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. 

As healthcare continues its transition to value-based, patient and member-centric care models, CIOs are increasingly under pressure to deliver seamless, proactive, and personalized experiences across the care continuum. Traditional Customer Relationship Management (CRM) platforms digitize communications but fall short in orchestrating real-time, intelligent engagement. The result is often fragmented experiences, high patient churn, inefficient workflows, and unmet member expectations. To address these limitations, healthcare enterprises are turning to Systems of Execution (SoE) – intelligent platform layers that go beyond passive data repositories to drive real-time decisioning and workflow automation across clinical and administrative functions. SoE represent the next evolution of CRM, which makes it capable of orchestrating adaptive, AI-driven engagement journeys that respond dynamically to clinical risk signals, social determinants of health, and benefit changes. In this Viewpoint, we explore SoE’s transformative potential across healthcare CRM by highlighting real-world use cases that improve care coordination, automate workflows, and elevate patient and member engagement.. Scope Industry: healthcare Geography: global Contents In this report, we explore: SoE’s role in transforming patient and member engagement across healthcare organizations A detailed roadmap for healthcare CIOs to implement SoE effectively, including foundational enablers such as unified data fabrics, AI-powered decision engines, and adaptive workflows A three-stage SoE maturity model with illustrative use cases and implementation best practices for each stage Strategic guidance to align CRM modernization with value-based care goals to improve engagement, care coordination, and operational efficiency

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

In recent years, technology enterprise adoption and digitalization have significantly reshaped Revenue Cycle Management (RCM), transforming how healthcare providers optimize financial performance and patient engagement. To enhance provider reimbursements, streamline claims processing, and accelerate value-based care initiatives, healthcare providers have made digital adoption their RCM strategies’ foundation. To meet growing enterprise demands, RCM platform providers are expanding their capabilities through investments in AI/gen AI-driven automation, strategic partnerships, and acquisitions to drive efficiency and financial sustainability. In this report, we evaluate 22 RCM platform providers mapped on the Everest Group PEAK Matrix® framework. The report analyzes the RCM platform market size, growth trends, and key capabilities, offering insights into market success metrics. It offers enterprises the information they need to make informed sourcing decisions in the evolving RCM landscape. Scope Industry: healthcare Product: revenue cycle management Geography: US Contents In this report, we: Assess healthcare RCM platforms market trends Examine each platform provider’s capability and market success-related dimensions Analyze platform providers’ key strengths and limitations Membership(s) Healthcare Payer and Provider Information Technology Revenue Cycle Management 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

The Electronic Health Record (EHR) landscape is significantly transforming, with enterprises seeking next-generation solutions to address interoperability and data security challenges. This shift compels providers to innovate their offerings and introduce advanced platforms that enhance clinical workflows, enable interoperability, support value-based care, and enhance data security. Following suit, Oracle has launched its next-generation EHR offering, which includes automated workflows, integrated clinical decision support, and enhanced data interoperability. In this report, we examine Oracle’s current market position, key product announcements, and industry objectives. We also review Oracle’s next-generation EHR technology and cover essential issues and objectives around health information management for healthcare enterprises. Scope Industry: healthcare Geography: global Service: healthcare technology Contents In this report, we: Examine key enterprise issues and objectives for advanced EHRI Review Oracle’s next-generation EHR announcement Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

In the past few years, enterprise adoption of technology and digitization has significantly increased, changing the landscape for healthcare providers and patients. To improve provider reimbursements, patient engagement, and care management and accelerate value-based care programs, healthcare enterprises have made digital adoption their growth strategies’ cornerstone. To address these emerging enterprise demands, providers are expanding their AI offerings, engaging in vertical-specific partnerships and acquisitions, and investing in centers of excellence. In this report, we examine 35 healthcare provider digital service providers featured on Everest Group’s PEAK Matrix® framework based on their capabilities. The report analyzes the provider digital services market size and growth and digital service themes for healthcare providers. It assesses providers on several capability- and market success-related dimensions and offers valuable insights to help enterprises make the right sourcing decisions. Scope Industry: healthcare Service: healthcare provider digital Geography: global Contents In this report, we: Assess healthcare provider digital services market trends Examine each provider’s capability- and market success-related dimensions Compare providers’ key strengths and limitations 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