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Showing 136 results
  • Viewpoint
    June 12, 2026

    Improper payments remain a persistent challenge for health plans despite sustained investment in payment integrity. Many payer organizations still manage pre-pay and post-pay activities as separate functions, limiting their ability to convert recovery insights into earlier…
  • Roundtable
    April 16, 2026

    Following our GBS Operating Model FutureCast workshop, Everest Group is convening a select group of GBS leaders for an interactive working session on Thursday, May 07, to pressure test emerging perspectives on reimagining the operating model in the age of agentic AI.  …
  • PEAK Matrix®
    April 10, 2026

    Healthcare payers and providers are operating under sustained pressure from fragmented engagement ecosystems, rising consumer expectations, and intensifying regulatory and quality mandates. Disconnected clinical, administrative, and customer interaction systems continue to limit end-to-end visibility across member…
  • Roundtable
    March 31, 2026

    Following our GBS Operating Model FutureCast workshop, Everest Group is convening a select group of GBS leaders for an interactive working session on Tuesday, April 14, to pressure test emerging perspectives on reimagining the operating model in the age of agentic AI.  …
  • Viewpoint
    March 17, 2026

    Healthcare enterprises face mounting pressure to improve Star/HEDIS performance, reduce Medical Loss Ratios (MLR), lower avoidable utilization, and enhance operational efficiency. Although digital tools and program expansion have increased over the past decade, most care management…
  • Accelerator
    Nov. 21, 2025

    Procurement organizations prioritize reducing costs, managing risks, and creating business value. Category management helps achieve these goals by optimizing category spend, identifying cost-saving opportunities, and improving operational efficiency. This report equips healthcare payer services (BPS and…
  • LinkedIn Live
    Nov. 19, 2025

    In an evolving landscape where analyst relations (AR) shape market perception and business success, leaders continued to look for proven tactics embraced by experienced AR professionals. Everest Group’s Katrina Menzigian, along with industry experts from other…
  • Blog
    Nov. 05, 2025

    In 2006, I visited my first captive center in Bengaluru. At the time, the model was still in its formative years – many multinational organizations were only beginning to explore the potential of setting up their own in-house centers…
  • Market Insights™
    Nov. 05, 2025

  • Market Insights™
    Nov. 05, 2025

  • State of the Market
    Oct. 31, 2025

    Clinical and Care Management (CCM) is becoming a strategic priority for healthcare enterprises, driven by the need to improve outcomes, contain costs, and comply with intensifying regulatory demands. Once seen primarily as a cost-control function, CCM…
  • Tech Provider Spotlight
    Sep. 30, 2025

    The Payment Integrity (PI) market is structurally resetting. Payers are moving from retrospective audits to preventive, pre-payment validation using AI, predictive analytics, and automation to detect anomalies early, improve coding accuracy, and reduce provider abrasion. This…
  • PEAK Matrix®
    Aug. 26, 2025

    The Clinical and Care Management (CCM) operations market is rapidly transforming as payers and providers face mounting pressures from rising care complexity, workforce constraints, and financial risk exposure. Fragmented data systems, coupled with growing regulatory demands,…
  • LinkedIn Live
    May 14, 2025

    As the healthcare landscape continued to evolve, the payment integrity market experienced a dynamic transformation. ️ In this thought-provoking LinkedIn Live session, we explored the shifting dynamics of payment integrity —from the growing preference for pre-payment…
  • Briefings
    May 14, 2025

    Everest Group hosted its exclusive launch event for its new Advanced SciTech Service. This program is designed to help you navigate the complex landscape of emerging science and technology, enabling you to integrate cutting-edge innovations effectively…
  • PEAK Matrix®
    March 06, 2025

    The Utilization Management (UM) healthcare market faces challenges such as administrative burdens in prior authorization and inconsistent clinical criteria, causing delays and inefficiencies. To overcome these issues, payers are partnering with specialized UM service providers, integrating…
  • Thematic Report
    Jan. 27, 2025

    Generative AI can potentially revolutionize the healthcare payer industry, driving innovation across critical areas like claims processing, member engagement, and care management. By enhancing operational efficiency and improving outcomes for both payers and members, it is…
  • Thematic Report
    Jan. 24, 2025

    Generative AI can potentially revolutionize the life sciences industry, driving innovation across key areas of the value chain. By streamlining drug discovery, optimizing clinical trials, and enhancing decision-making, it can significantly reduce the time and cost…
  • Conference
    Dec. 03, 2024

    Everest Group hosted its exclusive launch event for its new Advanced SciTech Service. This program is designed to help you navigate the complex landscape of emerging science and technology, enabling you to integrate cutting-edge innovations effectively…
  • PEAK Matrix®
    Sep. 17, 2024

    In 2023, US healthcare providers faced formidable challenges. Although patient volumes have started to recover, increased labor expense and talent shortage caused administrative burdens and workflow issues to become more pronounced. Despite slight improvements in hospital…

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