This RadarView™ provides a holistic view of the leading service providers offering healthcare payer business process transformation services. It begins by summarizing key trends shaping the market’s supply side and continues with a detailed assessment of 22 service providers. Each profile presents an overview of the service provider, its key IP assets, a list of clients and partnerships, and brief client case studies. Each profile concludes with analyst insights on the provider’s practice maturity, domain ecosystem, and investments and innovations.
Why read this RadarView?
The healthcare payer business process industry is experiencing rapid transformation fueled by technological innovation and evolving member expectations. Payers are increasingly deploying generative AI, machine learning, and robotic process automation to streamline functions such as claims processing and prior authorization. At the same time, there is a heightened focus on value-based care, with service providers prioritizing personalized, efficient care management to enhance outcomes and member engagement.
The Healthcare Payer Business Process Transformation 2025 RadarView™ highlights key supply-side trends in this space and Avasant’s viewpoint on them. It aids companies in identifying top service providers to assist them in healthcare payer business process transformation. It also analyzes each service provider’s capabilities in technology and delivery support, enabling organizations to select the right strategic partners for their healthcare payer processes.
Featured providers
This RadarView includes a detailed analysis of the following healthcare payer business process transformation service providers: Accenture, Cognizant, Concentrix, Conduent, Exela Technologies, EXL, Firstsource, Genpact, HCLTech, Hexaware, Infosys, NTT DATA, Omega Healthcare, Optum, Sagility, Shearwater Health, Smart Data Solutions, Sutherland, Vee Healthtek, Viaante, Wipro, and WNS.
Methodology
Our evaluation of service providers is based on primary input from the providers, focused briefings, public disclosures, validation from their clients, and Avasant’s ongoing market interactions. The assessment is across the three dimensions of practice maturity, domain ecosystem, and investments and innovation, leading to our recognition of service providers that have brought the most value to the market over the past 12 months.
Table of contents
About the report (Page 3)
Executive summary (Pages 4–9)
-
- Definition and scope
- Avasant recognizes 22 top-tier providers offering healthcare payer business process transformation services
- Provider comparison
Supply-side trends (Pages 10–14)
-
- Service providers’ revenue and client growth are accelerating due to the need to enhance the quality of care, control rising costs, and improve overall efficiency.
- Clients are favoring outcome/KPI-based and output/transaction-based pricing models due to the emerging demand for value-based care models.
- Service providers are differentiating themselves to enhance their service offerings and maximize value for their clients.
- There is a heightened emphasis on building domain and service delivery capabilities via strategic acquisitions and investments in AI-powered offerings.
Service provider profiles (Pages 15–59)
-
- Detailed profiles for Accenture, Cognizant, Concentrix, Conduent, Exela Technologies, EXL, Firstsource, Genpact, HCLTech, Hexaware, Infosys, NTT DATA, Omega Healthcare, Optum, Sagility, Shearwater Health, Smart Data Solutions, Sutherland, Vee Healthtek, Viaante, Wipro, and WNS.
Appendix (Pages 60–63)
-
- RadarView assessment
- Research methodology and coverage
- Interpretation of classification
Key contacts (Page 64)
Read the Research Byte based on this report. Please refer to Avasant’s Healthcare Payer Business Process Transformation 2025 Market Insights™ for demand-side trends.