Build vs. Buy: The True Cost of DIY Healthcare Automation
Key Takeaways
• The Initial Build is Only the Tip of the Iceberg: A "simple" in-house patient automation MVP can easily cost $750,000+ and take 9-12 months to build before delivering any value.
• The True TCO is ~2x the Initial Cost: When factoring in the ongoing "maintenance tax," new feature development, and compliance overhead, a conservative 3-Year Total Cost of Ownership (TCO) for a DIY tool can exceed $1.45 million.
• Compliance is a Crushing, Unseen Cost: The burden of keeping a home-grown platform compliant with constantly evolving HIPAA and TCPA regulations is a massive, ongoing resource drain that specialized vendors distribute across hundreds of clients.
• The Opportunity Cost is the Real Killer: While your team spends 18 months and $1M+ building a tool, they aren't solving other core business problems. That delay could mean forfeiting tens of millions in at-risk revenue, like Medicare Quality Bonuses.
It's one of the most critical decisions a healthcare technology leader can make: when a new need for patient automation arises, do we build a custom solution or buy a specialized platform?
The allure of building is powerful. It promises total control and a perfect fit for your existing workflows. The "buy" option comes with a clear and often substantial price tag. This comparison, however, is dangerously misleading.
The true cost of a DIY healthcare platform isn't the initial development; it's in the massive, hidden costs of maintenance, compliance, and opportunity. This is a practical, CIO-level framework for calculating the true Total Cost of Ownership (TCO) of the "build" decision.
Before diving into the analysis, explore how proven automation platforms can eliminate these hidden costs while delivering immediate value.
Phase 1: The Initial Build – The $750,000 Tip of the Iceberg
Building even a "simple" MVP for healthcare outreach is a major undertaking. A lean, realistic team includes:
• 1 Product Manager
• 2 Senior Software Engineers
• 1 DevOps/QA Engineer (handling infrastructure, security, and testing)
The fully loaded annual cost for this small team can easily exceed $750,000. Due to the stringent security and HIPAA compliance requirements, building a robust MVP will take, at minimum, 9-12 months. So before you've made a single patient call, you are already deep in the red.
While you're spending 12 months building, proven platforms are already delivering results like this medication adherence success rate.
Read Patient Engagement Platform Success Case StudyPhase 2: The Ongoing Maintenance Tax – The 90% You Don't See
The real costs begin the day your platform goes live. Industry analysts estimate that ongoing maintenance consumes 15-25% of the initial development cost, every single year.
Your Annual Maintenance Tax: $750,000 x 20% = $150,000 per year.
This covers bug fixes, infrastructure costs, and minor feature requests. This is the cost just to keep the lights on.
Phase 3: The Compliance Treadmill – A Cost That Never Sleeps
This is the hidden cost that makes build vs. buy in healthcare unique. Compliance isn't a one-time setup; it's a constant, resource-intensive effort.
HIPAA & Security: You are now solely responsible for ongoing security audits, penetration testing, and evolving data breach protocols.
TCPA & Communication Laws: As we've detailed in our TCPA Compliance Guide, these rules are constantly changing. Your legal and engineering teams must dedicate significant time to monitoring these changes to avoid multi-million-dollar penalties.
This is where specialized compliance platforms become invaluable - they handle these evolving requirements automatically.
A specialized vendor distributes these immense compliance costs across hundreds of clients. When you build, you bear the entire burden alone.
Calculating the True TCO and the Crushing Opportunity Cost
Let's model a conservative 3-year TCO for your in-house platform:
3-Year Total Cost of Ownership (TCO) - Build
Year 1: $750,000 (Initial Development)
Year 2: $150,000 (Maintenance) + $200,000 (New Features) = $350,000
Year 3: $150,000 (Maintenance) + $200,000 (New Features) = $350,000
3-Year TCO: ~$1,450,000
But the most significant cost isn't on this spreadsheet. It's the opportunity cost. While your team spends 18 months building this tool, an 18-month delay in launching an effective adherence program could mean forfeiting $48 million in Quality Bonuses.
Consider how ready-to-deploy conversational AI infrastructure can help you capture this revenue immediately instead of waiting years for a custom build.
Schedule Your 30-Minute TCO Workshop
Get a customized analysis of your build vs. buy decision with real TCO calculations.
A Smarter Path: Buy Expertise, Not Problems
At Rivvi, our entire company is your dedicated R&D team for patient engagement. We believe your world-class engineers should be focused on your core mission, not reinventing outreach automation.
A "buy" decision offers:
Speed: Go live in weeks, not years. Start seeing ROI, like our pilot's 89% engagement rate, this quarter.
Proven Results: Access battle-tested solutions that have already delivered results across medication adherence programs and comprehensive care management.
Cost: A predictable SaaS fee that is a fraction of the cost of hiring a single engineer.
Expertise: You instantly inherit years of specialized R&D in automation, TCPA compliance, and conversational AI.
Focus: Your team remains focused on the unique challenges that differentiate your organization.
The build vs. buy decision isn't about owning code. It's about TCO, speed-to-market, and strategic focus. For a non-core function like patient outreach, building is rarely the smarter choice.
Ready to Make the Smart Choice?
See how leading health plans are achieving better outcomes with lower TCO through proven automation platforms.
If you are facing this critical decision, let's schedule a 30-minute TCO workshop.
Explore how specific industry solutions like health plan automation and ACO platforms deliver immediate ROI without the massive development investment.
Content Upgrade
Download our free Build vs. Buy TCO Calculator (Excel Template). Use this powerful spreadsheet to model the true, 3-year cost of a "build" decision for your organization and compare it to a "buy" approach.