In late 2014, Cognizant (a leading provider of IT, business consulting, enterprise applications and business process services) acquired TriZetto (a healthcare IT solutions vendor to the payer and provider market) for $2.7bn. This was a major acquisition and will undoubtedly reap a number of positive effects for Cognizant going forward although there are still some concerns. In this blog post, I'm going to lay out the pros and cons that I have seen throughout my research to hopefully get a rounded picture of what the future may hold for Cognizant.
Pros
- This acquisition adds a comprehensive range of innovative and complex software solutions (especially core payer software) and consulting capabilities to Cognizant’s portfolio, enabling it to offer end-to-end solutions in the US healthcare market – one of its key verticals.
- TriZetto reaches almost half of the insured American population through its 245,000 healthcare provider clients as it dominates the core claims marketplace. Cognizant's long standing reputation in services will serve to compliment this position as they look to take advantage of the synergies between the two. This will also create the opportunity to enhance EHRs from claims and EHR data. Finally, Cognizant may seek to expand joint capabilities in care management, population health and PBM-related services.
- This acquisition will put pressure on other India-led outsourcers as Cognizant pushes away from Infosys and Wipro and further towards TCS. Cognizant will also look to move away from the stigma of a low-cost India-led player and start positioning itself as more of a direct threat to global MNCs. It will also be harder for smaller software and IT services providers to compete with the combined size of Cognizant and TriZetto.
- Cognizant will look to cross-sell and up-sell to clients covered by both parties (estimated to be over 30.) This will enable Cognizant to forge deeper relationships, capture greater wallet share and potentially upgrade some clients to strategic clients.
Cons
- The acquisition has brought about a law suit by fellow solutions provider Syntel. Syntel claims that the acquisition terminated a contract it had with TriZetto as well as mishandled information. Syntel is asking for $3.4m in rebates as well as $6.1bn in punitive damages. If this goes through then it will be a very significant blow at a time when Cognizant is onboarding TriZetto, making the transition even more difficult [1].
- Cognizant will need to reduce its partnership network to avoid overlap with the additional capabilities TriZetto brings to the table. For example, both Pegasystems and TriZetto have claims management solutions and so this may lead to Pegasystems being ousted to avoid a clash of interests. Whether this will be a positive or negative in the long run is up for debate but it should be interesting to see how it pans out.
- Some analysts believe that Cognizant may have overpaid for the acquisition as the $2.7bn price tag comes in at almost four times TriZetto's revenues last year. Although Cognizant is confident that this is a positive move going forward, TriZetto hasn't matched Cognizant's growth pace as of late and so it is bargaining on combined market presence rather the sum of two products [2].
- There may be integration problems both geographically and from a business perspective. With Cognizant being very consulting/systems integration/services heavy and TriZetto focusing on software, they may have a few differences in opinion of how to approach the market although it seems as though Cognizant will keep TriZetto as a single entity rather than attempting to merge it into their business. Geographically, Cognizant is primarily based in India whereas only a third of TriZetto's staff are based over there [2]. Although this will give Cognizant a positive local presence, there may be some teething issues.
In my personal opinion, a lot of the concerns are focused on the "now" and how TriZetto will be integrated into Cognizant's organization and strategic plan. Although this may cause some initial problems, if they can work these out then there is an abundance of opportunity to both differentiate itself from competition, improve its current and future client base and expand its software and services portfolio. Whether this will slow down Cognizant's acquisition and geographical expansion strategy is yet to be seen but the future looks bright in my view.
That's all for now folks, as always I'm interested to know your thoughts on this topic so feel free to comment below and finally, if you like my content please subscribe, follow me on Twitter and share on social media.
Best Regards,
Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC
- CRN, Syntel Sues Cognizant For More Than $6 Billion After TriZetto Acquisition, 13 Jan 2015, http://www.crn.com/news/managed-services/300075362/syntel-sues-cognizant-for-more-than-6-billion-after-trizetto-acquisition.htm
- Financial Times, Cognizant rejects claim it overpaid for TriZetto, 15 Sep 2014, http://www.ft.com/cms/s/0/56a0d63c-3cec-11e4-a2ab-00144feabdc0.html#axzz3QxY763G9
Welcome one and all! Thank you for keeping up to date with my blog, it is very much appreciated and I hope you're finding it an interesting read. Today we're going to be talking about predictions in Healthcare IT both in the near term and further into the future.
There's a lot of content out there discussing potential trends and predictions going forward and so I took the time to review a variety of sources and have decided to cover just three trends I believe are the most widely acknowledged and have the potential to have the greatest impact on the Healthcare vertical. As always, I'd love to hear your feedback on the trends I've covered in this blog as well as others you feel are important so leave your comments below.
1) Data-driven digital strategies
Data is at the heart of everything these days. It arrives in droves in various forms from numerous sources and with varying levels of security protecting it, making it a minefield for organizations to manage. A fully encompassing and actionable strategy is essential throughout the data life cycle from storing the data to analyzing it. Not only does Big Data claim to reduce costs of healthcare (by more than $300bn just for the US alone according to McKinsey) [1] but also to improve quality of care by making better decisions based on more accurate data. I personally see data as the foundation for analytics to build upon. Sure, proper data management can streamline operations, cut costs and improve reporting quality but there is a market appetite for analyzing this data to improve decision making and predict what's down the line. Before clients can do so, the data needs to be accurate, secure and managed properly. Analytics based on inaccurate data is not only a waste of time and resources but is also dangerous in a healthcare setting. By no means is this a simple task though.
IDC is putting heavy emphasis on digital strategies claiming that by 2016, operational inefficiency will become critical at 25% of hospitals, driving them to budget for a data-driven digital strategy [2]. With an increasing focus on performance quality (including measuring and reporting quality), it is vital that the data is accurate, accessible and actionable [3].
Not only will healthcare organizations require the IT know-how to manage this data but they will also need to ensure that all stakeholders such as the lines of business, clinicians, IT vendors and C-level executives are all educated and on the same page as to what roles they will play in this strategy going forward.
2) No excuses for lack of interoperability
Philippe Houssiau, Vice President of Healthcare in the UK for CSC sees that there is no excuse for a lack of interoperability with systems in place across the care continuum and a drive from policy makers [4]. Although we have the technology to solve the interoperability issue, it's by no means a simple task.
The UK's Better Care fund claims that it will save £253m from reduced emergency admissions during 2015-2016. This seems to be widely considered as an unrealistic target, which is made only worse by an expected NHS funding gap of £65bn by 2030. UK healthcare organizations are therefore in the unenviable position of trying to improve the quality of care whilst also having to dramatically cut costs [5] [6].
Regardless of the monetary figure, the operational benefits of making systems interoperable are undeniable. The lack of uptake, the negative feedback and the functional issues of EHRs have primarily been due to lack of interoperability. Not only does this take up valuable time of healthcare practitioners but also encourages the use of quicker workarounds, which subject the organization to unforeseen cyber security threats.
3) Agile, flexible and scalable IT infrastructures
As well as the increasing amount of data, there is also increasing adoption of devices and applications in the healthcare vertical. IDC expects around 70% of healthcare organizations to invest in consumer-facing mobile apps, wearables, remote health monitoring and virtual care by 2018 [1]. As mentioned previously, not only is the amount of data increasing but also the variety of sources too.
Patients are increasingly interacting with healthcare providers virtually and also via mobile devices and applications. What's interesting to note here is that the recent alliance between Apple and IBM is very well placed to take full advantage of this trend as they cover both the consumer side with Apple devices and applications and the enterprise side building on IBM's experience and footprint in the market. But anyway, I digress...
Organizations must prepare themselves for the influx of data by investing in agile, flexible and scalable IT infrastructures to cope with this increase. Naturally, this plays right into the hands of cloud and SaaS providers who are able to scale up and down based on demand. However, the healthcare industry has notoriously been very cautious when adopting the cloud as some CIOs believe that adopting the cloud signifies giving up control and thereby opening the doors to security issues. Although many organizations are still wary of the cloud, which can be seen by the uptake of private cloud in comparison to public, gradually they are starting to become more confident in using it.
I could go on and on but I'll leave it there for now. I'd love to hear what you're seeing in the market, whether you agree or disagree with the trends/predictions mentioned above or any other comments you may have so feel free to comment below.
Best Regards,
Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC
- Tech Republic, Big data will enhance healthcare, but to whose benefit?, Nov 24, 2014, http://www.techrepublic.com/article/big-data-will-enhance-healthcare-but-to-whose-benefit/
- IDC, FutureScape: Worldwide Healthcare 2015 Predictions, Nov 12, 2014
- CSC, Why Healthcare Reform Hinges on Data, http://www.csc.com/health_services/publications/91654/116373-why_healthcare_reform_hinges_on_data
- Ehealth Insider, 15 predictions for 2015, Jan 2, 2015
- Public Finance, Health Foundation analysis predicts £65bn NHS funding gap, Jan 23, 2015
- LGC Plus, Unrealistic better care fund targets must be revised, says NHS England, Jan 5, 2015
