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.

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

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

Healthcare Data and Analytics (D&A) Services Provider Compendium provides accurate, comprehensive, and fact-based snapshots of 35 providers, including their scale of revenue, overview of client base, company overview, revenue split by geography, segment, value chain, and buyer size, along with Everest Group’s PEAK Matrix® service provider assessment. The compendium also examines the global healthcare D&A service provider landscape. The report will enable current and potential buyers of payer operations to assess the providers on their strengths and limitations, based on their desired capabilities. Scope Industry: healthcare Geography: global This report is based on Everest Group’s annual RFI process for the calendar year 2023, interactions with leading healthcare D&A services providers, client reference checks, and an ongoing analysis of the healthcare D&A services market Contents Each provider profile captures the following details: 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 Everest Group assessment: providers’ position on Everest Group’s PEAK Matrix® and overall evaluation of provider capabilities with key strengths and limitations Membership (s) Healthcare Payer and Provider Information Technology Healthcare Payer and Provider Business Process Data & Analytics Sourcing and Vendor Management

Healthcare enterprises are recognizing the growing importance of Data and Analytics (D&A) in their growth strategies, as data-driven decision-making gains significance. Traditionally, D&A services focused on cost-cutting and operational optimization; however, there has been a shift toward prioritizing customer satisfaction and improving health outcomes. This shift has led healthcare enterprises to invest in data integration and advanced analytics, with a specific focus on areas such as data privacy, value-based care, and population health. Although payers have been leading in the adoption of D&A, providers are rapidly catching up, with the pandemic serving as a catalyst for this trend. Providers are assisting healthcare enterprises in defining their D&A strategy and roadmap, upgrading their infrastructure, and providing relevant recommendations for enterprise-level decision-making, resulting in tangible business benefits. In this report, we assess 35 healthcare D&A service providers featured on Everest Group’s Healthcare Data and Analytics Services PEAK Matrix® Assessment 2023 Each provider profile offers a comprehensive overview of its service focus and key strengths and limitations. The research will help buyers select the right-fit provider for their needs, while providers will be able to benchmark themselves against the competition. Scope Industry: healthcare Offering: D&A services Geography: global The assessment is based on Everest Group’s annual RFI process for the calendar year 2023, interactions with leading D&A service providers, client reference checks, and an ongoing analysis of the healthcare D&A services market Contents In this report, we: Study healthcare D&A services market trends Examine 35 healthcare D&A service providers’ capabilities and offerings List providers’ key strengths and limitations Membership(s) Healthcare Payer and Provider Information Technology Healthcare Payer and Provider Business Process Sourcing and Vendor Management

The COVID-19 pandemic ushered in sweeping changes in how we use healthcare services – including rising virtual healthcare visits, mobile apps for health and wellness solutions, and online purchase of drugs. Technology has played a vital role in fighting the pandemic itself. At the same time, many of these technologies have scope for improvement that could, in fact, help us fight future pandemics.  In this report, we explore the role of technology in fighting future pandemics. We discuss the investments needed to strengthen the healthcare technology infrastructure and the challenges that healthcare systems need to overcome to adopt technology solutions. We also look at the critical role that India can play in the battle against pandemics.  Scope  Industry: healthcare Geography: global The research contains findings from a survey among 61 healthcare practitioners and leaders (29 clinicians, 12 nurses, 10 healthcare enterprise and health tech institution CXOs, and 10 healthcare technology academics)  Contents: This report studies: Pandemic-driven changes Key technology developments to tackle future pandemics Barriers to the adoption of healthcare technology in India India’s role in tackling future pandemics Membership (s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

Increasingly, healthcare enterprises are supporting their growth strategies with data-driven decision-making to reduce costs, enhance operational efficiencies, deliver better member/patient engagement, and improve health outcomes. The pandemic has further accelerated analytics adoption, as enterprises race to become more agile to meet the unprecedented demands of the healthcare ecosystem.  Although payers are ahead of providers in leveraging analytics, a majority of enterprises are yet to access the complete benefits of their analytics initiatives due to the lack of the right skill sets, analytics adoption in silos, and inefficient data management practices. Providers can help enterprises formulate the core vision for analytics, modernize their data landscapes, derive insights, and provide the right set of recommendations to enable enterprise-wide decision-making that drives business value.  In this report, we analyze 25 providers featured on the Healthcare Analytics Services PEAK Matrix® Assessment 2022. These providers are classified as Leaders, Major Contenders, and Aspirants based on their positioning on the Everest Group PEAK Matrix® – a composite index of distinct metrics related to a provider’s capability and market impact. Scope Industry: healthcare (payer and provider) Services: analytics services Geography: global Contents This report offers: An assessment of healthcare analytics service providers on several capability and market success-related dimensions A detailed profile of each provider, including a capability overview, case studies, offerings, recent developments, and enterprise sourcing considerations Membership(s) Healthcare Payer and Provider Business ProcessHealthcare Payer and Provider Information Technology Sourcing and Vendor Management