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  • State of the Market

    June 30, 2025
    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. 
  • Viewpoint

    June 12, 2025
    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
  • Viewpoint

    May 08, 2025
    The shift from fee-for-service to Value-based Care (VBC) is increasing due to payer mandates and the long-term promise of improved outcomes and lower costs. However, this transformation is unfolding amid economic uncertainty, tariff-driven inflation, and healthcare provider financial strain. Several hospitals lack the capital, operational agility, or data integration required to scale VBC adoption effectively. As Centers for Medicare & Medicaid Services (CMS) expands its adoption through the Alternative Payment Model (APM) framework, healthcare providers struggle to align limited resources with long-term strategic goals. To succeed in this evolving environment, healthcare organizations must invest in automation, analytics, and AI-enabled tools that improve financial and clinical performance. Agentic AI offers the potential to ease documentation burdens, close care gaps, and support compliance in a fragmented data ecosystem. In this report, we highlight how the emerging divide in the VBC landscape, shaped by resource availability, risks exacerbating disparities in care quality and organizational resilience. The report offers actionable strategies to navigate payer demands, optimize contracts, and realign RCM provider partnerships to support value-based models. Scope Industry: healthcare Geography: North America Contents In this report, we: Simply the VBC concept Evaluate systemic barriers slowing VBC adoption Assess VBC adoption trends in the future Analyze the healthcare provider strategy blueprint for VBC’s success
  • Tech Vendor Spotlight

    Feb. 26, 2025
    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
  • State of the Market

    Dec. 27, 2024
    The impact sourcing ecosystem is rapidly expanding due to the growing interest in sustainable and socially responsible business practices. Enterprises and providers are increasingly incorporating diverse and underserved talent into their operations due to cost efficiency, access to specialized talent, and alignment with ESG and SDG objectives. Traditional providers dominate hiring volumes, while specialists see steady growth in revenue and headcount as they refine talent initiatives and partner with NGOs and educational institutions. Buyers recognize the dual value of cost benefits and corporate citizenship, advocating for more robust reporting and impact sourcing policies’ disclosure. In response, providers are investing in enhanced training programs, certifications, and technology upskilling, enabling impact workers to transition to more complex, higher-value roles. Despite generative AI’s disruptive potential concerns, agentic AI emerges as a promising tool to empower the impact workforce. Key market trends include the CXM industry’s increasing contribution to impact sourcing revenue, growing adoption of impact workers in MEA and APAC regions, and alignment with regulatory frameworks promoting fair labor practices. Governments support impact sourcing through incentives and regulations, while providers adopt inclusive hiring strategies and offer tailored employee support to complement workforce diversity and drive social impact. In this report, we explore macroeconomic drivers, buyer feedback, and generative AI’s influence on the impact sourcing space. Africa stands poised to lead the global impact sourcing growth, showing this approach’s transformative potential in fostering a purpose-driven and sustainable business landscape. The report aims to enable enterprises and providers to incorporate impact sourcing and other inclusive talent management strategies in their organizations. Scope Broad industry with a focus on impact sourcing talent strategy Geography: global Impact sourcing programs of both impact sourcing specialists and traditional service providers This report is based on primary and secondary data collection, conversations with market participants (buyers, outsourcing service providers, and impact sourcing specialists), and fact-based research Contents In this report, we analyze: The concept of impact sourcing and the comprehensive impact sourcing market landscape, including market size, trends, and talent portfolio Impact sourcing’s talent management practices across the hire-to-retire cycle Buyers’ take on impact sourcing Impact sourcing engagement case studies Technology’s role on the impact sourcing market and the future of impact sourcing programs Memberships This Market Report is available to All Memberships
  • Thematic Report

    Dec. 18, 2024
    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
  • Tech Launch Perspective

    Dec. 05, 2024
    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
  • PEAK Matrix®

    Nov. 25, 2024
    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
  • Provider Compendium

    Sep. 27, 2024
    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
  • PEAK Matrix®

    June 28, 2024
    Care management is a vital healthcare aspect that ensures patients and members receive coordinated and personalized care. Traditional healthcare professionals served as care managers, coordinating care plans and facilitating communication among payers and providers. Post-COVID, technology advances such as gen AI have transformed care management. Advanced data analytics, telemedicine, and Electronic Health Records (EHRs) 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 in the Care Management Platforms PEAK Matrix® Assessment 2024. 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. Scope Industry: healthcare Geography: global This report is based on Everest Group’s annual RFI process for the calendar year 2023, interactions with leading care management platform providers, client reference checks, and an ongoing analysis of the care management platforms market Contents In this report, we: Assess care management platforms market trends Examine enterprises’ sourcing considerations Compare providers’ key strengths and limitations Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management