Healthcare Payer BPO – Annual Report: From Cost Reduction to Value-Driven Outsourcing – Moving On Up

8 Aug 2016
by Manu Aggarwal

The global healthcare payer BPO market grew at a healthy pace during 2012-2015, reaching ~US$5.5 billion in 2015. Stringent regulatory compliances, increase in healthcare spending globally, and shift in industry characteristics (such as focus on value-based care) are some of the key factors driving the growth in the market.

Over the last three years, healthcare payer market witnessed increased volume of work as well as a rise in the average ACV. Claims processing continues to be the most outsourced and offshored process within the value chain. Technology-led solutions are gaining traction in healthcare BPO, with platform solutions being the most preferred by the buyers. Also, evolved pricing models such as transaction- or outcome-based pricing are gaining dominance.

Scope and Methodology

  • Proprietary database of over 300 healthcare payer BPO contracts (updated annually)
  • Coverage across 20 healthcare payer BPO service providers including Accenture, Cognizant, CGI, CSC, Concentrix, Dell, EXL, Firstsource, Genpact, HCL, HCCA, Hexaware, HGS, iGate, Infosys, Serco, SourceHOV, Sutherland Global Services, Wipro, Xchanging, and Xerox


This report provides comprehensive coverage of the global healthcare payer BPO market, including adoption trends across geographies, key solution characteristics, drivers & challenges, and service provider landscape. It will assist key stakeholders (buyers, service providers, and technology providers) to understand the changing dynamics of the healthcare payer BPO market and identify the upcoming trends. Some of the findings in this report are:

  • The healthcare payer BPO market continued to grow at a healthy CAGR of 15% during 2012-2015
    • Increasing adoption of outsourcing services due to an ever-changing regulatory landscape was the key growth driver
  • North America dominated the market, accounting for over 90% of the global healthcare payer BPO outsourcing spend
    • Adoption across other geographies, though prospective, is still very small at the global scale
  • “Contract renewal” witnessed higher growth as compared with “new contract signings” during 2014-2015, as buyers’ deferred new contracts signings awaiting expected political changes in the country
  • Small buyers (revenue <US$5 billion) drove adoption of BPO services during 2014-2015
  • Market share continues to be concentrated among few service providers, with the top three service providers accounting for 60% of the market share by revenue
  • Robotic Process Automation (RPA) is a new lever to further reduce the cost of operations. It is expected to play an significant role in the future

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