--- title: Five-Year TCO of a Co-Managed IT Operating Model for a 100-Provider Clinic Group description: Explore the five-year TCO of a co-managed IT model for a 100-provider clinic group and learn how costs stabilize after initial transition. image: https://blog.fivenines.com/hubfs/blog/taya-migration/60-five-year-co-managed-clinic-tco-cfo.docx.png --- [Skip to the main content.](https://blog.fivenines.com/five-year-tco-of-a-co-managed-it-operating-model-for-a-100-provider-clinic-group#main-content) 1-855-817-5959    [help@fivenines.com](mailto:help@fivenines.com) [![FN\_Reverse\_Logo](https://blog.fivenines.com/hs-fs/hubfs/FN_Reverse_Logo.png?width=3022&height=849&name=FN_Reverse_Logo.png "FN_Reverse_Logo")](https://fivenines.com/) [![FiveNinesPrimaryLogo](https://blog.fivenines.com/hs-fs/hubfs/FiveNinesPrimaryLogo.png?width=3022&height=849&name=FiveNinesPrimaryLogo.png "FiveNinesPrimaryLogo")](https://fivenines.com/) - [Solutions](https://fivenines.com/solutions/) - [Managed IT Services](https://fivenines.com/solutions/managed-it-services/) - [Cybersecurity Services](https://fivenines.com/solutions/cybersecurity/) - [Cloud & Productivity](https://fivenines.com/solutions/cloud-productivity/) - [Projects & Enhancements](https://fivenines.com/solutions/it-projects/) - [Placement Services](https://fivenines.com/solutions/onsite-it/) - Industries - [Finance & Banking](https://fivenines.com/industries/banking/) - [Healthcare](https://fivenines.com/industries/healthcare/) - [Legal](https://fivenines.com/industries/legal/) - [Nonprofit](https://fivenines.com/industries/non-profit/) - [Manufacturing & Logistics](https://fivenines.com/industries/manufacturing-logistics/) - [Small & Mid-Sized Businesses](https://fivenines.com/industries/smb/) - [Insights](https://fivenines.com/resources/) - [Resource Library](https://fivenines.com/resources/) - [Blog](https://blog.fivenines.com) - [About](https://fivenines.com/about/) - [About Five Nines](https://fivenines.com/about/) - [Leadership Team](https://fivenines.com/our-team/) - [Community Impact](https://fivenines.com/community/) - [Partnerships](https://fivenines.com/partnerships/) - [Careers](https://fivenines.com/careers/) - [Company News](https://fivenines.com/news/) Let's Talk Get Support Toggle Menu Toggle Menu Let's Talk Get Support - [Solutions](https://fivenines.com/solutions/) - [Managed IT Services](https://fivenines.com/solutions/managed-it-services/) - [Cybersecurity Services](https://fivenines.com/solutions/cybersecurity/) - [Cloud & Productivity](https://fivenines.com/solutions/cloud-productivity/) - [Projects & Enhancements](https://fivenines.com/solutions/it-projects/) - [Placement Services](https://fivenines.com/solutions/onsite-it/) - Industries - [Finance & Banking](https://fivenines.com/industries/banking/) - [Healthcare](https://fivenines.com/industries/healthcare/) - [Legal](https://fivenines.com/industries/legal/) - [Nonprofit](https://fivenines.com/industries/non-profit/) - [Manufacturing & Logistics](https://fivenines.com/industries/manufacturing-logistics/) - [Small & Mid-Sized Businesses](https://fivenines.com/industries/smb/) - [Insights](https://fivenines.com/resources/) - [Resource Library](https://fivenines.com/resources/) - [Blog](https://blog.fivenines.com) - [About](https://fivenines.com/about/) - [About Five Nines](https://fivenines.com/about/) - [Leadership Team](https://fivenines.com/our-team/) - [Community Impact](https://fivenines.com/community/) - [Partnerships](https://fivenines.com/partnerships/) - [Careers](https://fivenines.com/careers/) - [Company News](https://fivenines.com/news/) # Five-Year TCO of a Co-Managed IT Operating Model for a 100-Provider Clinic Group [Five Nines Executive Team](https://blog.fivenines.com/author/five-nines-executive-team) : Aug 28, 2026, 6:00:01 AM 1 min read [Business Continuity](https://blog.fivenines.com/topic/business-continuity) [Healthcare](https://blog.fivenines.com/topic/healthcare) [Finance](https://blog.fivenines.com/topic/finance) [Tech Operations Insights](https://blog.fivenines.com/topic/tech-operations-insights) ![Five-Year TCO of a Co-Managed IT Operating Model for a 100-Provider Clinic Group](https://blog.fivenines.com/hubfs/blog/taya-migration/60-five-year-co-managed-clinic-tco-cfo.docx.png) *TL;DR* - A 100-provider clinic group operating co-managed IT typically runs at a recognizable five-year total cost composed of partner fees, internal staff, tooling, training, transition costs, integration overhead, and executive oversight. - The composition shifts year to year: year-one transition spike, years two through five at predictable run-rate. - The CFO question is not whether co-managed costs more or less than alternatives in year one. It is what the cycle reveals. ## The Seven Cost Components a Co-Managed IT Engagement Actually Includes Partner fees recurring. Internal staff retained. Tooling split. Training. Transition cost year one. Integration overhead recurring. Executive oversight. ## How Co-Managed IT Costs Settle After Year One Year one heavy. Years two through five stable.   ## Why "Internal-Only Is Cheaper" Doesn't Hold in Thin Talent Markets A CFO will hear: \*internal-only is cheaper.\* False in markets without talent depth.   ## The TCO Analysis That Makes the Co-Managed Decision Defensible A defensible approach involves clinic CFO through structured TCO across operating models.   ## Year-One Price Comparisons Hide What the Cycle Actually Costs TCO across the cycle reveals what year-one comparisons hide. If your clinic has not produced multi-year TCO in the last twelve months, that is the conversation worth having with your Tech-Operations partner. Five Nines Technology Group is the Tech-Operations partner serving clinics, hospitals, and healthcare practices across the region. We focus on helping CFOs size operating-model decisions on five-year TCO. ## Frequently asked questions How does year-one cost compare to steady-state? Year one runs meaningfully higher. Can the partner fee be negotiated mid-cycle? Annual escalation typically; substantive renegotiation at renewal. How does this compare to fully managed TCO? Highly clinic-specific. What if the partnership ends mid-cycle? Transition costs apply. Does TCO include compliance program costs? Should, at most defensible engagements. Should the board see TCO? Yes, summary form. How does HIPAA program cost integrate? As part of overall cost composition. ## Related Blog Posts [![Five-Year TCO of a Co-Managed IT Operating Model for a Community Bank](https://blog.fivenines.com/hubfs/blog/taya-migration/10-five-year-co-managed-tco-cfo.docx.png)](https://blog.fivenines.com/five-year-tco-of-a-co-managed-it-operating-model-for-a-community-bank) #### [Five-Year TCO of a Co-Managed IT Operating Model for a Community Bank](https://blog.fivenines.com/five-year-tco-of-a-co-managed-it-operating-model-for-a-community-bank) Why the Year-One Price Comparison Misses Most of the Cost A community bank CFO walking into a co-managed IT decision typically sees the partner... [Business Continuity](https://blog.fivenines.com/topic/business-continuity) [Finance](https://blog.fivenines.com/topic/finance) [Tech Operations Insights](https://blog.fivenines.com/topic/tech-operations-insights) [Banking](https://blog.fivenines.com/topic/banking) [Read More](https://blog.fivenines.com/five-year-tco-of-a-co-managed-it-operating-model-for-a-community-bank) [![Co-Managed IT vs Fully Managed Operating Model for Clinics: What Fits Your Governance Posture](https://blog.fivenines.com/hubfs/blog/taya-migration/61-co-managed-vs-outsourced-clinic-ceo.docx.png)](https://blog.fivenines.com/co-managed-it-vs-fully-managed-operating-model-for-clinics-what-fits-your-governance-posture) #### [Co-Managed IT vs Fully Managed Operating Model for Clinics: What Fits Your Governance Posture](https://blog.fivenines.com/co-managed-it-vs-fully-managed-operating-model-for-clinics-what-fits-your-governance-posture) Why the Managed IT Decision Is a Governance Choice, Not a Contract Renewal A clinic CEO walking into a managed IT decision is rarely framed as a... [IT Services](https://blog.fivenines.com/topic/it-services) [Business Continuity](https://blog.fivenines.com/topic/business-continuity) [Healthcare](https://blog.fivenines.com/topic/healthcare) [Tech Operations Insights](https://blog.fivenines.com/topic/tech-operations-insights) [Read More](https://blog.fivenines.com/co-managed-it-vs-fully-managed-operating-model-for-clinics-what-fits-your-governance-posture) [![Co-Managed IT vs Fully Managed Operating Model: Which Fits Your Community Bank's Risk Appetite](https://blog.fivenines.com/hubfs/blog/taya-migration/11-co-managed-vs-outsourced-bank-ceo.docx.png)](https://blog.fivenines.com/co-managed-it-vs-fully-managed-operating-model-which-fits-your-community-banks-risk-appetite) #### [Co-Managed IT vs Fully Managed Operating Model: Which Fits Your Community Bank's Risk Appetite](https://blog.fivenines.com/co-managed-it-vs-fully-managed-operating-model-which-fits-your-community-banks-risk-appetite) Why the IT Operating-Model Decision Is a Governance Choice, Not a Renewal A community bank CEO walking into an IT operating-model conversation is... [Business Continuity](https://blog.fivenines.com/topic/business-continuity) [Finance](https://blog.fivenines.com/topic/finance) [Tech Operations Insights](https://blog.fivenines.com/topic/tech-operations-insights) [Banking](https://blog.fivenines.com/topic/banking) [Read More](https://blog.fivenines.com/co-managed-it-vs-fully-managed-operating-model-which-fits-your-community-banks-risk-appetite) ## Let's get in touch   [**(402) 817-2630**](tel:402-817-2630) [help@fivenines.com](mailto:help@fivenines.com) [Lincoln, NE](https://fivenines.com/contact/lincoln) [Omaha, NE](https://fivenines.com/contact/omaha) [Kearney, NE](https://fivenines.com/contact/kearney) [Central City, NE](https://fivenines.com/contact/central-city) [St. Louis, MO](https://fivenines.com/st-louis) ![cyberverify-1](https://blog.fivenines.com/hs-fs/hubfs/cyberverify-1.png?width=110&height=110&name=cyberverify-1.png)![aicpa](https://blog.fivenines.com/hs-fs/hubfs/aicpa.png?width=110&height=110&name=aicpa.png) ### Are we a good fit? [![Schedule Consultation](https://no-cache.hubspot.com/cta/default/1857420/interactive-196258273705.png)](https://blog.fivenines.com/hs/cta/wi/redirect?encryptedPayload=AVxigLJNfuYeY4sHqnUnNOtu4%2BOVTIFPFuBdLd0pPWn%2BpatmQQAMzCzzsOjCC8dX7Dq4tDnf5iXmbu7BWib124tWibjHPZCggui6y%2BvVbX3XJJrKNGVdFKphF0UqjshlfsUq9YE7ZEVxPNRhbGjpZ8xeYoJyKpc7bFqJ%2FtAdXT6SCHPx1HYZL9wiAOtycNafXqnyGjIjhg%3D%3D&webInteractiveContentId=196258273705&portalId=1857420)   - [Privacy Policy](https://fivenines.com/privacy-policy/) - [HTML Sitemap](https://fivenines.com/html-sitemap/) © 2026 Five Nines Technology Group | 5617 Thompson Creek Blvd Lincoln, NE 68516 [Facebook](https://www.facebook.com/gonines)[Linkedin](https://www.linkedin.com/company/five-nines-technology-group/) [Blog](https://blog.gonines.com/?__hstc=143714730.45718742b0726c421d8592d7ea71f58b.1757514685996.1758029308186.1758134756251.4&__hssc=143714730.31.1758134756251&__hsfp=1745665186)   [Client Support](https://fivenines.com/client-login/) Return to top ```json { "@context" : "https://schema.org", "@type" : "FAQPage", "mainEntity" : [ { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Year one runs meaningfully higher." }, "name" : "How does year-one cost compare to steady-state?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Annual escalation typically; substantive renegotiation at renewal." }, "name" : "Can the partner fee be negotiated mid-cycle?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Highly clinic-specific." }, "name" : "How does this compare to fully managed TCO?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Transition costs apply." }, "name" : "What if the partnership ends mid-cycle?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Should, at most defensible engagements." }, "name" : "Does TCO include compliance program costs?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Yes, summary form." }, "name" : "Should the board see TCO?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "As part of overall cost composition." }, "name" : "How does HIPAA program cost integrate?" } ] } ```