Platforms are Reshaping Healthcare: How to Lead the Change 

Getting healthcare no longer means “going to a place “—increasingly, it’s a platform you interact with. Platforms are the way to enable companies to observe, interact with and provide value to consumers as they engage with the organization. From virtual-first care to AI-powered diagnostics, platforms are transforming how patients engage, how providers deliver and how systems create value. Over the past decade, platform-based health startups have generated 2.6x the returns of pure healthcare SaaS businesses (Summit Health) because they know success is about the interactive business system, not just the IT. 
 
Prophet has conducted extensive research on how to build a platform business model to unlock uncommon growth. Our findings are outlined in the book “Winning Through Platforms: How to Succeed When Every Competitor Has One”, which breaks down 24 platform plays to transform and grow your business. 
 
We see health systems facing urgent demands to invest in platform plays: to serve and connect multiple types of customers (i.e., patients and payors), to measure healthcare usage patterns and to effectively use this data to optimize the customer and end-user experience. Health systems that create this feedback loop will find that successful platforms aren’t just point solutions like MyChart; they’re complete business systems that attract diverse users and continuously optimize care. 

Platforms are Already Changing the Game 

Digital-First Platforms Are Reshaping Expectations and Outcomes 

Patients expect to manage their health like their finances or travel: digitally, intuitively and on their terms. In the past decade, the share of patients who accessed their digital medical record or patient portal has seen a sharp increase from 25% in 2014 to 65% in 2024. Health systems that meet these expectations are already seeing returns. One Medical, for example, has demonstrated that ongoing patient engagement through its app results in fewer ER visits, simplified same-day booking and a three-fold increase in digital encounters. More generally, according to Panda Health, nearly two-thirds of health system leaders report their investments in digital health solutions have met or exceeded ROI expectations. 

Data Is the New Medicine 

Remote patient monitoring (RPM), AI and smart devices are generating vast amounts of data and using it to anticipate readmissions, optimize triage and personalize interventions. Powered by Biofourmis’ AI-guided RPM, one health system cut 30-day readmissions by 70% and slashed care costs by 38%,a clear signal that data can improve outcomes. 

All predictive systems come with biases and limitations. However, at their best, these systems streamline routine care so clinicians can focus on atypical cases. In turn, these edge cases present an opportunity to help retrain models, refine classifications and ultimately make care more inclusive. The result? A shift from reactive responses to proactive, personalized care that works better for everyone. 

Insurers Are Becoming Platforms and Setting the Rules 

UnitedHealth Group, Cigna and CVS/Aetna are becoming vertically integrated payors and providers. United’s Optum, for example, has acquired hundreds of clinics and physician groups, positioning itself to own every part of the patient experience, from insurance to diagnosis to treatment. They own the data, the clinics and the billing systems creating closed-loop platforms that manage risk and deliver care. These models are driving better coordination and incentivizing lower costs, with 24.5% of U.S. payments now tied to two-sided risk contracts. 

Health Systems Have Unique Platform Advantages 

While startups and behemoths have moved quickly to establish a platform advantage, they haven’t fully realized the value platforms can provide. That’s because most solutions remain fragmented. For example, virtual care programs often succeed only when properly scaled across populations, conditions and with enough utilization. Without patient engagement and trust at scale, impact is limited. 

Health systems have the breadth and reach to change this. They already own the patient journey, physical infrastructure and care delivery staff. They can integrate platforms more thoroughly than competitors, turning isolated solutions into a cohesive experience that builds trust between patients and their providers. 

Platforms Extend Physical Infrastructure 

As care delivery expands across outpatient clinics, urgent care centers, ambulatory surgery sites and newly acquired hospitals, digital platforms are becoming the connective tissue that makes these assets work together efficiently, intelligently and at scale. 

Platforms Expand Revenue Opportunities 

Digital platforms open new pathways for revenue generation, especially in areas that traditional infrastructure can’t reach. By offering services like chronic condition management, behavioral health support and preventive care through virtual channels, health systems can tap into new markets and patient segments. 

Platforms Guide Smarter Investment 

Platform-generated data helps health systems make more informed decisions about where and how to invest. By analyzing patient engagement, service utilization and care outcomes across digital and physical touchpoints, systems can identify gaps and forecast demand. This intelligence enables leaders to optimize both digital and physical assets, ensuring that new clinics, services and technologies are deployed where they have the greatest impact. 
 
So what? Established health systems don’t need to become disruptors, but they do need to learn from them. The challenge is to evolve while staying true to their mission, assets and community relationships. That means integrating digital platforms not as standalone tools, but as strategic enablers of their broader business.