Service innovation has been a hot research topic in general and also in the specific healthcare context. In the literature empirical evidence about the impact of novelty of service innovation on its success is inconclusive. A plausible explanation is that the used analytical frameworks do not fully capture the complexity of service innovation. This study employs a four-dimension framework of novelty and posits that the success of service innovation does not depend on individual dimensions. Based on the set-membership theory with a configurational analysis, as well as a comparison between Chinese and Dutch healthcare systems, this study puts forward propositions on the relationship between novelty and success of healthcare service innovation. The findings augment extant service knowledge by demonstrating why interdependencies among various newness dimensions of novelty are essential to consider for gaining an accurate understanding of healthcare service innovation success, particularly in different countries