The case describes the challenges related to topline enhancement faced by Sparsh Nephrocare, a growing chain of dialysis centers in India. In the early years of its operations (2010-2015), Sparsh grew mainly by opening new centers and focused on cost leadership to maintain profitability. However, as Sparsh's founders, Gaurav Porwal and Saurav Panda, look to raise Series B funding, they are faced with the challenge of how to fuel the next phase of growth at the existing centers. Any option worth investigating must ensure that the company's relationships with various stakeholders in a fragmented ecosystem are not adversely affected. This includes ensuring good outcomes for patients and preserving the autonomy of nephrologists and the importance of the hospitals that house these dialysis centers.

Spreadsheet supplement for case ISB131.