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  • PEAK Matrix®
    April 03, 2025

    The payment integrity market is strategically shifting from post-payment recovery to proactive pre-payment accuracy, thereby reducing costs and enhancing efficiency. AI-driven tools are advancing fraud detection, real-time claims validation, and predictive risk modeling, while next-generation technologies,…
  • Provider Compendium
    Sep. 26, 2023

    Healthcare Payer Operations Provider Compendium provides accurate, comprehensive, and fact-based snapshots of 29 service providers, including their scale of operations, company overview, recent developments, key delivery locations, major clients, technological solutions, and Everest Group’s PEAK Matrix®…
  • PEAK Matrix®
    June 23, 2023

    The healthcare industry constantly evolves, requiring organizations to continuously adapt and enhance their capabilities to stay competitive. The shift toward value-based care has presented various opportunities such as telehealth, population data analytics, remote patient monitoring, commercial…
  • Provider Compendium
    March 30, 2022

    Healthcare Payer Operations – Service Provider Compendium provides accurate, comprehensive, and fact-based snapshots of 32 service providers, including their scale of operations, technology solutions, and delivery locations, along with Everest Group’s PEAK Matrix® service provider assessment.…
  • PEAK Matrix®
    Feb. 17, 2022

    Healthcare is among the fastest changing and most dynamic of business sectors, making it vital for organizations in the field to constantly evolve and build on their foundational capabilities. The global pandemic has brought into the…
  • Provider Compendium
    July 31, 2020

    The Healthcare Payer Operations – Service Provider Compendium provides accurate, comprehensive, and fact-based snapshots of 29 healthcare payer operations service providers. In it, we present the providers’ scale of operations, technology solutions, and delivery locations, along…
  • PEAK Matrix®
    June 09, 2020

    Consumerism, the rise of digital, margin pressures, regulatory uncertainty, and value-based care are increasingly pushing healthcare payers to rethink their business models. Many payers – especially larger ones with multi-state presence – are strengthening their market…
  • PEAK Matrix®
    Dec. 13, 2019

    Healthcare challenges, such as changing business and care delivery models to support patient-centricity and consumerism, growing competition from both within and outside the industry, and increasing regulatory pressures, are leading to increased investments in data and…
  • PEAK Matrix®
    Dec. 20, 2019

    The payer industry is facing several issues such as escalating costs, declining margins, widespread regulatory amendments, shift from volume- to value-based care model, and rising consumerism. Digital adoption is influencing all aspects of the payer value…
  • Thematic Report
    June 25, 2019

    The healthcare payer BPO service provider profile compendium provides accurate, comprehensive, and fact-based profile snapshots of 27 service providers in the market. Specifically, the report allows for comparison of the service providers on their areas of…
  • PEAK Matrix®
    April 17, 2019

    With multiple M&As and partnerships being announced, healthcare payers have had a busy last couple of years. Quest for consolidation across the value chain has led payers to merge with PBMs, acquire providers (physician practices, home…
  • Thematic Report
    Oct. 05, 2018

    The Industry Trends reports provide industry-specific data, developments, and insights that enable global sourcing managers to navigate through the complexity and make clear and effective decisions suited to their specific industries. These reports provide detailed information…
  • Thematic Report
    June 29, 2018

    After a year of stalled investments owing to market uncertainty, healthcare payers restarted investments in areas such as value-based care adoption, care management, utilization & disease management, population health, and consumer experience. On the technology front,…
  • PEAK Matrix®
    Oct. 27, 2017

    The Healthcare and Life Sciences (HLS) landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with…
  • Provider Compendium
    April 18, 2017

    The healthcare payer BPO service provider profile compendium provides accurate, comprehensive, and fact-based profile snapshots of 20 service providers in the market. Specifically, the report allows for comparison of the service providers on their areas of…
  • State of the Market
    March 31, 2017

    Healthcare payer BPO market grew strongly during 2013-2015, reaching US$9.1 billion (including government business) in 2016. Obamacare contributed to a large extent in this growth story. However, with the election of Donald Trump as the President…
  • PEAK Matrix®
    Feb. 03, 2017

    As Obamacare continues to bring about changes in the market, healthcare payer market remains in a dynamic state. The impending decision about top payer consolation has added to the uncertainty in the market. Some of the…
  • PEAK Matrix®
    Oct. 31, 2016

    The Healthcare and Life Sciences (HLS) landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with…
  • PEAK Matrix®
    Nov. 17, 2015

    Introduction The healthcare landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with mobile computing, social…
  • Thematic Report
    Aug. 31, 2016

    Introduction The healthcare payer BPO service provider profile compendium provides accurate, comprehensive, and fact-based snapshots of 19 service providers in the market. Each five-page profile presents a comprehensive picture of a provider’s service suite, scale of…

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