In the face of challenges such as rising healthcare costs, uncertainty over healthcare reform, IT/systems integration, and alignment of incentives with healthcare providers, the healthcare payor industry is aggressively pouring digital investments and adopting cutting-edge technologies, including generative AI, advanced analytics, automation, and cybersecurity, to address these challenges. Healthcare payor companies are leveraging digital technologies to revolutionize their processes. Healthcare payor enterprises collaborate with service providers for digital transformation, which requires strong technological expertise and delivery capabilities.
Both demand-side and supply-side trends are covered in our Healthcare Payor Digital Services 2024 Market Insights™ and Healthcare Payor Digital Services 2024 RadarView™, respectively. These reports present a comprehensive study of digital service providers in the healthcare payor industry, including top trends, analysis, and recommendations. It takes a close look at the leaders, innovators, disruptors, and challengers in this market.
We evaluated 34 service providers across three dimensions: practice maturity, partner ecosystem, and investments and innovation. Of the 34 providers, we recognized 21 that brought the most value to the market over the past 12 months.
The reports recognize service providers across four categories:
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- Leaders: Accenture, Cognizant, HCLTech, Infosys, Optum, and Wipro
- Innovators: Capgemini, Eviden, IBM, Infinite Computer Solutions, NTT DATA, TCS, Virtusa
- Disruptors: DXC, Genpact, LTIMindtree, Persistent Systems, Tech Mahindra
- Challengers: Exela Technologies, Hexaware, Mphasis
Figure 1 below from the full report illustrates these categories:
“Payors are under constant pressure to optimize the cost of care while improving its quality,” said Nishant Verma, managing partner at Avasant. “Through investments in preventive care, payors are containing costs by reducing admission rates and identifying high-risk patients, as well as establishing a direct connection with members.”
Matthew Barlow, partner at Avasant, added, “Payors are investing heavily in digitally enabled platforms, tools, and devices to get closer to members, offer price transparency, and remotely monitor patients through preventive apps, wearables, and IoMT devices.”
The reports provide several findings, including the following:
- Payviders are transforming healthcare by connecting payors and providers.
- Healthcare payors are driving down costs and improving quality through innovation.
- Alternative payment models are revolutionizing healthcare by incentivizing value-based care, driving improved outcomes and patient-centered approaches.
- Excellence in HEDIS and Medicare Advantage Star Ratings helps consumers choose and gives healthcare payors the competitive edge needed for recruitment success and revenue growth.
- Healthcare payors are promoting equitable access and sustainability.
“Healthcare payors navigate intricate pricing structures and an evolving regulatory landscape,” said Eratha Poongkuntran, research leader at Avasant. “Embracing innovative pricing models and value-based approaches is crucial to ensuring equitable access to effective treatments while managing costs effectively.”
The RadarView also features detailed profiles of 21 service providers, along with their solutions, offerings, and experience in assisting healthcare payor enterprises in their digital transformation journeys.
This Research Byte provides a brief overview of the Healthcare Payor Digital Services 2024 Market Insights™ and Healthcare Payor Digital Services 2024 RadarView™ (click for pricing).