From Labor to Intelligence: Rewire Healthcare Payer Operations for a Tech-First Era

Payer operations were reaching a structural inflection point. As cost pressure, regulatory scrutiny, and AI-enabled operating models reshaped the landscape, payer leaders had to rethink how sourcing and operating design delivered measurable business outcomes.

In this session, Everest Group experts broke down how sourcing expectations were evolving, what defined a next-generation payer operating model, and how leaders could evaluate tech-first partners to drive scalable, outcome-based impact.

What questions did this event answer for participants?

• Why were traditional sourcing models becoming structurally unsustainable?
• How were AI-enabled, tech-first models reshaping sourcing and value creation?
• Where could payers move beyond incremental efficiency to outcome-based impact?
• How should payers evaluate and leverage tech-first partners?
• What did it take to implement a next-generation operating model?