INTRODUCTION

The healthcare industry witnessed a rapid increase in the IT and business process outsourcing adoption in recent years. Regulatory reform, consumerization of healthcare, market consolidation, and emergence of new technologies accelerated outsourcing in the healthcare market. In order to cater to this growing market segment, a number and variety of service providers have developed capabilities.

With healthcare companies stepping up adoption of outsourced delivery, there is an uptick in demand for research and market intelligence on demand and supply trends in healthcare outsourcing, across the three major market segments – payer, provider, and life sciences. The need is more pronounced for the vertical-specific application outsourcing (AO) function, where business challenges are driving greater adoption. Everest Group’s healthcare outsourcing research program addresses this market requirement by analyzing outsourcing trends and service provider capabilities specific to IT AO in the healthcare vertical.

In this report, we analyze the capabilities of 15+ AO service providers specific to the global healthcare payer sector. Eight of these service providers are mapped on the Everest Group PEAK Matrix, which is a composite index of a range of distinct metrics related to a service provider’s capability and market success.

Scope of analysis

• Industry: Healthcare payers (public health plans, private health plans)
• Services: Large (TCV >US$25 million), multi-year (>three years), and annuity-based application outsourcing
• Geography: Global
• Sourcing model: Third-party AO transactions; excludes shared services or captives

CONTENTS

This report is structured across four key sections, each containing insights on the payer AO service provider landscape, with a specific focus on large-sized contracts:

• Payer AO service provider landscape: Analysis of individual service provider capabilities in the payer AO space along the following dimensions:
  • Delivery capability:
    • Scale
    • Scope
    • Domain investments
    • Delivery footprint
  • Market success:
    • Transaction activity
• Payer AO PEAK Matrix: Payer AO PEAK Matrix and analysis of PEAK clusters:
  • Mapping of payer AO service providers on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix
  • Commentary on the capabilities of each service provider:
    • Delivery capability characteristics (scale, scope, domain investments, and delivery footprint)
    • Market success characteristics (transaction activity)
  • Upcoming service providers in the payer AO space
  • Other notable payer AO service providers not analyzed on the payer AO PEAK Matrix
• Implications for key stakeholders: Implications of identified payer AO service provider landscape characteristics for key stakeholders:
  • Implications for service providers
  • Implications for buyers
• PEAK payer AO service provider profiles: Detailed profiles containing the following information for each of the eight service providers featuring on the payer AO PEAK Matrix:
  • Corporate summary and payer AO business overview
  • Detailed assessment of payer AO capabilities
  • Healthcare and payer AO domain investments
  • Payer AO transaction activity
  • Key offshore delivery locations for payer AO