The healthcare industry faces challenges such as a shortage of clinical talent, a growing elderly population, and disparities in care access. Chronic diseases are on the rise, influenced by lifestyle choices and air quality. According to the CDC, chronic diseases chronic diseases contribute significantly to increased healthcare spending and mortality. To bridge this gap, healthcare organizations must deliver cost-effective care, expand infrastructure, and address Social Determinants of Health (SDoH) to improve access. Proactively identifying high-risk patients is essential for efficient resource allocation and cost reduction. Innovations in care delivery, targeted interventions, and investments are required to enhance care quality and outcomes. In this viewpoint, we discuss the trends driving care management policies’ adoption, outsourcing opportunities, and the evolution of care delivery. It also highlights challenges in delivering quality care and suggests ways for providers to support enterprises in overcoming these obstacles, with the ultimate goal of achieving superior patient care outcomes. Scope Industry: healthcare Geography: North America Contents In this report, we examine: Key market trends driving the increased outsourcing of care management operations A look into the past, present, and future dynamics of healthcare models Key challenges that enterprises face in handling care management operations and the solutions providers offer to support them Membership(s) Healthcare Payer and Provider Business Process Sourcing and Vendor Management

Medical coding is one of the most frequently outsourced segments in the Revenue Cycle Management (RCM) value chain. Geriatric population growth and rising incidences of chronic diseases are increasing the demand for skilled medical coders. This, in combination with a shortage of qualified personnel within healthcare providers, is driving growth in the outsourcing of medical coding services. Additionally, the transition from inpatient to home-based care delivery, the adoption of telehealth and remote patient monitoring, and the addition of new code sets have made medical coding processes more complex. These shifts in the medical coding services landscape are compelling healthcare providers to seek support from third-party vendors. This compendium provides detailed and fact-based snapshots of 22 medical coding Business Process Services (BPS) providers. Each profile provides a comprehensive picture of the provider’s strengths and limitations. The compendium will enable providers to benchmark their capabilities against their peers, while buyers will be able to assess the providers based on their sourcing needs. Scope: Industry: healthcare Geography: global Contents: In this report, we feature 22 medical coding BPS provider profiles and include: Scale of operations, key leaders, and recent developments, along with acquisitions, revenues, FTEs, and clients FTE split by certification and revenue split by facility type Technology suite and brief descriptions of key proprietary solutions Key service delivery locations Providers’ strengths and limitations Membership(s) Healthcare Payer and Provider Business Process Sourcing and Vendor Management

Medical coding is one of the most outsourced segments in the Revenue Cycle Management (RCM) value chain. With a growing geriatric population and rising incidence of chronic diseases, the demand for skilled medical coders is on the rise. This increase in demand for qualified coders, combined with shortage of suitable personnel, is driving the growth of outsourced medical coding services. Additionally, the shift from an inpatient to a home-based care delivery model, the adoption of telehealth and remote patient monitoring, and the addition of new code sets have increased the complexity associated with medical coding processes. These gradual shifts in medical coding services are prompting healthcare providers to leverage third-party providers for support. In this research, we present a detailed analysis of 22 operations service providers featured on Everest Group’s Medical Coding Operations PEAK Matrix® Assessment. We provide a relative positioning and analysis of the providers and our evaluation of their strengths and limitations. Scope Industry: healthcare business process Geography: global Contents This report features a detailed analysis of 22 operations service providers and includes: A relative positioning of the providers on Everest Group’s PEAK Matrix® for Medical Coding Operations An analysis 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

Revenue Cycle Management (RCM) Operations –Provider Compendium provides accurate, comprehensive, and fact-based snapshots of 31 service providers, including their scale of operations, technology solutions, and delivery locations, along with Everest Group’s PEAK Matrix® service provider assessment. The compendium also sheds light on the global RCM operations service provider landscape. The study will enable current and potential buyers of RCM operations to assess the providers’ strengths and limitations. Scope Industry: healthcare business process Geography: global Contents Each service provider profile captures the following RCM operations-related details: Service suite and scale of operations: key leaders, services suite, FTEs, revenue, recent developments, and partnerships Delivery locations: city-level detail of key delivery locations worldwide Capabilities and clients: major engagements, revenue split by geography, FTE split by process coverage and location, and revenue split by engagement model Technology solutions: brief descriptions of key technology solutions Everest Group assessment: service provider’s position on the Everest Group PEAK Matrix®, market share and delivery capability assessment, and overall evaluation of service provider capabilities Membership(s) Healthcare Payer and Provider Business Process Sourcing and Vendor Management

The COVID-19 pandemic added to the financial burden of healthcare providers as footfall reduced and elective surgeries were postponed. Today, although volumes are steadily reaching pre-pandemic levels, healthcare providers are facing strong headwinds due to an unprecedented talent shortage. The surge in talent demand has intensified financial pressures on providers as they battle to match soaring wages and retain talent. Healthcare providers are overhauling their strategies and future-proofing their operations by becoming more receptive to outsourcing operations to alleviate cost pressures and ensure business continuity. Healthcare providers are also adopting technologies such as automation and analytics to reduce their dependency on talent and streamline operations. In this research, we present a detailed view of 31 Revenue Cycle Management (RCM) operations service providers featured on the RCM 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 providers to identify suitable partners to transform their business processes. Scope Industry: healthcare business process Geography: global Contents This report includes a detailed analysis of 31 RCM operations service providers and includes: A relative positioning of the providers on Everest Group’s PEAK Matrix® for RCM Operations An analysis 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

A regulatory overhaul is forcing MedTech enterprises to change their operating models to remain relevant in a fast-evolving business landscape. Additionally, they need to build supply chain resiliency to battle supply shortages in the industry and focus on innovation to keep up with trends such as wearables, rising acceptance of minimally invasive surgeries, and focus on patient-centric solutions. These changes are driving enterprises to re-evaluate their strategies and operations by increasing the use of third-party support and adopting digital technologies such as Robotic Process Automation (RPA), advanced analytics, and Artificial Intelligence (AI) / Machine Learning (ML) across their value chain. In this report, we examine the key themes characterizing the MedTech operations market, including the implications of these themes on enterprises and providers, outsourcing dynamics, and technological adoption. Scope Industry: life sciences BPS Geography: global Contents In this report, we focus on: Key themes impacting the MedTech operations market Outsourcing dynamics and trends in the MedTech operations market Membership (s) Life Sciences Business Process Sourcing and Vendor Management