The healthcare outsourcing landscape is evolving rapidly as financial pressures, technological advancements, and regulatory shifts drive payers and providers to rethink their operations.  

The outsourcing market is far from immune to these trends, and leading service providers are now actively positioning themselves to stay ahead.  

Reach out to discuss this topic in depth. 

Based on industry developments over the past 18 months, here are three critical trends shaping the future of healthcare payer outsourcing. 

1. Mergers & acquisitions: A market in motion 

Investment activity in the healthcare outsourcing sector has surged, driven by financial pressures and technological disruptions—particularly the rise of Generative AI (gen AI). The market remains highly competitive, with firms aggressively building capabilities through acquisitions to fill gaps and strengthen their offerings. 

Private equity firms are playing a major role in shaping the landscape, especially in prone to disruption areas such as payment integrity—a critical function in reducing fraud, waste, and abuse. Notable transactions include: 

• New Mountain Capital’s US$3 billion consolidation of The Rawlings Group, Apixio’s payment integrity business, and Varis to create a powerhouse leveraging artificial intelligence (AI) to improve payment accuracy. 

• KKR-backed Cotiviti’s expected US$3 billion acquisition of Edifecs, aimed at enhancing administrative and clinical data-sharing capabilities. 

• Sagility’s acquisition of BroadPath Healthcare Solutions (January 2025), adding over 30 clients and strengthening its claims processing, provider credentialing, and member engagement capabilities. 

• TowerBrook Capital Partners and Clayton, Dubilier & Rice’s acquisition of R1 RCM (August 2024): R1 RCM, a healthcare technology company specializing in revenue cycle management, was taken private in a deal valued at $8.9 billion 

• New Mountain Capital’s strategic investment in Access Healthcare (January 2025): This investment aims to accelerate Access Healthcare’s transformation of revenue management for healthcare organizations 

For outsourcing providers, these moves highlight the importance of building robust capabilities in payment integrity, care management, revenue cycle management, and digital health—whether through acquisitions, partnerships, or internal innovation. 

2. Growing adoption of outsourcing by healthcare providers 

Historically, healthcare providers have been slow to outsource, but that is changing as rising administrative costs and razor-thin margins push hospitals to seek external expertise. 

Revenue cycle management (RCM) remains the most visible area for outsourcing, with hospitals increasingly turning to external firms for financial operations. Some of the most significant provider outsourcing deals in 2024 (source: Beckers Healthcare) include: 

• Ensemble Health Partners secured multiple RCM partnerships, including full revenue cycle management services for Independence Health System (PA), Carilion Clinic (VA), Tower Health (PA), and Beebe Healthcare (DE). The partnership with Carilion Clinic involves transitioning 780 employees, while Tower Health will shift 675 employees to Ensemble. 

• Conifer Health Solutions, Tenet Healthcare’s RCM arm, expanded its footprint, securing a 10-year contract with five Alabama hospitals and partnering with Adventist Health to manage its revenue cycle services. 

• The Brooklyn Hospital Center (NY) signed a 10-year deal with Med-Metrix, transitioning its entire RCM workforce to the outsourcing provider. 

• UCI Health’s acquisition of Tenet Healthcare’s Pacific Coast Network included a built-in outsourcing contract with Conifer Health Solutions for revenue cycle management. 

Beyond revenue cycle management, outsourcing is expanding into additional areas: 

• Clinical documentation & AI-driven coding – Companies like Suki and Nuance are reducing physician documentation burdens with AI-driven solutions. 

• Patient engagement & call centers – More hospitals are outsourcing patient outreach and scheduling to improve operational efficiency. 

• Prior authorization automation – Firms like Availity are helping providers speed up approvals and reduce administrative burdens. 

For service providers, this shift opens new opportunities beyond traditional RCM. Providers are actively seeking automation, AI, and efficiency-enhancing solutions—making it a prime time for innovative outsourcing firms to step in. 

3. The rise of partnership-driven ecosystems 

To remain competitive, service providers are increasingly forming strategic partnerships to create integrated, end-to-end solutions. These ecosystems bring together diverse capabilities to address the growing complexity of healthcare operations. 

Key partnership trends include: 

• Data management firms collaborating with tech giants – Healthcare analytics companies are working with platforms like AWS and Google Cloud to develop scalable solutions. 

• Service providers teaming up with system integrators – Traditional outsourcing firms are partnering with Big 4 firms  and others to offer holistic, technology-enabled solutions. 

• Health plans working with AI-driven startups – Payers are leveraging AI and automation to streamline workflows and enhance service delivery. 

These partnerships reflect a broader industry move toward comprehensive, technology-driven solutions that combine multiple capabilities to tackle complex healthcare challenges. 

What next for the sector? 

The healthcare payer outsourcing market is undergoing a major transformation, shaped by a surge in mergers and acquisitions (M&A) activity, increasing provider adoption of outsourcing, and the rise of collaborative ecosystems.  

These developments are not just industry shifts—they represent critical signals that service providers must analyze and respond to strategically. 

For outsourcing firms, the key question is no longer “What is happening?” but rather “What are we going to do about it?” 

• How do these trends impact our competitive position? 

• Where do we need to strengthen our capabilities—through investment, partnerships, or acquisitions? 

• What gaps exist in our service portfolio, and how do we address them proactively? 

• Are we aligning with the technologies and operational models that healthcare organizations are prioritizing? 

Standing still is not an option. Service providers that adapt quickly, innovate aggressively, and build the right alliances will be the ones that thrive in this evolving landscape. Now is the time to think critically, make bold moves, and take a leadership stance in the healthcare outsourcing market. 

If you found this blog interesting, check out our Optimizing Pricing Strategies For Healthcare AI Startups: Expert Insights For Payer And Provider Innovation | Blog – Everest Group blog, which delves deeper into another topic regarding the healthcare sector. 

If your interested in hearing more about healthcare outsourcing trends in 2025 and beyond, please reach out to Ankur Verma (ankur.verma@everestgrp.com).  

Mid-Market Organizations

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Join us as we reveal findings from the annual “Mapping the Next: Key Priorities for 2025” study, offering an inside look into the top concerns, expectations, and goals of industry leaders for the coming year. This session will spotlight leaders’ core priorities, such as technology adoption, digital transformation, generative AI, customer experience, and sustainability.

Our experts will also discuss critical global services decisions, including build vs. buy strategies, in-house vs. outsourcing, onshore vs. offshore operations, and the balance between long-term and short-term contracts.

This is your chance to hear exclusive, high-impact insights and gain an edge so you can make more informed decisions that will improve organizational resilience, competitiveness, and chances of future success for 2025.

What questions will the webinar answer for the participants?

• What are the trends that will shape the global services market in 2025?
• What are the likely changes in sourcing spend, sourcing strategy (in-house vs. outsource), and locations?
• What is the enterprise outlook on tech and AI adoption in 2025?
• Which digital services and next-generation capabilities are expected to be in demand?
• How are outsourcing deals, enterprises’ leverage of service providers, and bill rates expected to change?

Who should attend?

• Enterprise/business leaders (CIOs, CDOs, CTOs, CFOs, CPOs)
• Global sourcing leaders
• GBS/shared services center heads
• Leaders at IT and BP providers

As the global services landscape continues to evolve, 2024 has brought unique challenges. While the cost of delivering global services continued to increase, pricing came to a standstill for many services and even declined for some. The growing adoption of the Global Capability Center (GCC) model has further transformed the economics of outsourcing, prompting both buyers and service providers to reevaluate key elements of their agreements.

Watch this on-demand webinar as our panel of pricing experts analyzed the significant trends of 2024 and offer a forward-looking view on IT and BPO services pricing for 2025. This session will provide valuable insights into the pricing strategies and key levers that can help both parties achieve win-win outcomes in an increasingly complex environment.

What questions did the webinar answer?

• How has the cost of delivering IT and BPO services and pricing changed in 2024?
• What levers are buyers and providers pulling, and is a win-win arrangement possible
• What is the outlook for pricing and costs?

Who should attend?

• CIOs, CTOs, CDOs
• IT executives, IT strategy leaders
• BPO department leaders
• GBS leaders managing IT and BPO outsourcing contracts
• Pricing leaders
• Solutioning leaders
• Pre-sales leaders
• Large pursuits leaders
• Finance Leaders

Related Content:

• The Evolution and Growth of Global Capability Centers (GCCs) and the Critical Role of Providers | Blog
• Five Key Steps Buyers Should Take to Optimize Services Contracts | | Blog
• Unlocking Revenue Potential: Service Provider Strategies for Tools/Accelerator Monetization  | Blog

In today’s IT services landscape, early signs of recovery are beginning to emerge. While North America shows encouraging momentum, Europe remains steady, making it an optimal time for organizations to prepare for the next phase of growth.

This webinar provided insights into the IT services market in EMEA, focusing on current outsourcing pricing trends and the forecast for 2025 in key European markets. We’ll also share our observations on what European organizations expect from their IT service providers and what makes a successful outsourcing deal in today’s dynamic environment.

Watch on-demand to hear from our commercial and solution experts as they discuss strategies to prepare for upcoming deal renewals in 2025 and how to navigate the shifting IT services landscape with confidence.

What questions did the webinar answer?

• How has the demand for IT services in EMEA evolved in 2024, and what’s the outlook for 2025?
• What are the latest outsourcing pricing trends, and what is the forecast for 2025 in European markets as we start to see early green shoots of recovery?
• What do European organizations expect from their IT service providers?
• What does a good outsourcing deal look like in this shifting market?

Who should attend?

• Service providers
• Sales leads
• Category managers
• Sourcing and vendor management stakeholders

Given the cost pressures in most organizations, there are always questions about whether a particular outsourcing deal and vendor are generating the right value… 

This is where third-party contract benchmarking plays a crucial role in ensuring that outsourcing agreements are not only cost-effective, but also aligned with broader organizational goals, including transformation and innovation. 

Reach out to discuss this topic in depth. 

What is contract benchmarking?  

Contract benchmarking involves comparing the terms of an outsourcing agreement—such as pricing, service levels, and performance metrics—with industry standards or best practices.  

By engaging a third party for this process, companies ensure an objective and independent assessment, avoiding potential biases or limitations in internal evaluations. Benchmarking allows businesses to assess whether their contracts are competitive and aligned with market realities.  

Traditionally, contract benchmarking focused largely on costs and pricing , which remains an essential element. However, with the growing demand for more value-driven outcomes, modern benchmarking practices have expanded beyond mere cost comparisons to evaluate elements of transformation, innovation, and strategic alignment.  

Why third-party contract benchmarking is essential: 

1. Unbiased assessment: Third-party benchmarks provide an objective perspective, devoid of internal biases or conflicts of interest. This ensures that the organization is getting the best value for money, without compromising on quality or strategic alignment 

1. Informed decision-making: Outsourcing contracts often involve complex and multi-faceted arrangements. Third-party benchmarks give businesses access to a broad array of data points from multiple contracts, industries, and regions, allowing for informed decision-making. For instance, in a recent benchmarking engagement, the client realized that while its year 1 prices were in line with the market, by year 3 the pricing was 6% higher than the benchmarks. The reason was a provider-biased cost of living (COLA) clause. The client used these findings to not only re-align the current contract, but also its other outsourcing contracts 

1. Protection against overcharging: By analyzing market trends and comparing pricing models, third-party benchmarking helps organizations avoid paying too much for services. This becomes especially important in long-term legacy contracts where pricing can become quickly outdated given the rapid advancements in technology and rise of artificial intelligence (AI) 

1. Negotiation leverage: Armed with data from independent benchmarks, organizations have better leverage during negotiations. Whether it’s renegotiating a current deal or initiating a new one, benchmark data ensures that companies can negotiate from a position of strength  

1. Performance monitoring: Beyond pricing, third-party benchmarking evaluates performance levels against industry standards. This ensures that service providers are delivering at par or above market expectations 

Important to note here, that benchmarking should not be treated as a silver bullet to make an outsourcing relationship difficult for service providers. There can be (and have been) situations where the benchmarks revealed that the provider was truly delivering good quality services at competitive prices. 

Moving beyond costs

In today’s digital era, organizations are now expecting their outsourcing partners not just to deliver services efficiently but to actively contribute to innovation, process improvements, and digital transformation. Consequently, contract benchmarking is evolving to measure these broader outcomes.  

1. Reclassification of the pricing model: Benchmarking plays a pivotal role in evolving pricing models and resource unit structures by providing a data-driven comparison against market standards . For example: As an outcome of a recent benchmarking exercise, a client evolved its network services resource units based on the size/configuration of the device, compared to one based on the underlying functionality i.e. core/distribution/access switch, as that was the key factor that really determined the provider’s efforts and consequently the price for the service provider.
2. Optimize the pricing model: Benchmarking can uncover inefficiencies where low-cost services were bundled with higher-cost ones. By decoupling these services, the clients can transition to a more granular and flexible pricing model. This allows for better cost control and a model more reflective of the actual service delivered. 
3. Rate card rationalization: On multiple occasions, benchmarking projects have also helped clients to re-look and rationalize their rate card structure removing inefficiencies such as role redundancies, unnecessary clubbing or the blending of diverse roles, varied experience bands associated with the same role, mix-up of role and skills hierarchy, etc.  
4. Innovation and digital enablement: Modern contract assessments, look at how service providers are contributing to digital transformation initiatives—whether it’s adopting new technologies like AI, automation, or cloud computing to improve efficiency and productivity.  

Strategic alignment through benchmarking: 

Third-party benchmarking helps ensure that outsourcing contracts are strategically aligned with an organization’s long-term goals. While cost will always be an important factor, businesses must consider how outsourcing arrangements contribute to their overall growth and transformation objectives. A benchmark that evaluates a vendor’s ability to innovate, improve service quality, or enhance customer experience provides a more holistic view of the contract’s value.  

The future of contract benchmarking: a focus on value creation: 

As outsourcing continues to evolve, especially with the advent of generative AI (gen AI), contract benchmarking will further emphasize value creation rather than just cost savings. 

Service providers will be evaluated on their ability to drive business outcomes—whether it’s through enhanced efficiency, improved customer satisfaction, or supporting a company’s digital transformation journey.  

In conclusion, third-party contract benchmarking is no longer just about ensuring you’re paying a competitive price. It’s about ensuring that your outsourcing relationships are aligned with your business objectives, driving innovation, improving performance, and creating long-term value. 

By adopting a broader approach to benchmarking, organizations can ensure they are not just getting the best deal but also the best partner for their strategic transformation. 

If you found this blog interesting, check out our blog focusing on Nine Tactics That Can Improve Salesforce Contract Negotiation | Blog – Everest Group (everestgrp.com), which delves deeper into another topic of Benchmarking. 

If you have any questions, would like to delve deeper into the Commercial and Solutions Analytics service line, or would like to reach out to discuss these topics in more depth, please contact Ricky Sundrani and Rahul Gehani,

Join Everest Group’s Krishna Charan for an insightful discussion on the future of services procurement. The expert panel will explore how innovative companies are leveraging advanced vendor management system (VMS) capabilities to transform their SOW management, mitigate risks, and unlock significant value.

Key takeaways:

• Insights into market trends driving the growth of services procurement
• Strategies to tackle misclassification risks and improve SOW governance
• How AI-powered automation and analytics are reshaping services procurement management

Register

Krishna Charan
Vice President, Everest Group
David Feldman
Vice President, Contingent Workforce Management, Mastercard
Manfred Vogels
Vice President, EMEA Markets, Beeline

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