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Highlights

  • Healthcare enterprise leaders must collaborate with service providers as they combine multiple segments of the healthcare ecosystem (integrate vertically).

  • An analysis of the market shows that this integration can be categorized into three archetypes, with each offering opportunities. 

  • Tech-enabled services hold the key to unlock the value that vertical integration brings in healthcare. 

Rohan Kulkarni

Practice Leader, Healthcare and Life Sciences, HFS Research

Nitin Kumar

Vice-president and Senior Managing Partner, Digital Health and Wellness Business Unit, TCS

Healthcare enterprise leaders must collaborate with service providers as they vertically integrate multiple segments of the healthcare ecosystem to address market dynamics. Healthcare in the US is at a crossroad of opportunities to address systemic challenges and the status quo, as all attributes of the triple aim (cost of care, health outcomes, and experience of care) track sub-optimally.

This paper, jointly written by TCS and HFS, explores three archetypes within an integrated healthcare ecosystem – the ecosystem connector, the orchestrator, and the disruptor – and sheds light on how tech-enabled services can unlock value in healthcare.   

Connectors improve outcomes 

Ecosystem connectors integrate health, wellness, and care to reduce costs and improve health outcomes across all types of coverage, translating into better enterprise margins. Working with a services partner can provide technology enablement and change management to facilitate the transition. 

Orchestrators harmonize non-acute care delivery and financial coverage

This archetype proactively addresses wellness and primary care to mitigate expensive acute care, particularly for senior populations. The orchestrator expects to drive down the cost of care, improve health outcomes, and replace declining commercial fully insured revenues. Service provider partnerships accelerate innovation, AI-ML adoption, technology modernization, and operating model transformation to enable seamless consumer experiences.

The disruptor learns from cross-industry success stories 

The disruptor applies lessons of success from other industries and builds a portfolio of products to address the health needs of consumers. This archetype improves access to primary care and medication for the uninsured and the underinsured, positively impacting the long-term cost of care. Service providers help disruptors accelerate workflow addressal, optimize processes, and meet health IT needs in order to help increase the consistency and predictability of outcomes. 

A vertical integration within healthcare will drive demand for tech-enabled services to realize the value of the new business constructs and change the trajectory of triple aim attributes.