Case Study · RISE with SAP Advisory

U.S. Healthcare Network Saves 30%
on RISE with SAP and Protects Patient Care Budget

📘 This guide is part of our SAP Licensing Knowledge Hub — your comprehensive resource for SAP licensing, compliance, and cost optimization.

A regional U.S. healthcare network with 15,000 SAP users was facing a multi-million-dollar RISE with SAP proposal that threatened to divert critical funds from patient care. Redress Compliance helped them right-size licences, benchmark pricing, negotiate flexible contract terms, and secure HIPAA-compliant data protections — delivering a 30% cost reduction and a contract structure uniquely suited to healthcare.

Healthcare RISE with SAP 30% Savings 5 min read
📖 This case study relates to the RISE with SAP pillar. See also: S/4HANA Licensing Guide · RISE Tiers & 2025 Changes · RISE Advisory Services
30%
Total Cost Reduction vs SAP’s Initial Proposal
15,000
SAP Users Across Hospitals & Clinics
±10%
Annual Volume Flexibility Negotiated
3 Years
Contract Term (vs SAP’s Proposed 5)

Background

A regional healthcare network in the United States — operating multiple hospitals and clinics — was exploring RISE with SAP to migrate from SAP ECC to S/4HANA. The organisation had approximately 15,000 employees using SAP across finance, supply chain, and HR functions.

SAP’s initial RISE proposal bundled S/4HANA Cloud, SuccessFactors (HR), cloud infrastructure, and managed services into a single multi-year subscription. As a healthcare provider, the network placed critical importance on three priorities: data security and HIPAA compliance, budget protection to ensure IT costs did not divert funds from patient services, and contract flexibility to accommodate the unpredictable funding environment of a nonprofit healthcare organisation.

Challenges

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Prohibitive Initial Cost

SAP’s first RISE quote was tens of millions over five years — far beyond the network’s budget. The pricing included cloud infrastructure and add-ons the hospital did not fully need. Leadership suspected the bundle concealed hidden costs: premium hosting markups, automatic escalators, and non-essential modules that would inflate costs over the contract term.

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Rigid Long-Term Commitment

The standard RISE contract offered a 5-year term with minimal flexibility — unsuitable for a nonprofit healthcare environment with unpredictable funding cycles. The hospital could not commit to a half-decade obligation without the ability to scale down if patient volumes, budgets, or strategic priorities changed mid-term.

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Licensing & Compliance Complexity

The user base ranged from power users in finance to hundreds of occasional users (doctors accessing analytics dashboards). Mapping these diverse roles to SAP’s FUE model was complex, and the risk of over-licensing was significant. Additionally, any cloud contract had to meet HIPAA requirements for data handling, auditability, and data residency — and SAP’s boilerplate terms did not clearly address all of these.

How Redress Compliance Helped

1

Needs Assessment & Right-Sizing

Redress worked with the hospital’s IT and finance teams to dissect every line of the RISE proposal. A meticulous usage analysis determined which SAP components and how many users were genuinely needed. Modules with no clinical or business value were cut. User licences were right-sized — ensuring staff with basic needs (e.g., doctors viewing dashboards) were not assigned expensive Professional/Advanced classifications. This exercise alone identified over 25% in potential savings by eliminating shelfware and reducing excessive FUE counts.

2

Benchmarking & Alternative Options

Leveraging experience across dozens of healthcare SAP deals, Redress benchmarked the quote against those of similar organisations. The benchmarking showed that peer institutions had secured significantly deeper discounts and greater flexibility from SAP. Redress also evaluated alternatives — staying on ECC longer with extended support, or utilising third-party support (Rimini Street) — to provide the client with credible leverage. The message to SAP was clear: the hospital had options, knew the market, and expected a competitive offer.

3

Contract Flexibility Negotiation

A key goal was injecting flexibility into the rigid standard RISE contract. Redress negotiated provisions tailored specifically for healthcare: the final agreement allowed the client to adjust subscription volumes by ±10% each year to account for swings in patient volume or funding. They also secured a 3-year term (vs SAP’s proposed 5) with an option to renew, giving the network an exit if cloud benefits did not meet expectations. Critical data protections were added: all patient data must remain in-country, and SAP signed a HIPAA Business Associate Agreement (BAA).

4

Cost Reduction & Incentives

Redress’s strategy led SAP to apply healthcare sector incentives and offer deeper discounts. SAP removed or heavily discounted bundled services the hospital did not need and offered credits for existing perpetual licences. Annual price increase caps were negotiated to give the hospital predictable IT costs year over year. The final deal came in approximately 30% lower in total cost than the original proposal — saving millions that could be redirected to patient care and medical technology.

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Outcome and Impact

DimensionBefore (SAP’s Initial Proposal)After (Negotiated with Redress)
Total 5-year costTens of millions (SAP’s initial quote)~30% lower than initial quote
Contract term5 years, rigid, no early exit3 years with renewal option — mid-term checkpoint
Volume flexibilityFixed commitment, no adjustment±10% annual adjustment to subscription volumes
User licensingOver-provisioned FUE with unnecessary modulesRight-sized FUE, unnecessary modules removed
HIPAA complianceBoilerplate terms, unclear protectionsExplicit BAA, data residency, audit rights
Price escalationNo caps (SAP standard 5–7% annual increases)Capped annual increases for cost predictability
Financial

Millions Saved for Patient Care

The 30% cost reduction freed up millions of dollars over the contract term. For a nonprofit healthcare provider, these savings translate directly to patient services, medical equipment, and clinical staffing — not overspending on enterprise software.

Operational

Flexibility Preserved

The ±10% annual volume adjustment and 3-year term give the network the ability to adapt as healthcare demand, funding, and strategic priorities evolve. This is a safety net rarely seen in standard SAP cloud agreements.

Compliance

HIPAA Protections Secured

All regulatory requirements — HIPAA BAA, data residency (in-country), audit rights, and data handling provisions — are contractually embedded. The hospital moves to RISE with SAP confident that sensitive patient data is handled properly.

Client Quote

“Redress Compliance treated our budget and mission as if it were their own. They cut through SAP’s complex proposal and found us a path that preserves critical funds for patient care. We went from feeling cornered by a huge contract to feeling in control of our tech future. Redress’s independent advice gave us confidence that every decision was in our best interest.”

— CFO, Regional Healthcare Network

Key Takeaways for CIOs

1

Never Accept SAP’s First RISE Proposal

SAP’s initial RISE quotes are heavily loaded with bundled services, premium infrastructure, and over-provisioned FUE. Discounts of 25–40% are consistently achievable with proper benchmarking and negotiation. The first offer is a starting point, not a final price.

2

Right-Size Before You Negotiate Price

The biggest savings come from removing what you don’t need, not just discounting what SAP proposes. A thorough usage analysis that maps every user to the correct FUE classification and eliminates unnecessary modules typically identifies 20–30% in cost reduction before any pricing negotiation begins.

3

Demand Contract Flexibility

Standard RISE contracts are rigid 5-year commitments with no downward adjustment. Negotiate volume flexibility (±10–15% annual adjustment), shorter terms with renewal options, and explicit mid-term exit provisions. Healthcare, nonprofit, and public sector organisations have particular leverage to demand these terms.

4

Address Regulatory Requirements Explicitly

HIPAA, GDPR, data residency, and audit rights must be contractually embedded — not assumed. SAP’s standard cloud terms may not address industry-specific regulatory requirements. Negotiate explicit Business Associate Agreements, data location commitments, and compliance audit provisions before signing.

5

Use Independent Advisory for Leverage

SAP account teams negotiate RISE deals daily. Most enterprise customers negotiate them once every 3–5 years. Independent advisory firms bring benchmark data from hundreds of deals, knowledge of SAP’s internal pricing flexibility, and negotiation experience that levels the playing field. The ROI on advisory fees is typically 5–15×.

Frequently Asked Questions

How much can healthcare organisations typically save on RISE with SAP?+
Based on our experience across multiple healthcare RISE negotiations, savings of 25–35% from SAP’s initial proposal are consistently achievable. The savings come from three sources: right-sizing user licences (removing over-provisioned FUE and unnecessary modules), negotiating deeper discounts through benchmarking and competitive leverage, and restructuring contract terms (shorter terms, volume flexibility, price caps). For a multi-hospital network, this can represent several million dollars over the contract term.
Can RISE with SAP contracts be shorter than 5 years?+
Yes, though SAP prefers 5-year terms. In this case, we negotiated a 3-year term with a renewal option. SAP will accept shorter terms when presented with credible alternatives (staying on ECC, third-party support, or competing ERP platforms). The shorter term provides a mid-term checkpoint and reduces the risk of being locked into a contract that does not deliver expected value. The trade-off is that per-year pricing may be slightly higher on a shorter term — but the overall commitment and risk exposure are significantly lower.
Does SAP offer volume flexibility in RISE contracts?+
Not by default. SAP’s standard RISE contracts are fixed commitments with no downward adjustment during the term. However, volume flexibility (±10–15% annual adjustment) is negotiable, particularly for organisations with variable demand patterns — healthcare, seasonal businesses, and nonprofits. This flexibility must be explicitly negotiated into the contract. Without it, you pay for the peak commitment regardless of actual usage.
How does HIPAA compliance work in a RISE with SAP contract?+
HIPAA compliance in RISE requires explicit contractual provisions: SAP must sign a Business Associate Agreement (BAA), commit to data residency (specifying which data centres and countries store patient data), provide audit rights, and document data handling procedures. These are not included in SAP’s standard cloud terms by default. Healthcare organisations must negotiate these protections as part of the RISE contract — not rely on verbal assurances or generic cloud certifications.
Should we stay on ECC instead of moving to RISE?+
Staying on ECC with extended support (or third-party support) is a legitimate alternative that creates negotiation leverage. ECC mainstream support ends in 2027, but extended support is available until 2030. Third-party support from providers like Rimini Street can reduce support costs by 50%. For organisations not ready for S/4HANA, staying on ECC buys time. However, the long-term trajectory is toward S/4HANA. The key is using these alternatives as leverage to negotiate better RISE terms — not as a permanent strategy.
FF

Fredrik Filipsson

Co-Founder, Redress Compliance

Former Oracle, SAP, and IBM — now helping enterprises worldwide negotiate better software deals. 20+ years in enterprise licensing, 500+ clients served.

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