MedTech firms experience barriers when entering the healthcare sector, although their solutions could solve healthcare challenges. The study provides a conceptual framework for MedTech firms' business environment including institutional alignments and misalignments. These insights support MedTech firms' business model development when aiming for successful commercialization. The research is conducted with a multiple case study analyzing MedTech firms' and healthcare organizations' perspective regarding the business environment and relationship dynamics. The study generated three main findings. Firstly, an organizational and institutional logic analysis outlined essential problem areas where MedTech firms and healthcare organizations align differently. Secondly, suggestions on how the MedTech firm can respond to the identified problem areas through their business model are presented. Thirdly, the study provides an example of how social- and business literature can be connected to understand complex business environments. In contrast to a majority of prior research, the study is designed for the MedTech firm's perspective where the final result answering how the business model can be improved based on healthcare organizational and business insights.