Healthcare is among the fastest changing and most dynamic of business sectors, making it vital for organizations in the field to constantly evolve and build on their foundational capabilities. The global pandemic has brought into the spotlight opportunities such as telehealth, risk-based commercial models, and care management, along with an increased focus on digital initiatives, especially automation and analytics. To capitalize on these opportunities, providers are establishing strong ecosystem partnerships with leading third-party vendors, developing technology solutions, deploying innovative models such as Business-Process-as-a-Service (BPaaS) and payvider solutions for service delivery, and strengthening their consulting capabilities to provide end-to-end transformation for their clients.

In this research, we present a detailed analysis of 32 payer operations service providers featured on the Healthcare Payer Operations PEAK Matrix®. We provide a relative positioning and analysis of the providers’ market shares and our evaluation of their strengths and limitations. The study will enable healthcare payers to identify suitable providers to transform their business processes and differentiate themselves.

Scope

Industry: healthcare business process

Geography: global

Contents

This report features a detailed analysis of 32 healthcare payer service providers and includes:

• Relative positioning of the providers on Everest Group’s PEAK Matrix® for Healthcare Payer Operations
• Comparison of the providers’ capabilities and market shares
• Everest Group’s analysis of the providers’ strengths and limitations

Membership(s)

Healthcare Payer and Provider Business Process

Sourcing and Vendor Management