This report helps healthcare payors craft a robust strategy for digital transformation based on industry outlook and best practices. It begins with a summary of key trends shaping the healthcare payor industry, followed by the industry outlook over the next 18–24 months. We continue with a detailed assessment of 21 leading service providers. Each profile provides an overview of the service provider, their industry-specific solutions, and a list of representative clients and partnerships, along with brief client case studies. Each profile concludes with analyst insights on the provider’s practice maturity, investments and innovations, and partner ecosystem. The report can aid businesses in identifying the right partners and service providers to support their digital transformation journeys.
Why read this RadarView?
The healthcare payor industry is experiencing major disruption due to the lingering impact of the pandemic. The shift to different business and operating models, regulatory push from governments, and rising expectations of members/patients have accelerated the shift to value-based care (VBC), interoperability, and price transparency.
This report addresses the need for healthcare payors to understand the right action points to gain competitive advantage. It also identifies key service providers and system integrators that can help enterprises accelerate their digital adoption.
Featured providers
This RadarView includes an analysis of the following service providers in the healthcare payor digital services space: Accenture, Atos, Capgemini, Cognizant, Exela Technologies, Firstsource, HCL, Hexaware, IBM, Infosys, Infinite Computer Solutions, Mphasis, Mindtree, NTT DATA, Optum, Persistent Systems, TCS, Tech Mahindra, UST, Virtusa, and Wipro.
Methodology
The industry insights and recommendations presented are based on our ongoing interactions with senior executives, vendors, subject matter experts, and Avasant Fellows, along with lessons learned from consulting engagements.
Our evaluation of service providers is based on primary input from the providers, focused briefings, public disclosures, and Avasant’s ongoing market interactions. The assessment is across the three dimensions of practice maturity, investments and innovation, and partner ecosystem, leading to our recognition of those service providers that have brought the most value to the market over the last 12 months.
Table of contents
About the report (Page 3)
Scope of the report (Page 4–5)
Executive summary (Pages 6–8):
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- Key recommendations for healthcare payors
- Avasant recognizes 21 top-tier providers supporting healthcare payors in digital transformation
Lay of the land (Pages 9–16)
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- Trends shaping the healthcare payor industry
- Growth of US healthcare spending from 2019–2028
- Acceleration of preventive care investments by payors
- Inclusion of SDOH for predicting patient health and reducing disparities
- Deployment of interoperable offerings for regulatory compliance
- Focus on consumer-driven strategy
- Niche players focusing on consumerism
The road ahead (Pages 17–23)
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- Pursue acquisitions for horizontal and vertical integration of healthcare businesses
- Harness the power of AI and analytics to generate policies, contain costs, and manage members and providers
- Explore investments and partnerships with other players in the ecosystem
- Leverage emerging tech across the payor value chain
- Expand investments in startups to acquire specialized digital capabilities
- Partner with service providers to expedite digital transformation
RadarView overview (Pages 24–29)
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- Methodology and coverage
- Interpretation of classification
- RadarView assessment
Service provider profiles (Pages 30–93)
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- Detailed profiles for Accenture, Atos, Capgemini, Cognizant, Exela Technologies, Firstsource, HCL, Hexaware, IBM, Infosys, Infinite Computer Solutions, Mphasis, Mindtree, NTT DATA, Optum, Persistent Systems, TCS, Tech Mahindra, UST, Virtusa, and Wipro
Read the Research Byte based on this report.