Marketisation and the orchestration of healthcare networks in Finland

Abstract This paper discusses the coordination of change in healthcare networks and highlights their orchestration as a potentially valuable research avenue. In this study, theoretical propositions are drawn from literature of (a) strategic nets and business networks, and (b) institutional change. These propositions are tested by an exploratory study on the marketisation-oriented changes in Finnish healthcare. Findings indicate that network heterogeneity creates a structural possibility for partial optimisation, and marketisation is a spontaneous change process that fuels these partial optimisation habits. Orchestration across levels is needed, because heterogeneity and spontaneity create significant problems in outcomes. Further, a practical implication of the findings is drawn: the orchestration of countermeasures in healthcare networks is possible when the outcomes and/or threats of spontaneous ordering are understood.