The impending NHI will cause a disruptive change in the health care industry in South Africa. For that reason the affected firms need to prepare themselves. Furthermore the current stakeholders in the private health care sector are feeling disenfranchised in terms of how the NHI will turn out.The aim of this study was to understand the response of existing firms whose existence is threatened due to impending disruptive change.The research method that was used was qualitative and exploratory in design. It involved one on one semi structured interviews with 13 respondents from a total of 7 firms who were selected to participate in the study, from the following business groups: pharmaceutical firms, private hospitals, and medical distributors.The findings revealed that the majority of firms would respond by strengthening their relations with the government who is the key stakeholder in the NHI. Secondly, they would build capacity in terms of resources and capabilities in line with the NHI. Lastly, they would innovate their value offering in the current market or new markets.