Gartner Research

Market Guide for U.S. Healthcare Payers’ Core Administrative Processing Solutions


Healthcare payers cannot satisfy customers’ rising demands for value or effectively counter tech-savvy competitors using legacy core administrative processing solutions. Payer CIOs should use this Market Guide to accelerate their transformation to a more digital, nimble administrative environment.

Published: 25 June 2019

ID: G00367434

Analyst(s): Mandi Bishop

Table Of Contents

Market Definition

  • CAPS Are Critical Tools for Payer Business Enablement
  • Market Description
    • Next-Generation CAPS Support Payers’ Digital Business Ambitions
    • Ecosystem Enablement
    • Cloud Delivery
    • Modern Architecture
    • Configurability
    • Componentization
    • Value-Based Payment Enablement

Market Direction

Market Analysis

Representative Vendors

  • Market Introduction
  • Vendor Profiles
    • Advantasure (formerly ikaSystems)
    • Cognizant
    • Companion Data Services (CDS)
    • Conduent Health Solutions Plus (HSP), Managed Care Business Unit
    • Epic
    • HealthEdge
    • HM Health Solutions (HMHS)
    • Invidasys
    • Mphasis Javelina
    • NASCO
    • Oracle
    • Pegasystems
    • PLEXIS Healthcare Systems
    • RAM Technologies
    • Virtual Benefits Administrator

Market Recommendations

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