Healthcare organizations are shifting toward unified data platforms to address growing demands for interoperability, real-time insights, and compliance in a digital-first environment. This report explores how healthcare data management platforms are becoming central to achieving these objectives by integrating ingestion pipelines, governance frameworks, and analytics capabilities. The report highlights key market dynamics, including rising enterprise adoption of cloud-native platforms and increasing investments in generative and agentic AI to support predictive analytics, workflow automation, and decision-making. The market is witnessing a convergence of BigTech, HealthTech, and enterprise data providers, all competing and collaborating simultaneously to deliver differentiated solutions through enhanced AI, scalability, and modularity. Key buyer priorities include seamless integration with existing systems, robust data governance, and scalable analytics that can inform clinical and operational strategies. In this report, we assess 15 healthcare data management platform providers featured in the Healthcare Data Management Platforms PEAK Matrix® Assessment 2025. 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.

The shift toward value-based care, proactive population health management, and quality-linked reimbursement models is rapidly transforming the healthcare industry. Care management platforms have become foundational infrastructure, enabling organizations to manage chronic conditions, close care gaps, enhance regulatory reporting, and improve member outcomes. Recent advances have extended platform capabilities beyond documentation to include AI-enabled orchestration, real-time analytics, and interoperability frameworks that integrate Electronic Health Records (EHRs), claims, labs, pharmacy data, social determinants of health, and wearables. Providers are increasingly embedding generative AI for care plan automation, conversational engagement, and clinical record summarization, while agentic AI is beginning to assist in decision-making areas such as prior authorization. Despite these innovations, challenges persist in achieving seamless EHR integration, end-to-end workflow automation, and consistent adoption of next-generation features. Consequently, buyers are emphasizing platforms that offer scalability, automation, user-centric design, and interoperability with other systems. Providers, in turn, are differentiating through domain-focused capabilities (for example, chronic disease management and behavioral health), star optimization, and interoperability maturity. This report evaluates care management platform providers, positioning them as Leaders, Major Contenders, and Aspirants based on their vision, capabilities, and market impact. The analysis leverages Everest Group’s annual RFI process, provider briefings, buyer interviews, and proprietary market research.

Payers are undergoing rapid transformation to meet growing expectations around value-based care, proactive population health management, and quality-linked reimbursement. Care management platforms are emerging as foundational infrastructure, enabling payers to manage chronic conditions, close care gaps, enhance regulatory reporting, and improve member outcomes. Recent advances have expanded platform capabilities beyond documentation to include AI-powered orchestration, real-time analytics, and interoperability frameworks that integrate Electronic Health Records (EHRs), claims, labs, pharmacy data, Social Determinants of Health (SDoH), and wearables. Providers are embedding generative AI for care plan automation, conversational interfaces, and summarization of clinical records, while agentic AI is beginning to support decision-making in areas such as prior authorization. Despite these innovations, challenges remain in seamless EHR integration, limited workflow automation, and uneven adoption of next-generation capabilities. As a result, buyers are prioritizing platforms that deliver scalability, automation, user-centric design, and interoperability with other systems. Providers are differentiating through domain-specific capabilities (for example, chronic disease management and behavioral health), stars optimization, and interoperability maturity. In this report, we assess 19 care management platform providers, positioning them as Leaders, Major Contenders, and Aspirants based on vision, capability, and market impact. The analysis draws on Everest Group’s annual RFI process, provider briefings, buyer interviews, and proprietary market research.

Population Health Management (PHM) is a cornerstone of modern healthcare, enabling payers and providers to improve outcomes and reduce costs by proactively managing patient populations. As the burden of chronic disease, aging populations, and health inequities rises, PHM platforms provide structured, data-driven frameworks to support early intervention, coordinated care, and improved quality scores. The shift to value-based care is accelerating demand for PHM solutions that integrate diverse data sources, from EHRs and labs to claims, wearables, and Social Determinants of Health (SDoH). Despite significant progress, adoption challenges remain around interoperability, workflow integration, and costs. Payers and providers increasingly prioritize solutions that offer scalability, bidirectional FHIR-based data exchange, configurable workflows, and actionable insights. Platform providers are differentiating through AI-powered outreach, advanced equity analytics, and quality measure tracking integrated directly into EMRs. The report evaluates 20 leading global PHM platform providers across a range of core capabilities, including data unification and integration, risk stratification, care coordination, patient engagement, real-time analytics, and the incorporation of SDoH. It also explores how these platforms leverage next-generation technologies such as AI to generate intelligent insights and drive early interventions. In addition, the report features detailed profiles of each provider, outlining platform functionalities and highlighting case studies. Everest Group also shares its perspective on each provider’s market impact, innovation maturity, and capability depth.

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 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

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

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