This embedded case study focuses on Neusoft Medical to explore the mechanism through which the smart healthcare ecosystem achieves value co-creation under digital intelligence empowerment. The study found that the smart healthcare ecosystem co-creates value through a mechanism of “problem identification-digital-intelligence empowerment-digital-intelligence capability-value realization”. Digital intelligence empowerment helps address health challenges faced by the smart healthcare ecosystem and its three major subsystems. Each subsystem promotes the ecosystem overall value co-creation through vertical connection, horizontal coordination, and circular feedback. The smart healthcare ecosystem transcends the efficiency and economic value-driven mindset, with the “people-centeredness” approach runs through the entire value co-creation process, serving as the key guiding principle for value co-creation.