At its recent investor day meet, the management of Sagility, a Bengaluru-headquartered ITES firm focused on the US healthcare sector, indicated that the industry is currently witnessing headwinds from multiple factors, including visa-related policy decisions, the One Big Beautiful Bill Act (OBBBA), and regulatory complexities. These factors are putting pressure on payers, both private and public insurers, amid rising medical costs and volatility in the number of insured individuals, forcing them to balance growth, margins, and profitability, while managing increasing cost pressures. 

The company, which derives about 90% of its revenue from healthcare payers, with its top 10 clients contributing 84.6% of trailing twelve-month (TTM) revenue, sees margin management, cost control, and utilisation as top priorities for US insurers.

Ramesh Gopalan, CEO of Sagility, said the company’s strong execution, cost optimisation, and large-scale transformation capabilities are helping drive healthy growth across client segments. Analysts at Nomura, who attended the meet, noted that the US healthcare payer industry continues to face significant challenges, including stringent regulatory and compliance requirements, complex stakeholder relationships across payers, providers, plan sponsors, and members, as well as fragmented data systems and legacy technology infrastructure. They added that the sector also requires human-led clinical judgement in several processes, as mandated by law. 

“This necessitates the role for tech-led healthcare operations service providers such as Sagility. Sagility’s offerings in Gen-AI augmented, Agentic-AI embedded operations and end-to-end lifecycle operations are helping in strategic market expansion, according to management,” the note said.   

Similarly, analysts at Motilal Oswal said they view Sagility as a structural beneficiary of increasing outsourcing by the US payers. Reiterating ‘buy’ call after the meet, “We expect Sagility to deliver a low- to mid-teens growth, aided by increased volume of work from top clients, new client additions, cross-selling, and synergies from Broadpath and other initiatives, which will drive its revenue/ EBIT/PAT CAGR of 20%/28%/23% over FY25-28," said in their note.    

AI adoption still at an early stage

With the US healthcare system estimated to be a $5 trillion-plus market, Deloitte’s 2026 US Health Care Outlook Survey noted that 49% of surveyed healthcare organisations are still experimenting with GenAI and agentic AI while 18% have not adopted these technologies at all. 

“Technology solutions such as predictive AI and consumer-facing digital tools are compelling options for addressing the industry’s challenges with access and outcomes. About 70% of surveyed health care executives plan to pursue alliances with technology or digital companies in 2026,” the report said, indicating an accelerated rate of tech adoption in the sector. 

Indian tech firms looking at both organic and inorganic routes

Given the size of opportunity, Indian tech firms now seem to be looking at both organic and inorganic routes to grow this segment of business. A few days ago, India’s second-largest IT services and consulting company Infosys acquired Optimum Healthcare IT, a US-based healthcare IT and digital transformation solutions provider that provides consulting, implementation, and managed services for hospitals, health systems, and payers for $465 million in an all-cash deal.  

Salil Parekh, Chief Executive Officer, Infosys, in his statement said, “By bringing together Optimum’s provider experience with Infosys Topaz and Infosys Cobalt, we are positioned to create a differentiated value proposition for healthcare providers – accelerating end-to-end cloud, data, and digital transformation at scale,”   

While the deal is expected to close in Q1FY27, Nomura analysts expect the recent acquisitions to contribute 225bp to Infosys’s revenue growth in FY27F (assuming an entire 12 months of contribution). “We think these acquisitions will help Infosys get access to new clients and augment its capabilities in lifesciences and healthcare verticals (mainly from Optimum’s acquisition),” the note said.  

Similarly, during the Q3FY26 earnings call midcaps firms such as Persistent and Coforge both indicated good traction in the verticals. Signing one of its six large deals for Q3FY26 in the healthcare sector, Sudhir Singh, Chief Executive Officer, Coforge, sees the Healthcare vertical (particularly in the healthcare provider and Medtech industries) in the North America market have a significant runway for growth due to its size.   

Echoing the opportunity, during the earnings call, Sandeep Kalra, CEO and MD of Persistent Systems, highlighted strong demand for technology services in the sector. “We saw in the last three to four months a significant number of discussions on application and data modernization when it came to Healthcare Life Sciences or BFSI. We also saw in Healthcare Life Sciences a good number of discussions on transformation programs in mid to large firms,” he said.