Hello, I am Abhishek Singh, Senior Analyst,
with Everest Group. Here at Everest Group,
I currently lead the Healthcare Outsourcing
research program. Today, I'm here to talk
about a theme we are closely following and
that is the convergence of healthcare payers
and providers market in the U.S.
The U.S. healthcare market is at a unique
point in history as the traditional boundaries
between payers and providers are blurring
at an accelerated pace.
What this framework shows is that payers and
providers both, are choosing between the "acquire"
and "manage" side of the spectrum to assume
roles that span both care financing and care
delivery. Hence, the question is -- what is
the impact of this on healthcare outsourcing?
Because payers and providers fundamentally
have approached technology adoption differently,
this convergence in healthcare alters the
demand profile significantly.
"New" converged entities looking to realize
synergies across their outsourced portfolios
will seek service providers that provide competence
and expertise across the payer provider spectrum.
However, existing choices in the market for
such service providers are few.
In 2012, Everest Group evaluated service providers
in the healthcare industry by using their
large Application Outsourcing (AO) contracts
(>US$25 million TCV) as criteria.
The results of this evaluation were highlighted
on the Everest Group PEAK Matrix.
A quick look at the payer and provider PEAK
Matrix evaluations in conjunction, highlights
only few options that are strong across both
the segments.
Given that this may result in a supply-side
challenge, payers and providers will have
to consider and evaluate service providers
with balanced payer-provider service capabilities.
The corollary to the above is that service
providers who have a balanced and holistic
portfolio of healthcare offerings will find
themselves better placed to serve this new
market opportunity.
You can learn more about IT implications arising
out of payer-provider convergence in the viewpoint
we have recently released on this topic. You
can also write to us at info@everestgrp.com.
Thanks for watching.
