Traditional companies vs. platform‑startups in health, banking and energy: how regulated markets are being reconfigured

1. Introduction: why platforms are the key model to watch

Over the past ten years, the concept of a “platform” has stopped being synonymous with social networks or consumer marketplaces and has become the dominant architecture for business innovation. A platform‑type business model is not defined by producing a single service, but by orchestrating interactions between multiple sides of a market: providers, end users, regulators, developers and complementary third parties. Value creation lies not only in the product, but in the connections, data and transactions facilitated among those actors [1].

This logic is particularly relevant in sectors such as health, banking and energy. These are industries with heavy regulation, high capital requirements, critical infrastructure and, therefore, structural inertia that has historically favored closed, vertically integrated models. The regulation of health data and medical licenses, prudential banking standards or rules for access to power grids have consolidated oligopolies and legacy technology systems that are hard to transform [1][2]. However, that same regulation, combined with pressures around efficiency, sustainability and user experience, is opening cracks through which new platform players are emerging.

The central thesis is that platform‑startups in health (healthtech), banking (fintech and open banking) and energy (energytech and smart grids) are not just competing with incumbents on specific products; they are redesigning the architecture of the market itself. By modularizing the value chain, creating B2B2C infrastructure and exposing capabilities via APIs, these companies are reshaping who controls the user relationship, who owns critical data, and how margin is distributed between infrastructure and experience layers. Understanding this shift is essential for executives, product managers and founders operating in regulated sectors.

2. Comparative framework: how we will analyze traditional vs. platform‑startups

To systematically compare incumbents and platform‑startups in health, banking and energy, we will use three dimensions: business model, technology and architecture, and user experience (customer journey). In each, we will analyze specific criteria that explain why platforms generate different dynamics of competition and collaboration.

In the business model dimension, we will focus on four aspects: revenue sources, cost structure, degree of vertical integration and dependence on partners. Traditional companies in regulated sectors tend to combine recurring or regulated revenues (fees, premiums, long‑term contracts) with high fixed cost structures (physical infrastructure, regulated staff), which fosters defensive strategies. Platforms, on the other hand, tend to rely on variable transaction‑based revenue, subscriptions and B2B2C models, with lower marginal costs and higher operating leverage.

In technology and architecture, we will compare the type of systems (monolithic legacy vs. cloud‑native modular), level of interoperability, use of open standards and degree of intelligent automation (AI, advanced analytics). This is where API‑first models mark a break: they turn previously internal capabilities (processing payments, validating identities, orchestrating energy flows) into composable services on which third parties can build [1][2]. Interoperability ceases to be an aspiration and becomes a competitive requirement.

The user experience and end‑to‑end journey dimension will analyze UX design, personalization, transparency and user control over data. Traditionally, these sectors have offered fragmented journeys: multiple counters, forms, calls and little visibility into prices or status. Platforms aim to offer integrated, end‑to‑end experiences: from onboarding to after‑sales support, while orchestrating multiple providers behind a single interface. How consent and control over personal data are managed also becomes a key vector of trust and differentiation [1].

To frame the analysis, the table below summarizes the starting differences between traditional players and platform‑startups:

3. Case 1: Health (healthtech)

3.1 Traditional business model

In health, the traditional model is structured around hospitals, clinics, laboratories, insurers and public administrations, each with its own economic logic. Hospitals and clinics obtain most of their income per medical act: consultations, diagnostic tests, surgeries, stays, etc. These revenues are shaped by regulated tariffs, agreements with private insurers and public reimbursement systems. Insurers, for their part, collect periodic premiums and optimize profitability by managing risk and negotiating prices with their provider network [1].

This setup has been built on strong fragmentation. The primary care doctor, the specialist, the laboratory, the hospital and the insurer rarely share a single information platform or an integrated view of the patient. Regulation has contributed to this: strict health data protection rules, licensing and accreditation requirements, and the priority of clinical safety over interoperability have favored closed models focused on the institution rather than the patient [1]. The result is information silos, redundant processes and a user experience that suffers from this fragmentation.

In addition, the fee‑for‑service payment model incentivizes the volume of medical acts, not necessarily health outcomes. “Value‑based care” mechanisms, in which providers are paid based on clinical outcomes or long‑term cost savings, still have limited presence in many markets. This creates a mismatch between the value perceived by the patient (solving their health issue quickly, in a coordinated and transparent way) and the value measured and remunerated by the system (number of interventions and bed‑days).

3.2 Platform‑startups in health

Platform‑startups in health position themselves precisely in these gaps of coordination and interoperability. Telemedicine platforms, medical appointment aggregators, second‑opinion marketplaces and clinical‑record interoperability providers emerge as orchestration layers connecting patients, professionals and health organizations [1]. Their value proposition combines accessibility (remote consultations, extended hours), convenience (search by specialty, location, price and reputation) and, in some cases, greater transparency in wait times and costs.

Economically, these platforms use diversified revenue models. In B2C, they charge per digital consultation, monthly or annual subscriptions for priority access, or increase average ticket size by adding complementary services (remote monitoring, wellness programs). In B2B, they sell their software as a service (SaaS) to clinics and hospitals that want to digitalize appointments, patient management or teleconsultations under their own brand. In more advanced contexts, “value‑based care” schemes are emerging, where the platform shares risk with insurers or employers, charging based on health indicators or claims reduction [1].

This platform logic is beginning to redefine who controls the primary relationship with the patient. If the first interaction occurs through an appointments app, a telemedicine platform or a personal health data hub, the hospital becomes just another provider within an ecosystem orchestrated by a digital intermediary. Health regulation, with frameworks such as HIPAA in the U.S. and equivalent privacy rules in Europe and Latin America, forces these startups to invest heavily in compliance and security, which can slow expansion but also raises the barrier to entry for new competitors [1].

3.3 Technology: legacy vs. cloud‑native

On the technology side, the gap between incumbents and startups is especially clear. Traditional hospitals depend on on‑premise HIS (Hospital Information Systems) and EMR (Electronic Medical Records) designed decades ago to support internal administrative and clinical processes. They tend to be monolithic systems, heavily customized, with limited APIs and poor interoperability even within the same organization [1]. Each integration with a laboratory, insurer or public administration requires specific, costly, long‑duration projects.

Platform‑startups, by contrast, are born with cloud‑native architectures and API‑first principles. Their core is designed from the outset to expose standardized services (provider search, appointment scheduling, secure messaging, video consultation, consent management, access to clinical data) to different channels and partners. They adopt open health data standards, such as FHIR (Fast Healthcare Interoperability Resources), which facilitate interoperability between heterogeneous systems and enable the creation of shared clinical data hubs [1]. This makes true interoperability use cases possible, such as different hospitals and laboratories accessing the same record, leading to more accurate diagnoses and fewer duplicate tests.

On top of this flexible infrastructure, they deploy AI capabilities for triage, recommendation and diagnostic support. Symptom‑classification algorithms can guide the patient to the appropriate level of care (self‑care, teleconsultation, emergency), reducing pressure on scarce resources. AI‑assisted medical imaging tools help radiologists and specialists improve diagnostic accuracy and speed. Meanwhile, many incumbents move at a slower pace, constrained by their installed base and a more conservative approach to technology risk [1]. The result is a growing asymmetry in the ability to experiment and iterate on product.

3.4 User experience in health

In traditional healthcare, the patient journey is often long and opaque: figuring out which specialist to see, calling to book an appointment, waiting weeks, filling out paper forms, repeating basic information at every visit, traveling in person to pick up results, and facing non‑transparent bills. The patient navigates multiple interfaces (phone, front desk, fragmented web portals) and rarely has a consolidated view of their clinical history or associated costs [1].

Healthtech platforms have designed radically different journeys. From a single interface, the user can search for specialists filtered by location, availability, language, price or patient ratings; book an in‑person or digital appointment; conduct the video consultation; receive an e‑prescription; and access their history and personalized educational materials. All of this is supported by notifications, reminders and automated post‑consultation follow‑up. Administrative friction is shifted to the platform’s back‑office, which automates processes and integrates with insurance, pharmacy and laboratory systems [1].

Trust is critical. Managing health data requires conveying security and control. The most advanced platforms offer dashboards where users can see who has accessed what information, revoke permissions and decide which data to share with insurers, employers or wellness apps. This granular consent management, also driven by regulation, turns data control into a differentiating element of the experience. The user moves from being a passive subject whose data are “taken” to an active agent who holds their clinical information as an asset, reusable across different health and wellness services.

4. Case 2: Banking (fintech and open banking)

4.1 Traditional banking model

Traditional banking has historically operated as a monolithic producer and distributor of financial products: checking accounts, personal and mortgage loans, cards, investment products and insurance. The bank controls both the back‑end (balance sheet, risk, treasury) and the front‑end (branches, digital channels), and concentrates the customer relationship. Its revenues are based on net interest margin (difference between interest rates on assets and liabilities), product and service fees, and opaque charges associated with specific operations.

This model has been supported by branch networks, labor‑intensive processes and a closed, hard‑to‑evolve core banking architecture. Prudential regulation (Basel, national supervision) has focused on solvency and stability, but less on user experience or interoperability. The result has been banking that is robust but often slow and poorly personalized, where the customer had to adapt to the bank’s processes, not the other way around [1][2].

Moreover, the “everything under one roof” logic has led to complex product catalogs, bundling and low transparency. Comparing offers is difficult, and switching banks feels costly. This has reinforced relationship inertia that hindered entry by new players unable to replicate the entire service range at once.

4.2 Platform‑startups in banking

Fintech startups have unbundled this value chain, initially focusing on wedge products (payments, remittances, retail investing, consumer credit) and evolving into platforms that orchestrate multiple financial services. Purely digital neobanks offer accounts and cards with fully remote onboarding, real‑time notifications, foreign‑exchange features and budgeting tools, often with no visible fees. Financial aggregators let users see accounts and products from different banks in a single app, while “banking‑as‑a‑service” (BaaS) providers offer complete banking infrastructure via API so other companies can launch financial products without being banks themselves [1].

In these models, the business combines several revenue sources: transaction fees (payments, FX, remittances), premium subscriptions with added services (insurance, metal cards, higher limits), card interchange fees, and B2B fees for API usage (for example, charging a marketplace to use its account and virtual‑card infrastructure). This modular approach allows experimentation with new value propositions without the fixed overhead of a branch network. The platform positions itself as an aggregation and distribution layer, while balance‑sheet risk can sit with partner banks.

This shift has been enabled to a large extent by open banking frameworks, which require banks to open access (via secure, standardized APIs) to account data and, in some cases, to payment initiation, with the customer’s consent [2]. The consequence is the emergence of a new ecosystem where the user relationship can be mediated by non‑bank apps that “consume” data and services from multiple institutions, reshaping distribution power.

4.3 Technology and architecture

Technologically, traditional banks have operated on legacy core systems often built decades ago. These systems, designed for robustness and transactional consistency, are monolithic and hard to break into independent components. Any change in a critical module—for example, fee calculation or payment authorization logic—affects multiple parts of the system, making innovation cycles long and costly. Exposing capabilities to third parties was, until recently, marginal or nonexistent.

Fintechs, by contrast, have adopted microservices architectures and API‑first principles, where each capability (KYC, credit scoring, payment execution, card issuing) is implemented as an independent service that can scale and evolve autonomously. This allows much faster deployment cycles and the ability to “compose” new financial products from existing building blocks. Standardization of APIs under open banking schemes and messaging standards such as ISO 20022 has boosted interoperability, reducing friction in integrating multiple banks and financial institutions into a single platform [2].

This technological change also enables richer data analytics. Transaction data, which in traditional banking was used primarily for risk management and compliance, now feeds personalized recommendation engines, unusual‑behavior alerts, and financial‑education tools embedded in the user experience. Interoperability, both at the messaging level (SWIFT, ISO 20022) and API level, becomes the foundation for building more inclusive financial services—for example, interoperable mobile wallets that bring formal finance closer to unbanked populations [2].

4.4 UX: from the bank as institution to the bank as invisible layer

From the user’s point of view, the transition is visible. Traditional banking experience involved branch visits, lengthy forms, long approval times and an asymmetric information relationship. Opening an account, requesting a loan or investing meant navigating opaque processes, physical documentation and limited self‑service. Even with online banking, many key interactions still depended on the branch.

Fintech apps have reimagined the banking journey. Onboarding happens in minutes with automated KYC using document photos and biometrics; virtual cards are activated instantly; real‑time notifications track every movement; spending is automatically categorized, providing clear visualizations of consumption habits; and automated savings and “pots” for specific goals are offered. Users experience banking as more transparent, interactive and under their control.

Beyond direct experience, banking is “dissolving” into other journeys. E‑commerce platforms embed consumer financing at checkout; mobility apps integrate contextual insurance; B2B marketplaces offer factoring and credit to suppliers and merchants directly in their interface. In these cases, the financial institution becomes an invisible infrastructure layer, accessible via API. For traditional banks, this raises the choice between remaining the primary “owner” of the customer relationship or accepting a mostly “utility” role behind third parties closer to the end user.

5. Case 3: Energy (energytech and smart grids)

5.1 Traditional business model in energy

In energy, the classic utility model is based on total or partial integration of three links: generation, distribution and retail. Companies control large physical assets (plants, transmission and distribution networks) and offer standardized contracts to end customers, generally with little tariff variety and low transparency regarding price composition. The residential or business user is primarily a bill‑payer, with a passive role and no granular visibility into their consumption.

Regulation has been decisive in shaping this model. Rules on network access, regulated tariffs, licenses to operate as retailers or generators, and technical connection standards have favored market concentration in a few actors. Although retailing has been liberalized in many countries, bargaining power and information are still skewed toward large utilities. The transition to renewables, driven by public policy and climate commitments, is introducing changes but also new regulatory layers that condition the entry of new players [2].

This structure has generated inefficiencies in how distributed resources are used. The model of large centralized plants was optimal for 20th‑century generation technology and grid management, but is less suitable when rooftop solar panels, home batteries and connected electric vehicles proliferate. This is where platform‑startups have found room to innovate.

5.2 Platform‑startups in energy

Energytech platforms are emerging as intermediaries and orchestrators of an increasingly decentralized power system. There are P2P marketplaces connecting small renewable producers with consumers interested in green energy, enabling more flexible contracts and better remuneration for producers. Other players act as aggregators of distributed energy resources (DERs): home solar panels, batteries, EV chargers, which they coordinate in real time to provide flexibility services to the grid, such as peak‑demand reduction or short‑term energy injection [2].

In terms of business model, these platforms typically earn commissions on energy transactions, B2B SaaS fees from utilities wanting to manage smart grids, and revenue‑sharing schemes with distributed producers. For example, an aggregator may share revenue from flexibility services with the owners of the home batteries it manages. Green‑tariff marketplaces aggregate offerings from multiple retailers and charge customer‑acquisition commissions, while offering greater transparency on energy source, associated emissions and contractual conditions.

Energy regulation here is a double‑edged sword. Policies that incentivize distributed generation and renewable retailing facilitate the emergence of these platforms [2]. However, connection requirements, licenses and technical standards, along with regulatory variation between regions, introduce complexity and significant compliance costs. Startups must design models that adapt to these frameworks while positioning themselves as allies, not threats, to utilities that still control critical infrastructure.

5.3 Technology and data

Traditional energy infrastructure has been based on analog meters and closed SCADA systems, with low temporal data resolution and limited capacity for interaction with the end consumer. Information flow was one‑way and sporadic: meter reading once a month or quarter, billing, and little more. Utilities had internal management systems, but near‑real‑time data sharing with users or third parties was almost nonexistent.

The advent of smart meters, IoT (connected sensors) and real‑time management platforms is radically transforming this picture. Platform‑startups leverage these devices to collect granular consumption data (hourly, even minute‑by‑minute), integrate them into cloud platforms and apply AI algorithms to predict demand, detect anomalies and optimize use of distributed resources. Data interoperability between energy management systems enables orchestrated responses at neighborhood, city or regional level [2].

For users, this translates into applications that show real‑time, appliance‑level consumption, historical comparisons, savings recommendations and, in some cases, direct automation of devices (thermostats, EV chargers) based on price or sustainability signals. Platforms thus become an intermediate layer between network infrastructure and the home or business, enabling bidirectional flows of energy and data that were unthinkable with traditional analog infrastructure.

5.4 User experience in energy

In the traditional model, the user’s relationship with the energy company is reduced to receiving and paying a bill. The lack of granular information and clear options makes it hard for consumers to understand their usage, identify savings opportunities or express preferences for renewable vs. fossil energy. This vacuum has reinforced the perception of energy as an undifferentiated commodity, where the only relevant variable seems to be price and trust in providers tends to be low.

Energytech platforms reconfigure this role. The user becomes a prosumer: they can produce energy (solar panels), store it (batteries) and sell it to the grid or to other users through a P2P platform. Dedicated apps allow them to monitor and optimize consumption based on hourly prices, carbon footprint or renewable‑generation forecasts. Perceived value shifts: it is no longer just about “cheaper electricity”, but about control, autonomy and contribution to sustainability goals.

This new experience also demands new mechanisms of trust and transparency. The platform must clearly explain how prices are calculated, what share it keeps as commission and how incentives are distributed among actors. Managing consumption data, which can reveal home‑presence patterns or sensitive industrial habits, requires robust privacy and security controls. Platforms that combine clarity in their economic proposition with responsible data governance will be best positioned to build lasting relationships with increasingly active and informed users.

6. Cross‑cutting patterns: what platform‑startups in these sectors have in common

Comparing health, banking and energy reveals common patterns in how platform‑startups are reconfiguring regulated markets. The first is the unbundling of the traditional value chain into interoperable modules. Rather than replicating end‑to‑end what hospitals, banks or utilities do, these startups specialize in specific links: appointment orchestration, digital KYC, aggregation of distributed energy resources. They then expose these capabilities via APIs or B2B2C interfaces that other players can incorporate into their own offerings [1][2].

This process generates a new stratification of the market into infrastructure layers (