### **Company Overview** Sagility Ltd is a leading **technology-enabled healthcare services provider** exclusively focused on the U.S. healthcare market. The company supports **healthcare payers, providers, and their partners** in improving operational efficiency, member and provider experience, and quality of care while reducing administrative costs. With over **25 years of industry experience**, Sagility has evolved from a traditional outsourcing firm into a transformational partner, leveraging deep domain expertise, proprietary technology, and advanced analytics to deliver end-to-end solutions. Sagility serves **six of the top 10 U.S. health insurance payers by enrolment** and maintains long-term client relationships—some lasting over two decades. Post the acquisition of BroadPath Healthcare Solutions in early 2025, it has further strengthened its position as a pure-play healthcare services leader. --- ### **Business Model & Service Delivery** Sagility delivers comprehensive **end-to-end services across the healthcare value chain**, including: - **Claims Management & Payment Integrity** - **Revenue Cycle Management (RCM)** for providers (scheduling, coding, billing, collections) - **Clinical Services**: Utilization management, care coordination, chronic case management, and risk adjustment - **Member & Provider Engagement**: Enrollment, benefits administration, outreach, and support - **Provider Network Operations**: Credentialing, contracting, data management - **AI-Driven Automation & Analytics** As of mid-2025, Sagility: - Employs **~39,900 professionals** globally - Operates **33 delivery centers** across **India, the Philippines, the U.S., Jamaica, and Colombia** - Processes **over 119 million claims and manages ~78 million interactions annually** - Supports **77 active clients**, with strong retention and recurring growth from existing accounts The company uses a **multi-shore delivery model**, with over **94% of its workforce based offshore or nearshore**, enabling cost-effective, scalable, and compliant operations. --- ### **Technology & Innovation Strategy** Sagility combines **domain-specific healthcare expertise with cutting-edge technology** to drive client outcomes and operational excellence. #### **Core Platforms & Proprietary Tools** - **Provider Forward™**: Streamlines provider data management and credentialing - **Aging in Place**: A clinical program supporting elderly care and population health - **Member Engagement Platform**: Enables personalized outreach and care tracking - **Revenue Cycle Management Platform**: Uses predictive analytics to reduce denials and improve collections - **Document Processing Engine**: Leverages OCR and NLP for automated intake and classification of clinical documentation #### **Generative AI & Automation** Sagility has embedded **Generative AI (GenAI)** across its operations, having acquired **BirchAI (March 2024)** to accelerate its GenAI Center of Excellence. Key AI/ML-driven capabilities include: - **Nurse Assist**: Auto-summarizes clinical records for faster medical reviews - **Appeals Assist**: Automates appeal letter generation and improves payer star ratings - **Contract Validation**: Extracts and normalizes complex payer-provider contract terms - **Agent Assist Tools**: Real-time support for call center agents using AI knowledge retrieval and task prioritization - **Speech & Intent Analytics**: Enhances understanding of member and provider interactions As of Q1 FY26, Sagility had deployed **18 AI-based use cases across 8 clients**, with 15+ more in development. --- ### **Growth Strategy & Market Positioning** #### **Client Expansion & Revenue Growth** - Revenue: ₹55.7 billion in FY25 (~$670M), representing **17.2% YoY growth** - Q1 FY26 Adjusted EBITDA: ₹3,687 million (**24% margin**) - **88–89% of revenue from payers**, with provider segment growing rapidly (~34–37% YoY) - **Top 5 clients have average relationship tenure of 18 years** - **25-year partnership** with one major national payer; **10-year milestone** with a key workers' compensation services provider Sagility’s growth is driven by **"farming"**—expanding services within existing clients—rather than solely acquiring new logos. Recent quarters show significant expansion: - **18 out of 77 clients expanded engagements** in Q1 FY26 - **$32M in potential annual contract value won**, including build-operate-transfer (BOT) Global Capability Center projects #### **Mid-Market Expansion** Historically focused on large payers, Sagility now strategically targets the **mid-market segment** through: - The **acquisition of BroadPath Healthcare Solutions** (Jan–Feb 2025) - Adds **~30+ mid-market clients**, including health plans, TPAs, PBMs, and providers - Brings expertise in **Medicare and Medicaid member acquisition and enrollment** - Adds **1,600+ employees**, including sales and account management teams - Includes **Bhive**, a proprietary work-from-home platform, now integrated with Sagility’s GenAI tools - Development of **Integrated Business Process-as-a-Service (BPaaS)** solutions to target smaller health plans Sagility expects **over 20% revenue growth in FY26**, with BroadPath contributing significantly. --- ### **Strategic Acquisition: BroadPath Healthcare Solutions** - **Acquired January 2025** for ~₹502 crore in all-cash deal - BroadPath revenue: ~$70M in calendar year 2024 - Immediate **EPS accretive**, with financial synergies from cost reductions and cross-selling - Strengthened Sagility’s **U.S. onshore presence** and access to government program segments - Enabled **cross-selling opportunities** between Sagility and BroadPath clients (e.g., a major national payer already using BroadPath services) Post-acquisition, Sagility now serves **six of the top 10 U.S. payers** and has enhanced its delivery scalability via Bhive’s remote operating model. --- ### **Pricing & Commercial Model** Sagility is shifting toward **outcome-based, transformational contracts**, moving beyond traditional FTE or transaction-based pricing. #### **Per-Member-Per-Month (PMPM) Model** - Bundles **technology and operational services** into one fee - De-risks outcomes for clients and improves cost predictability - Covers both platform and delivery costs, delivering **20–30% cost savings** to clients #### **Gain-Sharing & Savings Commitments** - **Gain-share mechanisms** allow Sagility to retain a portion of **cost savings delivered above targets** - Clients are increasingly open to **large-scale transformation deals** with savings commitments, enabling Sagility to take wallet share from competitors #### **GenAI as a Revenue Driver (and Cannibalizer)** - GenAI is a **primary lever for client cost savings**, automating transactions and boosting agent productivity - AI-handled transactions billed at **lower rates**, creating short-term revenue pressure but unlocking larger contract wins - Sagility acknowledges **revenue cannibalization risk** but is investing aggressively in GenAI to **drive long-term client stickiness and expansion** --- ### **Competitive Landscape & Differentiation** - **Pure-play focus on U.S. healthcare** differentiates Sagility from generalist BPM providers - Competes with **Accenture, Cognizant, EXL, WNS, and Firstsource**, but faces **no true like-to-like competitor** in the healthcare-only niche - Key differentiators: - **End-to-end payer value chain expertise** - Proprietary platforms (Provider Forward™, Bhive, Nurse Assist) - Deep clinical capabilities and 2,000+ licensed clinicians - Proven success in transformational, savings-led outsourcing --- ### **Market Opportunities & Risks** #### **Tailwinds** - **Growing outsourcing in healthcare** due to: - Margin pressure from rising medical costs and reduced government funding - Clinician shortages driving demand for outsourced clinical services - Administrative complexity in U.S. healthcare system - **Total outsourced U.S. healthcare operations spend**: $48.67B in 2024 - **Total addressable market (TAM)**: ~$200B; only ~21% currently outsourced — **significant upside potential** #### **Regulatory & Market Resilience** - **Minimal exposure to ACA marketplace**, which faces membership decline - **Limited Medicaid revenue (mid-single digits)**, reducing risk from funding cuts - **Strong demand for automated eligibility, enrollment validation**, and compliance services amid tightening regulations - **No direct impact** from proposed 25% excise tax on foreign service payments due to clients’ focus on cost savings and technology adoption --- ### **Recognition & Workforce** - Named a **Leader** by Avasant (2025) in **Healthcare Payer Business Transformation** and **Clinical/Care Management** - Ranked in **Everest Group’s PEAK Matrix** and **ISG’s GenAI Service Provider Landscape** - Awarded **“Most Preferred Workplace FY’26”** by Marksmen Daily - **Annualized attrition rate**: 26.6% (Q1 FY26) - Focus on **future-ready workforce** through training, remote work models, and Agentic AI for recruitment and skill development ---