Listen

The radiopharmaceutical supply chain consolidated on paper on August 3, 2026, when Curium and Lantheus signed a definitive merger agreement. Yoel Bakas on why the period between signing and closing, an outside date of May 2, 2027, with extensions capped at November 30, is the only window in which a supplier has a structural reason to give you terms, and what to ask for while it is open. From Medsolve Dynamics.

 

The Half-Million-Dollar Anchor

August 10, 2026 · Listen

A radiation oncology capital price that has not moved in twenty years. Onboard imaging, arc delivery, the next iteration of arc delivery, a couch upgrade, all half a million dollars. The same couch is $250,000 on the older platform and half a million on the new one. Yoel Bakas spent two decades on the vendor side handing programs that number, and explains what it actually is: an anchor set to shape your budget before you have built the case for the purchase. Covered: how anchor pricing differs from cost-based pricing, why the number is self-reinforcing, what belongs in a one-page business case for a capital add-on, and how to arrive at a vendor meeting with your own number instead of theirs. Medsolve Dynamics, capital strategy, financial strategy, revenue and margin growth, and AI reality checks for oncology programs.

 

What Every New Radiation Oncology Administrator Should Know Before Their First Vendor Meeting

June 19, 2026 · Listen

Your first capital negotiation is against someone who runs forty a year. This explains where the vendor puts the leverage and how a new administrator levels the field. New administrator, capital negotiation, vendor meeting, supervision coverage, radiation oncology.

 

Why a Discount Off List Is Not a Number You Can Trust in Radiation Oncology Capital

June 17, 2026 · Listen

A percentage off a list price the vendor set themselves tells you very little. This explains why the value package matters more than the discount in a LINAC capital negotiation, and what a program should structure for instead. Capital strategy, vendor quote, service contract, radiation oncology.

 

After 20 Years Selling LINACs, This Is What I Saw From The Vendor Side

May 7, 2026 · Listen

A moment from the AMAC Spring Symposium 2026 talk on the day I told a room of oncology administrators that I have watched programs lose margin on contracts I helped sell them. Plus the 17-year ROI case study.

 

I Loved Selling Bundles: 20 Years On The Vendor Side Of LINAC Capital

April 28, 2026 · Listen

The economic case for a LINAC purchase rarely fails at signature. It fails in years two through eight, when the bundled add-ons start collecting service contracts and software renewals. After 20 years on the vendor side, here is what the inside of that conversation looks like, and why bundles are designed exactly this way.

 

Negotiating Inside a Structure the Vendor Built Before You Arrived

April 23, 2026 · Listen

Most oncology capital and service negotiations are decided before anyone sits down. Vendor teams map your budget range, rehearse responses to your objections, and identify pricing flexibility they never surface unless you ask the right way. Yoel Bakas spent 20+ years on the vendor side of those conversations at Varian, GE HealthCare, ViewRay, and Mevion before founding Medsolve Dynamics. In this short, he lays out what actually happens in the prep call two days before your meeting, and why harder negotiating rarely changes the outcome. Medsolve Dynamics is a vendor-neutral oncology consulting firm built for programs navigating margin pressure, capital scrutiny, and AI overload.

 

Preparation and Anticipation in Vendor Negotiations

April 8, 2026 · Listen

Preparation and Anticipation in Negotiations.

• Preparation is key.

• Anticipate objections.

 

Getting beyond price in vendor negotiations.

March 26, 2026 · Listen

In the context of radiation oncology capital conversations, the focus on price often overshadows other critical factors such as service coverage, software license terms, training, and delivery timelines. Vendors have already modeled the price negotiation and have a floor in mind, leading to a conversation that stays within their designed model.

• Price conversation overshadows critical factors.

• Vendors have already modeled price negotiation.

 

The asymmetry in sales conversations and the need for program leaders to have support.

March 24, 2026 · Listen

The conversation delves into the asymmetry in sales conversations, the structural information asymmetry, and the need for program leaders to have support when navigating major capital decisions or service contract renewals.

• Sales conversations are characterized by asymmetry.

• Program leaders need support in major decisions.

 

The importance of defining success and the problem before engaging in pricing discussions.

March 17, 2026 · Listen

The conversation delves into the misconceptions and limitations of requesting a quote from a vendor, highlighting the importance of defining success and the problem before engaging in pricing discussions.

• Vendor perspective.

• Importance of defining success.

 

Misconceptions and limitations of requesting a quote from a vendor.

March 17, 2026 · Listen

The conversation delves into the misconceptions and limitations of requesting a quote from a vendor, highlighting the importance of defining success before engaging in pricing discussions.

• Vendor perspective.

• Importance of defining success.

 

The Importance of Understanding the Negotiation Structure

March 17, 2026 · Listen

Preparing for a capital meeting involves understanding the negotiation structure and being aware of vendor flexibility. Medsolve can assist in navigating this process effectively.

• Negotiating within a structured framework.

• Vendor flexibility and pricing tiers.

 

Preparation for a capital meeting and negotiating within a pre-mapped structure.

March 17, 2026 · Listen

The conversation covers the preparation for a capital meeting, understanding likely objections, rehearsed responses, negotiating within a pre-mapped structure, negotiating blind, and the value of Medsolve in negotiations.

• Preparation is key to successful negotiations.

• Understanding the structure of negotiations is crucial for effective outcomes.

 

Negotiating with vendors requires a deep understanding of business assumptions and leverage points.

March 17, 2026 · Listen

Negotiating with vendors requires a deep understanding of business assumptions and leverage points. Preparation is key to successful negotiation.

• Business assumptions are crucial.

• Preparation is key.

 

The root causes of failed negotiations.

March 17, 2026 · Listen

The conversation delves into the complexities of oncology capital deals, highlighting the root causes of failed negotiations and the importance of alignment between deal structure and program needs. It also explores the impact of incorrect assumptions on costs and the significance of vendor relationships in this environment.

• Capital negotiations root causes.

• Alignment between deal structure and program needs.

• Optimistic utilization projections.

• Vague service expectations.

• KPIs not tied to patient flow.

• Impact of incorrect assumptions on costs.

• Importance of vendor relationships.

 

More field notes: Capital decisions · Building a proforma · all seven topics