diff --git a/R4.slnf b/R4.slnf
index 4469743c86..0e555d8325 100644
--- a/R4.slnf
+++ b/R4.slnf
@@ -10,6 +10,9 @@
       "src\\Microsoft.Health.Fhir.Azure\\Microsoft.Health.Fhir.Azure.csproj",
       "src\\Microsoft.Health.Fhir.Core.UnitTests\\Microsoft.Health.Fhir.Core.UnitTests.csproj",
       "src\\Microsoft.Health.Fhir.Core\\Microsoft.Health.Fhir.Core.csproj",
+      "src\Microsoft.Health.Fhir.CosmosDb.Core\Microsoft.Health.Fhir.CosmosDb.Core.csproj",
+      "src\Microsoft.Health.Fhir.CosmosDb.Initialization.UnitTests\Microsoft.Health.Fhir.CosmosDb.Initialization.UnitTests.csproj",
+      "src\Microsoft.Health.Fhir.CosmosDb.Initialization\Microsoft.Health.Fhir.CosmosDb.Initialization.csproj",
       "src\\Microsoft.Health.Fhir.CosmosDb.UnitTests\\Microsoft.Health.Fhir.CosmosDb.UnitTests.csproj",
       "src\\Microsoft.Health.Fhir.CosmosDb\\Microsoft.Health.Fhir.CosmosDb.csproj",
       "src\\Microsoft.Health.Fhir.R4.Api\\Microsoft.Health.Fhir.R4.Api.csproj",
diff --git a/R5.slnf b/R5.slnf
index b34a610a38..61bdc352fd 100644
--- a/R5.slnf
+++ b/R5.slnf
@@ -10,6 +10,9 @@
       "src\\Microsoft.Health.Fhir.Azure\\Microsoft.Health.Fhir.Azure.csproj",
       "src\\Microsoft.Health.Fhir.Core.UnitTests\\Microsoft.Health.Fhir.Core.UnitTests.csproj",
       "src\\Microsoft.Health.Fhir.Core\\Microsoft.Health.Fhir.Core.csproj",
+      "src\Microsoft.Health.Fhir.CosmosDb.Core\Microsoft.Health.Fhir.CosmosDb.Core.csproj",
+      "src\Microsoft.Health.Fhir.CosmosDb.Initialization.UnitTests\Microsoft.Health.Fhir.CosmosDb.Initialization.UnitTests.csproj",
+      "src\Microsoft.Health.Fhir.CosmosDb.Initialization\Microsoft.Health.Fhir.CosmosDb.Initialization.csproj",
       "src\\Microsoft.Health.Fhir.CosmosDb.UnitTests\\Microsoft.Health.Fhir.CosmosDb.UnitTests.csproj",
       "src\\Microsoft.Health.Fhir.CosmosDb\\Microsoft.Health.Fhir.CosmosDb.csproj",
       "src\\Microsoft.Health.Fhir.R5.Api\\Microsoft.Health.Fhir.R5.Api.csproj",
diff --git a/src/Microsoft.Health.Fhir.CosmosDb/Features/Storage/FhirCosmosClientInitializer.cs b/src/Microsoft.Health.Fhir.CosmosDb/Features/Storage/FhirCosmosClientInitializer.cs
index 36ba1c1f11..ae54926ece 100644
--- a/src/Microsoft.Health.Fhir.CosmosDb/Features/Storage/FhirCosmosClientInitializer.cs
+++ b/src/Microsoft.Health.Fhir.CosmosDb/Features/Storage/FhirCosmosClientInitializer.cs
@@ -30,7 +30,7 @@ public class FhirCosmosClientInitializer : ICosmosClientInitializer
         private readonly ILogger<FhirCosmosClientInitializer> _logger;
         private readonly Func<IEnumerable<RequestHandler>> _requestHandlerFactory;
         private readonly RetryExceptionPolicyFactory _retryExceptionPolicyFactory;
-        private readonly ConcurrentDictionary<string, CosmosClient> _cosmosClients;
+        private static CosmosClient _cosmosClient;
         private readonly object _lockObject;
 
         public FhirCosmosClientInitializer(
@@ -48,7 +48,6 @@ public FhirCosmosClientInitializer(
             _requestHandlerFactory = requestHandlerFactory;
             _retryExceptionPolicyFactory = retryExceptionPolicyFactory;
             _logger = logger;
-            _cosmosClients = new ConcurrentDictionary<string, CosmosClient>();
             _lockObject = new object();
         }
 
@@ -60,24 +59,16 @@ public CosmosClient CreateCosmosClient(CosmosDataStoreConfiguration configuratio
             string key = string.IsNullOrEmpty(configuration.Host) ? "local" : configuration.Host;
 
             // Thread-safe logic to ensure that a single instance of CosmosClient is created per host.
-            if (_cosmosClients.TryGetValue(key, out CosmosClient client1))
+            if (_cosmosClient != null)
             {
-                return client1;
+                return _cosmosClient;
             }
             else
             {
                 lock (_lockObject)
                 {
-                    if (_cosmosClients.TryGetValue(key, out CosmosClient client2))
-                    {
-                        return client2;
-                    }
-                    else
-                    {
-                        var client = CreateCosmosClientInternal(configuration);
-                        _cosmosClients.TryAdd(key, client);
-                        return client;
-                    }
+                    _cosmosClient = CreateCosmosClientInternal(configuration);
+                    return _cosmosClient;
                 }
             }
         }