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  • Provider Compendium
    June 30, 2025

    The payment integrity market is shifting from post-payment recovery to a proactive focus on pre-payment accuracy, aiming to reduce costs and improve efficiencies. AI is enhancing fraud detection, real-time claims validation, and predictive risk modeling. Simultaneously,…
  • 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…
  • State of the Market
    Dec. 18, 2020

    The healthcare provider industry has been plagued with numerous issues – care providers have been operating on thin margins due to high claims denials, increasing bad debts, and the higher cost of operations, partially because of…
  • 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…
  • 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,…
  • Thematic Report
    March 01, 2018

    The United States healthcare market experienced a tectonic shift in 2017, with President Trump’s (thus far unsuccessful) pursuit to repeal the Affordable Care Act (ACA) and replace it with a new law. Given the uncertainty of…
  • 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…
  • 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…