The outsourcing of logistics and supply chain activities to outside suppliers is an ever-increasing trend for at least a decade of time. As logistics and supply chain activities today are important to the competitive advantage, the effective management of outsourcing in this area also becomes an important agenda. The study demonstrated the importance of intra-company alignment and inter-company relationship in the supply chain outsourcing decision making, performance measuring and service provider management. It identified the need to improve the understanding of outsourcing’s impact on supply chain strategy by conducting cross-functional impact analysis at the process level. The focus on healthcare sector of Pakistan is unique work of its type. Readers will find a comprehensive research framework and data collection tool which can be used in similar research endeavors.