HOL teams do not have nearly the number of targets as other field forces. The number of payers, even in payer-heavy markets like the US, is limited, said May. Though the largest payers do have regional offices in addition to their corporate locations, interviewed executives reveal that visiting these regional centers is not a pressing need beyond showing payers how important they are to their companies. Key reimbursement decisions happen almost exclusively at the corporate offices, making them the real target audience. Combining the limited number of targets with the fact that payers almost universally ask to see only one HOL per company and that visits be limited to a few times annually it is not surprising that HOL teams operate small headcounts.