Value creation and value distribution in the Dutch health ecosystem

In the article The health(care) future of the Netherlands, we discussed five major shifts that will shape the Dutch health ecosystem of the future. These five shifts have the potential to create a great deal of value for Dutch citizens: we can gain years of healthy lives for lower costs. The shifts should be driven by innovations of parties that are currently already active in healthcare and of new players within the healthcare ecosystem. In exchange for the resulting value that they create for Dutch citizens, there should also be value for them to distribute. Nevertheless, the reality appears to be different.

For the existing healthcare ecosystem parties, value creation can be an elusive phenomenon. Initiatives that work well locally are not always upscaled sufficiently. However, initiatives that start on a larger scale become stranded in too much complexity. Besides the challenges relating to scale versus complexity, these parties also face conflicting stimuli in our system. In our system, the party with a key role in creating the added value can consequently lose out. 

For the new players in healthcare, our current healthcare ecosystem can seem a complicated labyrinth. A place with many stakeholders, established interests and inadequate market forces. These companies come from ecosystems with market forces where ‘value creation for an end-customer’ leads to a ‘return on investment’ in the form of a larger share in the ‘profit pool’. To them, healthcare often seems to be a place with a different language, where a different logic applies.

How can we unlock the potential value of the healthcare ecosystem of the future?

This article starts by discussing the value potential of the five shifts and the challenges for realisation. Followed by a point of view from outside healthcare, in order to reveal the special dynamics of our current healthcare ecosystem. Based on our knowledge of and experience with other ecosystems, we offer an overview of typical ecosystem market forces dynamics in relation to value creation and value distribution.

We use this to describe the current money flows in healthcare: who pays whom how much, and for what? After that we translate these insights into five fundamental system-level discussions that we feel must be taken into account in the debate on the future of Dutch health(care). We close this conceptual experiment with a concrete suggestion for a roadmap for value creation in the health ecosystem of the future.