In today’s dynamic healthcare landscape, Patient and Member Engagement (PME) has become a strategic imperative for healthcare enterprises and service and platform providers. Historically overlooked and limited to administrative touchpoints, PME has evolved into a mission-critical function that impacts patient/member satisfaction and business outcomes, such as retention, medication adherence, care outcomes, and cost improvements. Rising expectations, omnichannel demand, regulatory pressures, and advanced technology have accelerated the transition toward seamless, intelligent, and personalized engagement across the care journey.  In this report, we analyze the PME’s evolving role in healthcare and its significance in driving better outcomes. The report assesses key adoption trends, identifies technology and organizational accelerators, and highlights the barriers that limit PME’s scaling across the industry. Focusing on real-world enterprise priorities, the report outlines how healthcare organizations are using gen AI, predictive analytics, and agentic AI to enable self-service, deliver personalized communication, and proactively retain members and patients.  Additionally, the report examines the emergence of Systems of Execution (SoE) and their potential to unify data, drive AI-led engagement, and convert insights into real-time execution across touchpoints. It also provides sourcing guidance and strategic recommendations for payers and providers, emphasizing the need for a PME lead to drive enterprise alignment and measure experience success. 

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

Healthcare organizations generate massive data volumes from EHRs, IoT, labs, and billing systems, making effective data management essential. Interoperability, governance, and real-time analytics challenges hinder seamless data flow and insight generation. Healthcare data platforms address these issues by offering AI-driven analytics, ETL pipelines, and EHR connectivity, transforming raw data into actionable insights. These platforms improve operational efficiency, enhance patient outcomes, and enable data-driven decision-making. However, balancing innovation with compliance remains vital as organizations navigate regulatory complexities and privacy concerns. Advanced solutions ensure secure, scalable, and intelligent data management, enabling predictive analytics and real-time interoperability. As the healthcare landscape evolves, data platforms will be pivotal in optimizing workflows, streamlining care coordination, and driving digital transformation across the industry. In this report, we analyze the data platforms landscape, including key solution components, considerations to select the right tool, and leading providers. It highlights healthcare data platforms’ evolution from traditional data storage to AI-driven analytics, real-time interoperability, and predictive insights. The report profiles 15 leading technology providers that offer data platforms, highlighting their capabilities and industry use cases. Scope Industry: healthcare Domain: healthcare data platforms Geography: global Contents In this report, we provide: Each provider’s company overview Provider’s capability, market trends, and innovation dimensions Case studies demonstrating capabilities in the healthcare data management space Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

The age of generic, one-size-fits-all healthcare solutions has ended. Patient and member engagement is vital to ensure personalized care for patients. Today, personalized communication is essential to enhance user satisfaction and ensure adherence to treatment plans. Personalized engagement in healthcare is moving beyond mere administrative support, focusing on enriching patient experiences, enabling proactive communication, and delivering timely interventions to foster better health outcomes. In this report, we assess 20 providers featured in the Patient and Member Engagement Platforms PEAK Matrix® Assessment 2024. It 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 2024, interactions with leading patient and member engagement platform providers, client reference checks, and an ongoing analysis of the patient and member engagement platform market Contents In this report, we assess: Patient and member engagement platform market trends Enterprises’ sourcing considerations Providers’ key strengths and limitations 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

In the dynamic healthcare landscape, efficient claims management is vital. Traditionally, the claims management process relies on manual efforts and human judgment. Today, advanced analytics allow healthcare payers to optimize costs, reduce fraudulent claims, ensure regulatory compliance, and lower claims denial rates. Implementing analytics strategically in the healthcare ecosystem has significantly enhanced the claims management life cycle. In this report, we examine the role of analytics in transforming claims management, emphasizing the importance for healthcare payers and providers to prioritize analytics in claims management processes. The report assesses key trends, technologies, and focus areas in claims analytics, offering a comprehensive overview of how these advances lead to more efficient and effective systems. Additionally, it addresses the challenges providers face in adopting and implementing analytical techniques while offering insights into overcoming them. The report also examines the current state of claims management, offering actionable recommendations to use analytics to streamline operations and improve outcomes. It will help stakeholders understand the transformative potential of analytics in healthcare claims management and develop strategies to harness its benefits. Scope Industry: healthcare Geography: global Contents In this report, we: Examine the role of analytics in transforming claims management, highlighting how it can optimize costs, reduce fraudulent claims, ensure regulatory compliance, and lower claims denial rates Identify challenges healthcare payers face in adopting analytics and offer insights to overcome them Assess the current claims management status in the healthcare landscape Recommend best practices for using analytics to enhance efficiency and effectiveness 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

The Hospital at Home (HaH) healthcare delivery model enables patients to receive hospital-level care at home, improving patient comfort and potentially reducing extended hospital stays. Advanced technology and healthcare professionals support this innovative approach, which aims to provide high-quality care for acute and chronic conditions, thus transforming the healthcare landscape. The integration of HaH into acute care has the potential to revolutionize healthcare by offering comprehensive, cost-effective, and proactive care. Remote Patient Monitoring (RPM), a technology that facilitates real-time communication between patients and healthcare providers, plays a vital role in ensuring the effectiveness of the HaH model. Initially, chronic care adopted RPM, which has achieved considerable success and is now gaining traction in acute care. We anticipate further expansion in RPM adoption across various healthcare specialties. In this report, we examine the evolving landscape of HaH and the significant role that RPM plays in its effectiveness. It also explores the drivers and challenges of HaH adoption, future outlook, current adoption levels of HaH and RPM, and investments in care specialties. Scope Industry: healthcare Geography: global Contents In this report, we examine: The evolving HaH landscape RPM’s significance in the HaH model Drivers and challenges for HaH HaH’s future outlook Membership (s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management