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  • Blog
    July 08, 2026

    Artificial Intelligence (AI) is having its moment. After years of cautious skepticism, pilot-stage overhang, and boardroom debates, the conversation has moved beyond experimentation. Enterprises are no longer asking whether to deploy agents, they are now asking how fast they can scale them across their entire workflow estate. However, speed comes at a price and almost nobody is doing the math.   The warning signs…
  • 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…
  • Provider Compendium
    Dec. 30, 2025

    Enterprises are repositioning quality from a downstream testing activity to a strategic engineering capability embedded across the software development life cycle. As digital, cloud, and AI initiatives scale, expectations are moving beyond defect identification toward resilience,…
  • 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…
  • PEAK Matrix®
    Nov. 13, 2025

    Enterprises are elevating quality from a downstream test phase to a strategic engineering discipline woven through the software development life cycle. As digital, cloud, and AI programs scale, expectations shift from defect detection to resilience, velocity,…
  • Viewpoint
    Nov. 10, 2025

    As enterprises accelerate digital transformation and embrace next-generation technologies such as AI, generative AI, and cloud-native platforms, managing quality at scale has become increasingly complex. Traditional tool-centric quality approaches fall short in addressing fragmented processes, inconsistent…
  • 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…
  • PEAK Matrix®
    Oct. 29, 2025

    Enterprises are reimagining quality as a strategic engineering function rather than a downstream testing activity. As a result, demand for specialized Quality Engineering (QE) services is growing rapidly across industries. This analysis shows how the specialists…
  • 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…

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