Showing 4 results
-
Sep. 18, 2025Payers 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.
-
Tech Vendor Spotlight
Bridging Data and Care: A Comprehensive Guide to Population Health Management Platforms
Sep. 18, 2025Population 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. -
June 04, 2025Healthcare 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
-
April 12, 2023The 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