IT Outsourcing in Payer Industry – Service Provider Landscape with PEAK Matrix™ Assessment 2014: Rise of the Challengers

29 Oct 2014
by Abhishek Singh, Jimit Arora, Nitish Mittal



The healthcare industry is witnessing unprecedented churn and transformation, leading to a surge in adoption of IT and business process outsourcing. Driven by regulatory reforms, tenets of consumerization, market consolidation, and emergence of the next-generation digital avenues, acceptance of outsourcing has accelerated in the space. The payer industry is grappling with widespread reforms as well as increasing consumerization of demand fundamentally altering their operating model. To tackle these, market participants are actively looking at technology as a lever of operational efficiency and transformational change. As HIX, ACOs, payer-provider convergence, and the overall shift to value-based reimbursement get operationalized; payers need to chalk out an effective IT strategy.

With companies stepping up adoption of outsourced delivery, there is an uptick in demand for relevant research and market intelligence on demand and supply trends in healthcare outsourcing across each subvertical – payer, provider, and life sciences. The need is more pronounced for the vertical-specific IT outsourcing 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 ITO in the life sciences vertical.

In this report, we analyze the capabilities of 18 leading ITO service providers specific to the global payer sector. 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.

PEAK Matrix

Scope of the analysis

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

Average Revenue and Headcount


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

  • Implications for key stakeholders: Implications of identified payer ITO service provider landscape characteristics for key stakeholders:
    • Implications for service providers
    • Implications for buyers
  • 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
  • Market success:
    • Transaction activity
  • The 2014 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, and domain investments)
      • Market success characteristics (transaction activity)
    • Other notable service providers in the payer ITO space

Everest Group has a complimentary four-page PEAK Matrix preview document for this service provider landscape report.


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