Introduction

The healthcare landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with mobile computing, social media platforms, and “anytime-anywhere” information access). This combination of disruptive and legacy factors has driven healthcare firms to adopt new technologies, while also revamping their existing systems, processes, and interfaces.

As the technology mandate for healthcare enterprises evolves, so do their relationships with IT service providers. This, in turn, is driving the need for relevant research and market intelligence on demand and supply trends in healthcare outsourcing across the three major market segments – payer, provider, and life sciences. 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 20 ITO service providers specific to the global healthcare payer sector. These service providers are mapped on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix, which is a composite index of a range of distinct metrics related to a provider’s capability and market success.

Scope of the analysis

• Industry: Healthcare payers (public and private health plans)
• Services: Large (TCV > US$25 million), multi-year (>3 years), and annuity-based IT outsourcing
• Geography: Global (though with a slight skew towards the U.S. payer market, given dominant market activity)
• Sourcing model: Third-party ITO transactions; excludes shared services or Global In-house Centers (GICs)

Contents

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

• Payer IT service provider landscape: Analysis of individual service provider capabilities in the payer IT space along the following dimensions:
• Delivery capability:
• Scale
• Scope
• Domain investments
• Delivery footprint
• Innovation
• Buyer satisfaction
• Market success:
• Transaction activity
• Payer IT PEAK Matrix 2015 and analysis of the PEAK Matrix clusters:
• Mapping of payer IT service providers on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix
• Commentary on the specific characteristics of the PEAK Matrix clusters (Leaders, Major Contenders, and Aspirants)
• Commentary on the capabilities of each service provider:
• Delivery capability characteristics (scale, scope, domain investments, delivery footprint, innovation, and buyer satisfaction)
• Market success characteristics (transaction activity)
• Implications for key stakeholders: Implications of the market dynamics and identified payer IT service provider landscape characteristics for key stakeholders:
• Implications for service providers
• Implications for buyers

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