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IT Outsourcing in Healthcare Payer Industry - Service Provider Landscape with PEAK Matrix™ Assessment and Profile Compendium 2013

INTRODUCTION

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

As healthcare companies are stepping up the 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 IT outsourcing (ITO) function, where business challenges are driving greater technology adoption. Everest Group’s healthcare outsourcing research program addresses this market requirement by analyzing outsourcing trends and service provider capabilities specific to ITO in the healthcare vertical.

In this report, we analyze the capabilities of 15+ ITO service providers specific to the global healthcare payer sector. Twelve 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.

Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix for payer ITO

Scope of the analysis

  • Industry: Healthcare payers (public health plans and private health plans)
  • Services: Large (TCV > US$25 million), multi-year (>3 years), and annuity-based application outsourcing
  • Geography: Global
  • Sourcing model: Third-party ITO transactions; excludes shared services or captives

Regional scope of payer ITO contracts 

CONTENTS

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

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