Healthcare enterprises are increasingly recognizing the strategic value of Data, Analytics, and AI (DAAI) as data-driven decision-making becomes central to achieving business and clinical outcomes. While DAAI initiatives have traditionally focused on cost containment and operational efficiencies, there is now a clear shift toward enhancing patient experiences and driving improved health outcomes. This evolving focus is prompting organizations to invest in robust data integration capabilities and advanced analytics, with particular emphasis on data privacy, value-based care, and population health management. Although payers have historically led DAAI adoption, providers are rapidly advancing their capabilities. They are essential in shaping enterprise DAAI strategies and roadmaps, modernizing infrastructure, and delivering actionable insights that support high-impact decision-making. As a result, healthcare organizations are realizing measurable improvements in performance, care delivery, and patient engagement. In this report, we assess 32 healthcare DAAI providers featured on the Healthcare Data, Analytics, and AI Services PEAK Matrix® Assessment 2025. The report analyzes the healthcare DAAI services market size, DAAI service themes for healthcare enterprises, and providers’ capabilities and market success. The research will enable enterprises to select the best-fit provider for their sourcing needs. Scope Industry: healthcare Service: healthcare DAAI services Geography: global Contents In this report, we assess: Healthcare DAAI services market trends Each provider’s capabilities and market success Providers’ key strengths and limitations

The evolving landscape of Revenue Cycle Management (RCM) highlights how AI, automation, and outsourcing are transforming financial and operational efficiencies for healthcare providers. Despite persistent challenges such as billing complexities and staffing shortages, healthcare leaders are increasingly prioritizing advanced automation, AI-driven decision-making, and cybersecurity to modernize RCM processes. Generative AI is expected to play a vital role in this modernization, with 85% of RCM leaders believing it will enhance efficiency within the next five years. Key applications include real-time eligibility verification, AI-driven chatbots, and automated medical coding, though organizations must address challenges such as data accuracy, compliance risks, and integration with legacy systems. As RCM continues to evolve, technology-enabled outsourcing models are becoming essential for sustainable growth, enabling providers to optimize workflows, reduce costs, and enhance patient experiences. This report underscores that AI-driven RCM is no longer an option but a necessity for healthcare providers seeking financial resilience and operational excellence. Additionally, it highlights key considerations for selecting the right RCM partner and outlines how third-party providers can enhance RCM workflows for greater efficiency and compliance. Scope Industry: healthcare Geography: North America Contents In this report, we explore: Key RCM challenges healthcare providers face Investment priorities for 2025 through 2030 Current adoption of advanced analytics and intelligent automation, along with priority use cases The emergence of generative AI in RCM, healthcare providers’ readiness, key use cases under consideration, and mitigation strategies for associated risks and barriers An outsourcing strategy for healthcare providers to transition to a technology-powered outsourcing model Membership(s) Healthcare Payer and Provider Business Process Sourcing and Vendor Management

Pharmacy Benefit Managers (PBMs) play a key role in the healthcare industry, managing pharmacy products and facilitating real-time interactions among stakeholders. In recent years, PBMs have expanded beyond their core functions to adapt to evolving market dynamics. Key trends include regulatory changes, increased consumer focus on health management, and widespread technology adoption. In this report, we explore key themes in the PBM marketplace, highlighting common use cases, benefits, challenges, and emerging technologies and opportunities. The report aims to help providers understand the intricacies of pharmacy benefit management and guide enterprises in formulating the right PBM strategies. Scope Industry: healthcare Geography: global Contents In this report, we examine: The role of PBMs and value chain functions Key trends and demand drivers Challenges in adopting technology and associated trends Use cases that leverage AI and automation Investment priorities Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

Care management in healthcare ensures patients receive coordinated and personalized care. Traditional healthcare professionals served as care managers, coordinating care plans and facilitating communication among payers and providers. Post-COVID-19, technology advances, such as gen AI, conversational AI, and advanced automation, have transformed care management’s landscape. Advanced data analytics, telemedicine, and electronic health records have enhanced care management’s precision and accessibility. Care management platforms have improved healthcare services due to reduced healthcare costs, migration to value-based care models, and increased demand for patient-centered care. In this report, we assess 20 care management platform providers featured on the Care Management Platforms PEAK Matrix® Assessment 2024. The report will enable buyers to select the best-fit provider based on sourcing considerations and empower providers to benchmark their performance against their competition. Scope Industry: healthcare Geography: global Contents In this report, we examine 20 care management platform providers based on their: Scale of operations: revenue, buyer size, and geography Major case studies and consultative frameworks Proprietary solutions and key events Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

Care management is a vital healthcare aspect that ensures patients and members receive coordinated and personalized care. Traditional healthcare professionals served as care managers, coordinating care plans and facilitating communication among payers and providers. Post-COVID, technology advances such as gen AI have transformed care management. Advanced data analytics, telemedicine, and Electronic Health Records (EHRs) have enhanced care management’s precision and accessibility. Care management platforms have improved healthcare services due to reduced healthcare costs, migration to value-based care models, and increased demand for patient-centered care. In this report, we assess 20 care management platform providers featured in the Care Management Platforms PEAK Matrix® Assessment 2024. The report will enable buyers to select the best-fit provider based on their sourcing considerations and empower providers to benchmark their performance against their competition. Scope Industry: healthcare Geography: global This report is based on Everest Group’s annual RFI process for the calendar year 2023, interactions with leading care management platform providers, client reference checks, and an ongoing analysis of the care management platforms market Contents In this report, we: Assess care management platforms market trends Examine enterprises’ sourcing considerations Compare providers’ key strengths and limitations Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

As the healthcare industry shifts its focus toward prioritizing patients, patient involvement in their healthcare journeys is becoming increasingly important. In response to this evolving dynamic, healthcare enterprises are leveraging patient engagement platforms to enhance the overall patient experience across various touchpoints of interaction. These platforms serve as a vital link between patients and healthcare providers, promoting proactive healthcare management. As patients and healthcare providers increasingly demand personalized and accessible healthcare services, these platforms provide patients real-time access to their medical information, telehealth options, and appointment scheduling. This not only enhances the patient experience and satisfaction but also plays a vital role in optimizing healthcare resources and improving outcomes. Furthermore, within a rapidly evolving digital health ecosystem, patient engagement platforms are essential to ensure compliance with regulatory requirements and data security, contributing to healthcare businesses’ overall efficiency and success. In this report, we assess 19 patient engagement platform providers featured on the Patient Engagement Platforms PEAK Matrix®. The study will enable buyers to choose the best-fit platform provider based on their sourcing considerations, while providers will be able to benchmark their performance against each other. Scope Industry: healthcare Geography: global The assessment is based on Everest Group’s annual RFI process for the calendar year 2023, interactions with leading patient engagement platform providers, client reference checks, and an ongoing analysis of the patient engagement platforms market Contents In this report, we examine 19 patient engagement platform providers for their: Scale of operations: client base overview, revenue split by segment, value chain, buyer size, and geography Major case studies and consultative frameworks Proprietary solutions and key events Membership(s) Healthcare Payer and Provider Information Technology Outsourcing Excellence

In the healthcare sector, effective member engagement is vital for care coordination and improving outcomes. Despite significant investments in digital tools such as telehealth, healthcare payers struggle with adoption due to discrepancies between member needs and available functionalities. Barriers such as demographic differences and limited technology awareness hinder widespread adoption. However, there has been a notable increase in digital channel usage post-COVID-19, although interactions remain largely transactional. Member engagement technology enables data analysis, communication, and self-service but requires improvement to foster more proactive engagement. Members increasingly seek transparency, cost estimates, and wellness information from health plans, with growing interest in wellness management apps. . In this research, we assess start-ups that offer member engagement solutions, focusing on their capabilities and market impact, based on Everest Group’s analysis of exponential technology companies. The report provides insights into the evolving landscape and opportunities for health plans to enhance member engagement and healthcare delivery.. Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

Healthcare enterprises have made digital adoption the bedrock of their growth strategies to optimize processes, realize cost efficiencies, and improve member experiences. They are using digital services for value-based care and population health management, as well as to comply with changing regulations. To support enterprises on their digital transformation journeys, providers are ramping up capabilities through vertical-specific partnerships and acquisitions, investments in Centers of Excellence (CoEs), and training, among other things. These efforts are, in turn, driving the need for research and market intelligence on demand and supply trends in healthcare payer digital services. In this report, we assess 32 healthcare payer digital service providers mapped on Everest Group’s Healthcare Payer Digital Services PEAK Matrix® Assessment 2023. We classify these providers as Leaders, Major Contenders, and Aspirants based on their market impact and vision and capability. Scope Industry: healthcare Offering: payer digital services Geography: global (with focus on the US) Contents In this report, we examine 32 healthcare ITS providers for their: Scale of operations: client base overview, revenue, revenue split by segment, value chain, buyer size, and geography Major case studies and consultative frameworks Proprietary solutions and key events Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

Healthcare enterprises have made digital adoption the bedrock of their growth strategies to optimize processes, realize cost efficiencies, and enhance member experiences. They are leveraging digital services for value-based care and population health management, and to comply with changing regulations. To support enterprises on their digital transformation journeys, providers are ramping up their capabilities through vertical-specific partnerships and acquisitions, investments in Centers of Excellence (CoEs), and training, among other things. These efforts are, in turn, driving the need for research and market intelligence on demand and supply trends in healthcare payer digital services. In this report, we assess 32 healthcare ITS providers, which are mapped on the Everest Group PEAK Matrix®, a composite index of distinct metrics related to a provider’s capability and market impact. We focus on payer digital services market size and growth, digital service themes for healthcare payers, provider assessments on several capability- and market success-related dimensions, and Everest Group’s independent assessment of the providers to help enterprises make the right sourcing decisions. Scope Industry: healthcare Offering: payer digital services Geography: global (with focus on the US) Contents This report comprises three sections: Healthcare payer digital services market trends Assessment of 32 healthcare payer digital service providers on capability- and market success-related dimensions Enterprise sourcing considerations, highlighting the strengths and limitations of each healthcare payer digital service provider Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

In the current healthcare landscape, patient engagement platforms play a vital role. They serve as a crucial link between patients and healthcare providers, promoting proactive healthcare management. As consumers increasingly demand personalized and accessible healthcare services, these platforms give patients real-time access to their medical information, telehealth options, and appointment scheduling. This not only enhances the patient experience and satisfaction but also plays a vital role in optimizing healthcare resources and improving outcomes. Furthermore, within a rapidly evolving digital health ecosystem, patient engagement platforms are essential in ensuring compliance with regulatory requirements and data security, contributing to healthcare businesses’ overall efficiency and success. In this report, we assess 19 patient engagement platform providers featured on the Patient Engagement Platforms PEAK Matrix®. The study will enable buyers to choose the best-fit provider based on their sourcing considerations, while providers will be able to benchmark their performance against each other. Scope Industry: healthcare Geography: global The assessment is based on Everest Group’s annual RFI process for the calendar year 2023, interactions with leading patient engagement platform providers, client reference checks, and an ongoing analysis of the patient engagement platforms market Contents In this report, we: Assess the market trends for patient engagement platforms Examine enterprise sourcing considerations Study providers’ key strengths and limitations Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management