Targeting ‘average Jane’: The co-modification of for-profit nursing home care in the Netherlands

In the Global North, long-term residential care is increasingly shaped by globally financed, for-profit nursing home chains. Yet little is known about how such initiatives operate and how they interact with public healthcare systems. This article investigates a long-term care facility in the Netherlands backed by global investment capital. Drawing on the concept of co-modification (Asdal & Huse, 2023), defined as the co-creation of goods and services alongside markets and regulatory frameworks, we examine how actors across different layers of the healthcare system collaboratively transform care into a profitable product. Based on ethnographic observations, interviews with care providers and policymakers, and analysis of policy documents, we identify four interconnected practices through which co-modification unfolds: 1) articulating user value, 2) delineating a customer niche, 3) making products by standardizing, and 4) claiming space trough legitimacy work and strategic positioning in a health care system. We show how in this process globally financed care providers become increasingly entangled with regular care providers and reshape the healthcare system. In doing so, we extend the concept of co-modification to public healthcare systems under institutional constraints, show what work is needed in such circumstances, and introduce market segmentation as a co-productive mechanism linking valuation practices to the configuration of consumer populations.