Global Healthcare Spend | Market Insights™
August 16, 2016
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While the U.S. leads annual healthcare spending, other geographies also have a large healthcare spend with increasing private play
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While the U.S. leads annual healthcare spending, other geographies also have a large healthcare spend with increasing private play
As enterprises shift their focus from pure cost savings to improved customer service, the CCO delivery mix has been shifted to a balanced onshore/offshore model
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Nearshore and onshore locations offer a compelling digital service delivery value proposition
Onshore locations gaining favor among service providers as service complexity increases, clients demand onshore delivery, data security regulations increase, and newer tier-2 locations in onshore geographies mature
Businesses now demand that IT departments dramatically change the velocity of the cycle time it takes to take ideas from concept to production – often from as long as 12-18 months to only four to six weeks. Organizations can’t achieve a change of this magnitude with just a change in methodology. To do this, they must move to DevOps – a disruptive phenomenon with immense implications for the enterprise IT ecosystem and the service providers that support it.
Put another way, many IT firms batch or create software releases once or twice a year in which they bring out updates to their enterprise platforms. Businesses now demand a cycle time of one to two times a month for updates. What they want and need is a continuous-release construct.
Methodology alone cannot create the conditions in which organizations can form ideas, build requirements, develop code, change a system and do integration testing in the new timeframes. Hence the DevOps revolution.
DevOps is the completion of the Agile methodology. It builds the enabling development tools, integrates test conditions, and integrates the IT stack so that when developers make code changes, they also configure the hardware environment and network environment at the same time.
To do this, an organization must have software-defined data centers and software-defined networks, and all of this must be available to be tested with automated test capabilities. By defining coding changes with network and system changes all at the same time and then testing them in one integrated environment, organizations can understand the implications and allocate work as desired. The net result is the ability to make the kind of cycle time shifts that businesses now demand.
DevOps enables IT departments to meet the cycle time requirements. But the implications for how organizations buy services and how providers sell services are profound. Basically the old ways don’t work as well because of the new mandate for velocity and time. This causes organizations to rethink the technology, test beds, and service providers; and then manage the environment on a more vertical basis that cuts across development, maintenance, and testing, and allows the full benefit of a software-defined environment.
Let’s examine pricing, for example. Historically, coding and testing are provided on a time-and-materials basis. The productivity unleashed in a DevOps environment enables achieving approximately a 50 percent improvement in efficiency or productivity. Therefore, it is as cannibalistic or as disruptive to the development and maintenance space as cloud is to the infrastructure environment.
Furthermore, organizations can only operate a DevOps environment if they have a software-defined hardware environment – aka a private or cloud environment. This forces production into ensuring they perform all future development in elastic cloud frames.
Enterprises today are reevaluating where they locate their talent. Having technical talent in a remote location with difficult time zone challenges complicates and slows down the process, working against the need for speed.
So DevOps is a truly disruptive phenomenon that will disrupt both the existing vendor ecosystem and also the software coding and tool frames. Testing, for example, has been a growth area for the services industry, but DevOps environment largely automate testing services.
Another disruption is that DevOps takes a vertical view of the IT life cycle. It starts to integrate the different functional layers, creating further disruption in how organizations purchase IT services.
DevOps offerings are a new development among service providers, but the services industry to date has been slow to adopt the movement. DevOps is an internal threat to their existing business and requires providers to rethink how they go to market.
Eric Simonson’s recent blog, “John Mellencamp Named Honorary Everest Group Analyst of the Month,” highlighted the dominance of tier-3 locations in the United Sates for onshore service delivery. Now it’s time to take a look at the tier-5 and rural locations in the U.S., per the North America Domestic Outsourcing location landscape study we recently conducted for RevAmerica, an event focused solely on domestic ITO and BPO sourcing.
Given that places such as Oak Ridge, Tennessee, Albany, Georgia, and Jacksonville, Texas have populations below 100,000, with limited presence of colleges and poor connectivity to commercial airports, one would not expect them to contribute significantly to onshore service delivery. However, our analysis of tier-5 and rural locations revealed five interesting facts.
Tier-5 and rural locations are growing and have a sizeable share in the domestic sourcing market
Tier-5 and rural locations account for approximately 20 percent of the total service providers’ delivery centers, and 16 percent of the delivery FTEs in the United States. The Midwest region has the highest share of these delivery centers.
While onshoring in general has been on the rise, the leverage of tier-5 and rural locations has witnessed significant momentum. In the last decade, the number of new delivery center set ups in these locations has increased by ~150 percent, from an average of three centers per year in 2005-2006 to seven centers in 2013-2014.
At the same time, the share of tier-5 and rural locations in new U.S. delivery center set ups has gone up from ~19 percent in 2005-2006 to 25 percent in 2013-2014.
There are 100+ tier-5 and rural cities to choose from
More than a hundred tier-5 and rural locations are currently being leveraged by service providers for onshore service delivery. There are also a number of other potentially viable locales. Given the wide range of options these locations provide, they become an important consideration for players looking to establish a wider U.S. presence.
A large number of contact centers call these locations home
~61 percent of the existing centers in these locations deliver contact center services, as compared to 22 percent for IT services, and 17 percent for business process services. Leading multinational players such as Alorica, Convergys, Sitel, Sykes, Teleperformance, and Teletech leverage these locations for contact center service delivery.
These locations play a meaningful role in the location portfolio for domestic pure-plays
The leverage of tier-5 and rural locations is highest for domestic pure-plays – e.g., CrossUSA, Eagle Creek Software Services, Onshore Outsourcing, and Rural Sourcing Inc. – which have ~37 percent of their delivery centers in these locations. On an overall basis, traditional MNC’s still dominate the market landscape as they have significantly large number of delivery centers in the United States as compared to other players.
The talent pool is sizeable enough to support 1-2 moderate sized delivery centers per location
While talent availability in tier-5 and rural locations is generally lower than in tiers 1 to 4, they still offer a pool capable to support one or two moderate sized delivery centers. The typical delivery center size in these places is ~340 FTEs, as compared to a national average of ~445 FTEs. However, there is evidence of players achieving a scale of above 500 FTEs, especially for contact center services, where high school graduates are utilized.
As onshoring grows in the United States, leverage of tier-5 and rural locations will also grow. Service providers are establishing their presence in these locales due to their lower costs and lesser competitive intensity. Hence, there is a significant opportunity for economic development agencies in these locations to attract potential investors and create employment opportunities.
To download a full copy of our research on domestic delivery, please visit: https://research.everestgrp.com/Product/EGR-2015-2-R-1455/North-America-Domestic-Outsourcing-Services-Providers-Embrace-
For more Market Insights™ on this topic, please visit:
https://www.everestgrp.com/tag/domestic-sourcing
To download our presentation from the RevAmerica event, please visit: http://www.revamerica.com/program/
Photo credit: Wikipedia
3 indicators of the increasing preference for onshoring in contact center outsourcing
United States Domestic Sourcing Delivery Center Location Tiers
Last month I had the opportunity to attend and co-present with Eric Simonson at a special event in the outsourcing sector, RevAmerica 2015, held in New Orleans, LA. You can download our keynote presentation here. For those who might not know, RevAmerica is a domestic outsourcing event in its second year. The event focused on a multitude of topics and was attended by a strong community of service providers, buyers, economic development agencies, analysts/consulting firms, and academic institutions. Here are my top 10 takeaways from the event:
Buyers are looking at their IT and BP service delivery portfolio more holistically than ever and asking the shoring question more seriously. They are willing to evaluate onshoring as an alternate and in some cases willing to even bend their rules around cost savings to get the extra flexibility in delivery.
Service providers have a major role to play in onshoring growth as they can not only harness the available talent pool, but also create a delivery model that makes economic sense.
Domestic pure-play service providers are diligently making the business case for onshoring. The ones that do this without demeaning the offshoring benefits are likely to be more successful in not only winning pursuits, but also in sharpening their own value proposition for buyers. In this regard, I liked Genesis10, Nexient, and Rural Sourcing’s approach that are playing on the strengths of onshoring rather than making unnecessary comparisons with offshoring.
Economic development agencies (EDAs) are evolving in their thinking and go-to-market approach. Those who are serious about this sector, such as North Dakota Dept. of Commerce and Louisiana Economic Development (LED), have a more collaborative approach towards working with providers/enterprises. However, there is a lack of collaboration among economic development agencies for the common goal.
Talent development continues to be an area of immense interest. Partnership with universities, training/re-skilling programs to create talent in places where people have limited opportunities, and hiring veterans and their spouses are all examples of initiatives to strategically develop the available talent for domestic sourcing. A great example of this is the partnership between IBM, LED, and LSU College of Engineering where State of Louisiana will invest in the institution to expand higher education programs in order to increase the annual computer science graduate output to support IBM’s delivery center in Baton Rouge.
Tier-3 cities are the epicenter of activity in the domestic sourcing space, with maximum centers and headcount located in this cities. They are also the ones that will see maximum growth in the future, but we should watch for saturation trends.
The buzz around robotic process automation (RPA) is getting stronger, especially in the context of domestic sourcing as onshore providers can compete with the offshore labor arbitrage model by harnessing the potential of RPA (where applicable).
The role of educational institutions has to increase to make onshoring a compelling alternative in the eyes of both providers and buyers. EDAs can only promise sustainable talent pool, but not deliver it unless educational institutions show the flexibility and support at a sustained, tactical level – implying changing curriculum, adding industry interaction programs, etc. while still serving the overall mission.
Agile methodology and its implications for working models for IT teams are a great blessing for the onshore model. However, agile can only be one of the selling points. Domain expertise, ability to ramp up/ramp down, technology expertise, and cost of delivery are all factors for evaluating a provider’s capabilities in the onshore context.
The notion of “domestic sourcing = impact sourcing” is flawed. Beyond generating jobs for the underprivileged, domestic sourcing’s larger mandate is to create jobs for the unemployed educated people of the country. There are some domestic sourcing plays such as Onshore Outsourcing and Liberty Source that are doing impact sourcing in an onshore model.
Overall the event touched upon some very relevant topics from the domestic outsourcing perspective and is paving the way for developing a stronger ecosystem to support this sector. Kudos to the Ahilia team for organizing a great event! Last but not the least, in case you are interested in learning more about the domestic outsourcing landscape, you can download Everest Group’s full report here. You may also want to read Eric’s blog on tier-3 cities: John Mellencamp Named Honorary Everest Group Analyst of the Month.
Photo credit: Omni Royal Orleans
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