Sagility is a pure-play specialist in the unglamorous but vital back-office of American healthcare - it runs the claims, calls, and clinical reviews that health insurers and hospitals would rather not handle themselves. Born from a carve-out of Hinduja Global Solutions’ healthcare unit in 2022 and later listed in India by its private-equity promoter, the company has stitched together decades of domain knowledge with a string of acquisitions - DCI, BirchAI, BroadPath, CareSeed - each adding a new capability or client set. The recurring idea is to start with a narrow foot in the door, prove it can do the work better and cheaper, and then expand into running entire swathes of a client’s operations for a fixed per-member fee rather than billing by the hour. # Business segments A single engine serving the entire U.S. healthcare system - payers and providers - with technology-enabled operations that span claims, clinical management, and revenue collection, all moving from per-transaction billing to outcome-based managed services. ## 1. Payer operations: the administrative backbone of American health insurance **Sagility runs the complex, high-stakes paperwork and clinical decisions for health insurers, increasingly under long-term contracts where it gets paid a fixed fee per member rather than per task.** - **Claims from start to finish** - it handles the entire lifecycle of a medical, pharmacy, dental, or vision claim, using intelligent automation to adjudicate, prioritize appeals, and detect overpayments before or after money goes out the door. This is the core utility service that keeps insurers functioning. - **Clinicians on tap, guided by AI** - a workforce of over 2,100 licensed nurses and clinical specialists manages prior authorizations, chronic disease cases, and a 24/7 nurse helpline, with AI tools like Nurse Assist interpreting medical records against clinical protocols so that decisions are faster and more consistent. The clinical work splits into controlling today’s spend (utilization reviews) and managing tomorrow’s (population health), which means Sagility touches both the immediate cost and the long-term risk for an insurer. - **The Synchrony bundle: an insurer’s operations in a box** - the flagship offering wraps claims, provider data, provider calls, and IT support into a single managed service priced on a PMPM (per member per month) basis, with no separate license fee for the platform. Because the contract runs five to seven years and the platform is deeply embedded, an acquirer cannot easily rip it out, making the revenue sticky. - **Paid for outcomes, not hours** - the company is shifting from billing per full-time employee or per transaction to models where it earns a base fee plus a share of the savings or membership growth it generates, breaking the old linear link between headcount and revenue. In payment integrity, it already works on contingency, keeping a cut of the overpayments it recovers for clients. - **Land, prove, expand** - it typically enters a client with a traditional time-and-materials deal, demonstrates efficiency gains, and then converts the relationship into an outcome-based managed service, which is how the number of clients contributing over $20 million in annual revenue more than doubled from four to nine between FY23 and FY26. ## 2. Provider operations: collecting the money hospitals are owed **Sagility manages the entire revenue cycle for hospitals and physician groups - from scheduling a patient to collecting the final payment - with a stated ambition to grow this smaller but faster-expanding segment through larger, technology-wrapped deals.** - **Full-spectrum revenue cycle management** - the work spans front-office tasks like patient scheduling and financial clearance, middle-office medical coding, and back-office collections, denial management, and cash posting, so a hospital can outsource the whole chain of getting paid. - **A BPaaS model in the making** - the company is building a Business Process as a Service offering, aiming to win new logos with multi-service deals from day one rather than starting small and expanding. # Technology and AI capabilities **A 300-person dedicated AI and automation team builds and deploys proprietary platforms that are woven into every service line, with compliance and clinical safety as hard boundaries - healthcare AI must be explainable and auditable.** - **A suite of home-grown platforms** - tools like Contract Central automate overpayment detection by reprocessing claims against payer contracts, Provider Forward™ streamlines credentialing and provider data, and a Document Processing Engine uses domain-trained OCR to classify healthcare paperwork, all of which reduce manual effort inside the services Sagility sells. - **GenAI bought and built** - the BirchAI acquisition brought real-time, GenAI-powered customer support, while BroadPath’s Bhive platform added work-from-home delivery technology now being integrated with Sagility’s own GenAI solutions, and CareSeed contributed cloud-native quality-analytics platforms Forecast and Harvest. The company has deployed 37 AI use-cases and was recognized as a Leader in Generative AI services by ISG. - **AI with guardrails** - every AI deployment must be explainable, auditable, and regulator-ready, which is non-negotiable in a sector where a wrong clinical decision can harm a patient, so business and technology leaders make deployment calls jointly within a partnership ecosystem. # Group structure and partners **Sagility is an India-listed operating company controlled by a Dutch promoter, with U.S. subsidiaries that execute acquisitions and a debt repayment plan that aims to clear the remaining promoter borrowings by the end of FY27.** - The listed entity, Sagility Limited, is a subsidiary of Sagility B.V. in the Netherlands, and its U.S. operations run through step-down subsidiaries Sagility (US) Holdings Inc. and Sagility LLC. - Promoter bonds of Rs. 926.50 crores were outstanding as of March 2025, carrying 8% annual interest, with the company on track to repay them completely by end of FY27. - The company was carved out of Hinduja Global Solutions in January 2022 and has since grown through four acquisitions: DCI (payment integrity, 2023), BirchAI (GenAI, 2024), BroadPath (payer services and Bhive platform, 2025), and CareSeed (mid-market health plans and cloud analytics, 2026).