A Recombination-Based Internationalization Model: Findings from Narayana Health’s Journey from India to the Cayman Islands

Abstract

We present a longitudinal study of the expansion of Narayana Health (NH), a healthcare provider, within India and its subsequent development of a tertiary care hospital in the Cayman Islands. Contrary to past research suggesting that the alignment of a firm’s resources and managerial mindset with its home-country context can make internationalization difficult, we study how the Cayman project benefited from NH’s experience in India. First, NH responded with context-appropriate resources for designing hospitals for the different market segments within India. Second, in setting up the Cayman hospital, NH recombined select resources from these pre-existing hospitals in India. Building on these findings, we propose a recombination-based model for internationalization in which firms, while expanding in the host country, draw from, adapt, and then integrate diverse resources developed earlier to address home-country context heterogeneity. The proposed model is significant as it suggests how diverse resources developed in the home country can make a firm more effective in expanding in the host country.