everest group’s peak matrix for global payer it service ......l&t infotech tech mahindra...

Copyright © 2015 Everest Global, Inc.

This document has been licensed for exclusive use and distribution by TCS

Focus on TCS

December 2015

Everest Group’s PEAK Matrix for Global Payer IT

Service Providers

EGR-2015-12-E-1651

Copyright © 2015, Everest Global, Inc.

EGR-2015-12-E-16512

Introduction and scope

Everest Group recently released its report titled “IT Outsourcing in Payer Industry – Service Provider

Landscape with PEAK Matrix™ Assessment 2015”. This report analyzes the changing dynamics of the global

payer IT landscape and assesses service providers across several key dimensions.

As a part of this report, Everest Group analyzed 20 leading service providers on the Everest Group

Performance | Experience | Ability | Knowledge (PEAK) Matrix, specific to global payer IT, categorizing them

into Leaders, Major Contenders, and Aspirants. The PEAK Matrix is a composite framework that provides an

objective, data-driven, and comparative assessment of payer IT service providers based on their absolute

market success and delivery capability.

Based on the analysis, TCS emerged as a Leader and Star Performer. This document focuses on TCS’

payer IT experience and capabilities in the global payer IT market. It includes:

TCS’ position on the payer IT PEAK Matrix

Detailed payer IT profile of TCS

Buyers can use the PEAK Matrix to identify and evaluate different service providers. It helps them understand

the service providers’ relative strengths and gaps. However, it is also important to note that while the PEAK

Matrix is a useful starting point, the results from the assessment may not be directly prescriptive for each

buyer. Buyers will have to consider their unique situation and requirements, and match them against service

provider capability for an ideal fit.

https://research.everestgrp.com/Product/EGR-2015-12-R-1620/IT-Outsourcing-in-Payer-Industry-Service-Provider-Landscape-w


EGR-2015-12-E-16513

Background and scope of the research

Background of the researchThe 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 the 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.

We focus on: The landscape of service providers for healthcare payer IT

Assessment of the service providers on a number of capability-related dimensions Characteristics of Leaders, Major Contenders, and Aspirants on the Everest Group PEAK Matrix

Implications for healthcare payers and service providers

Scope of this report:

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)


EGR-2015-12-E-16514

TCS is positioned as a Leader and Star Performer

on Everest Group’s PEAK Matrix for large payer IT

relationships

Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix for large payer IT relationships1

Leaders

Major Contenders

Aspirants

Star Performers

Mark

et

su

ccess

Low

Low High

High

Delivery capability

(Scale, scope, domain investments, delivery footprint, innovation, and buyer satisfaction)

75th percentile

25

thp

erc

en

tile

25th percentile

CGI

Infosys

Wipro

AtosCSC

Capgemini+IGATEHPE

Virtusa

EPAM

L&T Infotech

Tech Mahindra

FujitsuUnisys

Hexaware

Accenture

CognizantIBM

TCS

75

thp

erc

en

tile

HCL Technologies

Dell Services

Major Contenders

Leaders

Aspirants

1 PEAK Matrix specific to large (>US$25 million TCV), multi-year (>three years) IT outsourcing relationships within the payer sector; the evaluation this year

(2015) is weighted more on Application Outsourcing (AO), as a majority of large deals have application outsourcing in scope

Source: Everest Group (2015)


EGR-2015-12-E-16515

TCS | Payer IT profile (page 1 of 5)

Corporate and healthcare overview

Company description: Tata Consultancy Services (TCS) offers a range of IT

and consultancy services across various industries. In the healthcare space,

TCS offers a consulting-led, integrated portfolio of IT and IT-enabled

infrastructure, engineering, and assurance services. TCS leverages a global

network of technology, domain and academic labs to co-create industry-relevant

solutions with its healthcare customers. It enables them to leverage

technologies to increase customer and patient centricity.

Headquarters: Mumbai, India

Website: www.tcs.com

Services offered for the healthcare vertical: IT services across

payer, provider, and life sciences segments. Services for the payer

segment include digital transformation, ADM development leveraging

distributed Agile, application maintenance, assurance, business

analysis, architecture migration, performance insight dashboards,

advanced analytics, claims management, policy administration, HIX,

fraud analytics, ICD-10 enablement and assurance services, legacy

transformation, BPO solutions, etc.

Major healthcare clients: Cigna, GlaxoSmithKline, Eli Lilly, Cadila,

and Cardinal Health.

Scale of healthcare subverticals

Payer Life sciences Provider

Key financial parameters

Revenue figures in US$ million Revenue1 from healthcare and

life sciences

Revenue1 from other verticals

Enterprise operating margin

1 Financial year ends on March 31

Note: Clients mentioned are specific to the payer segment, and have been identified only from public sources


>US$500 million US$100-500 million <US$100 million

Service mix

FY 2015; US$ million

Geographical mix

FY 2015; US$ million

100% = 15,454 100% = 15,454

North America

Continental

Europe

India

ADM

Other APAC

BPO

Assurance

services

Enterprise solutions including BI

Infrastructure

services

Engineering &

industrial

services (4.5%) Asset

leverage

solutions

(2.5%)

UK

Latin America

(2.10%)

MEA (2%)

51.90%

16.7%

11.6%

9.3%

6%

40.2%

13.8%15.6%

11.7%

8.5%

Consulting

(3%)

10,966 12,838 14,672602 604

782

FY 2013 FY 2014 FY 2015

27.0%

11,56813,442 15,454

29.1%26.9%

http://www.tcs.com/


EGR-2015-12-E-16516



Payer IT capability assessment and market success

PEAK Matrix dimensions assessment

Dimension Rating

Scale

Scope

Domain investments

Delivery footprint

Innovation

Buyer satisfaction

Market success

High Low

North America EMEA

Latin America APAC

Geographic scopePayer subsegments

Public health plans

Private health plans

Value chain solutionsFunctional scope

Product development Care managementIO

Policy servicing

and management

Claims

managementAO

SI/consulting Network management

Capability

dashboard

Established: Mature capabilities with high adoption

Credible: Strong capabilities with rising adoption

Emerging: Nascent capabilities with limited adoption

More engaged middle management to adopt design thinking and proactive problem solving by anticipating client

demands

Need for a more transparent approach to communication and project management

Can further streamline operations to increase agility and kick-off times

Areas of improvement

Increasing traction with public health plans as it leverages the emerging opportunity arising out of payer-provider

convergence

Delivering efficiency benefits (costs and YoY productivity benefits) at scale with assured delivery quality

Improving resource productivity and thus offering lower cost

Changing revenue mix with increased focus on IP, moving away from pure “efficiency enablers” to impetus for non-

linear growth through licensing revenue

Getting the onshore-offshore cost mix right

Strengths

Everest Group PEAK Matrix for life sciences ITO

Mark

et

su

ccess

LowLow High

High

Delivery capability


75th percentile

25

thp

erc

en

tile

25th percentile

CGI

Infosys

Wipro

AtosCSC

Capgemini+IGATEHPE

Virtusa

EPAM

L&T Infotech

Tech Mahindra

FujitsuUnisys

Hexaware

Accenture

CognizantIBM

TCS

75

thp

erc

en

tile

HCL Technologies

Dell Services

Major Contenders

Leaders

Aspirants


EGR-2015-12-E-16517

Proprietary solutions (representative list)

Line of business Solutions

Payer Digital strategy solution: The TCS digital maturity model provides a high level overview of the transition

from basic web presence and information gathering to a fully integrated and socially-enabled model

ICD-10 compliance solution: Framework for ICD-10 compliance including multiple system remediation

approaches such as migration, field expansion, and crosswalks

Harmony Test Framework: To address challenges in domain-specific business process testing, time-to-

market, and business component testing

Test Message Generator: Enables generation of healthcare messages that are to be used to test

various systems

Interoperability solution: For unifying healthcare data (transformation and translation)

M2M solution: Platform for enabling aggregation of health information, analytics, and event triggering

Health Insurance Exchange (HIX) integration

Payer performance insights dashboards and advanced analytic solutions

Connected Wellness: A digital patient/member engagement platform for payers, providers, employers

for wellness solutions, wellness platform, messaging backbone, -driven wellness program, device

integration, and Internet of Things (IoT)

Sharehub: A solution for providing real-time operational data requests providing a consistent and

integrated view of latest healthcare information.

TDM-Secure: Test data security solution for healthcare payers, providers, and PBM encompassing risk

assessment, prioritization, and remediation powered by a Securehub and ARM framework

Customer 720 : Customer 720 is innovative, cost-effective, flexible, and scalable solution built on light

weight MDM framework to rapidly achieve a unified view of customer by utilizing data from internal,

external/social and analytical sources


IT domain investments



EGR-2015-12-E-16518

Proprietary solutions (representative list) (continued)

Line of business Solutions

Payer Transaction Validation and Translation Engine: The solution allows subscribers to upload their

predefined file formats as a part of the enrollment process that get submitted to the payers. The engine

validates the syntax and content of the file being uploaded and then converted to the predefined format

that gets consumed by the enterprise system. Includes scrubbers that clean the data working with the

enterprise system and pre-available data

Device Integration: The device integration solution provides the ability to bring in device data, transform

it, and provide the ability to store the same in an IoT platform or a relational database. The solution

uses patterns to be able to bring in newer devices with minimal lead time, with APIs exposed that would

be utilized by the system of engagement


IT domain investments

Key alliances (representative list)

Alliance partner Purpose of alliance

(Several) General enterprise level alliances with vendors such as Salesforce, Alcatel-Lucent, Cisco, EMC, Google,

HP, IBM, MetricStream, Microsoft, NetApp, Oracle, Sun, SAP, and Xerox, for solutions across various

industry verticals



EGR-2015-12-E-16519


Key IT delivery locations

Confirmed location for payer ITO

>5,000 ITO FTEs

1,000-5,000 ITO FTEs

500-1,000 ITO FTEs

100-500 ITO FTEs

<100 ITO FTEs


NOT EXHAUSTIVE

India

Mexico

China

Brazil

Europe

Uruguay

Argentina

Chile

Peru

Ecuador

Colombia

Middle East

Australia &

New Zealand

North America

South Africa


EGR-2015-12-E-165110

Appendix


EGR-2015-12-E-165111

Everest Group’s PEAK Matrix is a composite index of a range of distinct metrics related to a service provider’s scale, scope,

technology/domain investments, delivery footprint, and resultant market success in the context of a given outsourcing function.

The service providers were mapped on

Everest Group’s Performance | Experience | Ability |

Knowledge (PEAK) Matrix

Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix for IT Outsourcing

High

Low

Low High

Ma

rke

t s

uc

ce

ss

(Tra

nsa

ctio

n a

ctivity)

75th percentile

Top quartile performance

across market success and

capability2nd or 3rd quartile performance


capability

4th quartile performance


capability

Aspirants

Leaders

Major Contenders

75

thp

erc

en

tile

25th percentile

25

thp

erc

en

tile

Delivery capability



EGR-2015-12-E-165112

Dimensions of service providers’ capability and

market success underlying the PEAK Matrix

Active ACV of

relevant deals

Relevant deals

Scale

Revenue

Domain

investments

Proprietary

solutions

Scope

Lines of

business

served

ITO

subfunctions

Geographies

served

Delivery capability

Ma

rke

t s

uc

ce

ss

Everest Group PEAK Matrix

Aspirants

LeadersMajor Contenders

Delivery

footprint

Delivery mix

Buyer

satisfaction

Buyer

perception score

Innovation

Innovative

solutions

FTEs Investments in

M&As and

certifications

Delivery regions

covered

Growth in

renewals (Year-

on-Year)

Innovative

engagement

models


EGR-2015-12-E-165113

Parameters identified for

quantifying innovation in

payer ITO

Based on the analyst’s

perception of the steps

taken by service providers

to align themselves with

the changing market

dynamics

Everest Group employed a combination of qualitative

and quantitative parameters to allocate an innovation

score to service providers

Innovation

Experience

(number of clients)

Percentage of

contracts

Number of

contracts

Qualitative Quantitative

Analytics

support

Outcome-driven

deals

Social media

support

Mobility

support

Cloud

support


EGR-2015-12-E-165114

Year 1

Year 0

Service

provider

Ma

rke

t s

uc

ce

ss

Capability

Everest Group confers the “Star Performers” title on

providers that demonstrate the strongest forward

movement over time on the PEAK Matrix

Methodology

Everest Group selects market Star Performers based on the relative YOY movement of each

service provider on the PEAK Matrix

In order to assess advancements on

market success, we evaluate the

performance of each service provider on

the PEAK Matrix across a number of

parameters including:

Active ACV of large active ITO deals

Relevant deals

In order to assess advancements on

capability, we evaluate the performance

of each service provider on the PEAK

Matrix across a number of parameters

including:

Annual growth in scale

Increase in scope of services

Expansion of delivery footprint

Technology / domain-specific

investments

The top quartile performers on each of the

identified parameters are identified and the

“Star Performer” rating is awarded to the

service providers with:

The maximum number of top quartile

performances across all of the above /

left-listed parameters and

At least one area of top quartile

performance in both market success

and capability advancement

The “Star Performers” title relates to YOY performance for a given service provider and does

not reflect the overall market leadership position. Those identified as “Star Performers” may

include “Leaders”, “Major Contenders”, or “Aspirants”

2015 Payer IT PEAK

Matrix Star Performers


EGR-2015-12-E-165115

Payer IT Star Performer 2015

Payer IT

Star Performer

2015

Distinguishing

features of market

success in 2014

Distinguishing features of

capability advancements

in 2014

Change in position

on the PEAK

Matrix for payer IT

Entered the

Leaders

category

~30% YOY growth on a

sizable payer IT

revenue base

Experienced

accelerated spending

from small- to mid-sized

payer clients and

Account Care

Organizations (ACOs)

Clients spread (beyond

North America) across

Europe and Asia Pacific

Broad range of domain

solutions catering to a

diverse set of buyers and

capabilities (public/private

health plans, PBMs, etc.)

Enhanced proprietary

solutions across claims

engines, compliance, digital

IT transformation, and

customer-centric platforms


EGR-2015-12-E-165116

FAQs (page 1 of 2)

Does the PEAK Matrix assessment incorporate any subjective criteria?

Everest Group’s PEAK Matrix assessment adopts an objective and fact-based approach (leveraging service

provider RFIs and Everest Group’s proprietary databases containing providers’ deals and operational

capability information). In addition, these results are validated / fine-tuned based on Everest Group’s market

experience, buyer interaction, and provider briefings

Is being a “Major Contender” or “Aspirant” on the PEAK Matrix, an unfavorable outcome?

No. PEAK Matrix highlights and positions only the best-in-class service providers in a particular

functional/vertical services area. There are a number of providers in the global scenario that are assessed

but do not make it to the PEAK Matrix at all. Therefore, being represented on the PEAK Matrix is itself a

favorable recognition

What other aspects of PEAK Matrix assessment are relevant to buyers and providers besides the

“PEAK Matrix position”?

PEAK Matrix position is only one aspect of Everest Group’s overall assessment. In addition to assigning a

“Leader”, “Major Contender” or “Aspirant” title, Everest Group highlights the distinctive capabilities and

unique attributes of all the PEAK Matrix providers assessed in its report. The detailed metric-level

assessment and associated commentary is helpful for buyers in selecting providers for their specific

requirements. It also helps providers showcase their strengths in specific areas


EGR-2015-12-E-165117

FAQs (page 2 of 2)

What are the incentives for buyers and providers to participate in / provide input to PEAK Matrix

research?

Participation incentives for buyers include a summary of key findings from the PEAK Matrix assessment

Participation incentives for providers include adequate representation and recognition of their

capabilities/success in the market place, and a copy of their own “profile” that is published by Everest Group

as part of the “compendium of PEAK Matrix providers” profiles

What is the process for a service provider to leverage their PEAK Matrix positioning status?

Providers can use their PEAK Matrix positioning rating in multiple ways including:

– Issuing a press release declaring their positioning/rating

– Getting customized PEAK Matrix profile for circulation (with clients, prospects, etc.)

– Quotes from Everest Group analysts could be disseminated to the media

– Leveraging PEAK Matrix branding across communications (e-mail signatures, marketing brochures,

credential packs, client presentations, etc.)

The provider must obtain the requisite licensing and distribution rights for the above activities

through an agreement with the designated POC at Everest Group

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About Everest Group

Everest Group is a consulting and research firm focused on strategic IT, business

services, and sourcing. We are trusted advisors to senior executives of leading

enterprises, providers, and investors. Our firm helps clients improve operational

and financial performance through a hands-on process that supports them in

making well-informed decisions that deliver high-impact results and achieve

sustained value. Our insight and guidance empowers clients to improve

organizational efficiency, effectiveness, agility, and responsiveness. What sets

Everest Group apart is the integration of deep sourcing knowledge, problem-

solving skills and original research. Details and in-depth content are available at

www.everestgrp.com and research.everestgrp.com.

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everest group’s peak matrix for global payer it service ......l&t infotech tech mahindra...

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