Collaboration with healthcare stakeholders is a fundamental component of a systems-based healthcare economy, and it will become the dominate business model going forward. Yet most healthcare industry stakeholders are failing to accept this inevitable transition. While many acknowledge the need to move toward a more integrated “systems thinking” approach – one that maps influence patterns, amplifies interdependencies, and drives collective outcomes, they struggle with actual implementation. A viable and sustainable information network provides the structure, aligned incentives and competitive collaboration the bricks and mortar, and trust the cornerstone. Until they can build that and foster a culture of transparency, they won’t achieve the cost and innovation benefits inherent in these cross-industry partnerships. Although healthcare stakeholders know they need to partner with others to be successful in this new systems-thinking economy, they need actionable strategies to demonstrate how the benefits of ongoing collaborations far outweigh the risks. This podium presentation will present original research aimed to qualify stakeholder perceptions on alignment and collaboration around the delivery of healthcare, in addition to critical hurdles they must overcome. A recent survey of close to 300 Biopharma executives, EU and US Payers, and US providers provides insight into their needs, their disparate perceptions, and their levels of confidence in the ability to shift to a systems-thinking collaborative culture. Approximately 25% of respondents stated they were not aligned with other stakeholders, though agree they need better alignment and foresee closer collaboration in the future. Over 70% of stakeholders believe data transparency and information-sharing is critically important to a successful and interoperable healthcare system, yet very few from each group were willing to demonstrate such transparency. Further detail will be given on insights and challenges gleaned from interviewing large and small stakeholders as well as practical strategies to guide the transformation to a systems-thinking industry.