The 2021 PEAK Matrix® report for RCM operations is here
Discover how service providers are elevating revenue cycle management (RCM) practices.
Optum was named a Leader by Everest Group’s 2020 PEAK Matrix™ Assessment. This illustrates the breadth and depth of our solutions and services.
- Revenue Cycle Management Operations
- Healthcare Provider Digital Services
- Healthcare Payer Operations Services
- Healthcare Payer Payment Integrity Solutions
- Healthcare Payer Digital Services
Leaders have established themselves as front-runners to support large customers. They differentiate themselves through:
- Balanced portfolios
- Ability to come up with innovative digital use cases
- Continued investments in developing technology and services capabilityThey have also showcased high levels of being proactive in taking their innovations and next-generation service offerings to clients.
Everest Group’s PEAK Matrix offers an annual objective, data-driven and comparative assessment of service providers. They base their assessment on a service provider’s market impact, vision and capability. The reports classify service providers as Leaders, Major Contenders and Aspirants.
Revenue Cycle Management Operations
Optum was recognized as a Leader for:
- Unique combination of RCM and care offerings
- Operational, consulting and technological expertise
Among 26 organizations, Optum360 achieved the top score for value delivered to clients.
“RCM’s role has evolved, and enterprises are looking for a combination of traditional RCM and care offerings. By leveraging a combination of its managed services, advisory and technology capabilities, Optum has emerged as one of the few players uniquely positioned to address this need. Additionally, its downstream capabilities, such as EDI, coupled with a readiness to participate in both end-to-end as well as modular engagements, have emerged as strong value propositions.” Manu Aggarwal, vice president, Everest Group
This graphic represents the Everest Group 2020 Peak Matrix for Revenue Cycle Management Operations. Ranking 26 vendors against both the impact they create in the market and their ability to successfully deliver services, the graph plots each company on a chart. The five lowest ranking vendors are identified as “Aspirants,” and from left to right (lowest to highest ranking) they are: ACU-Serve, Visionary RCM, Shearwater Health, Aviacode and Prochant.
The 14 middle performers, or “Contenders,” are: HCL Technologies, Himagine Solutions, WNS, MedAssist (Firstsource), Teleperformance, IKS Health, HGS, Genpact, Atos, NTT Data, AGS, Excela Technologies, Miramed Ajuba and Southerland Global Services.
The seven top performers were identified as 2020’s “Leaders.” They are: GeBBS, Access Healthcare, Omega Healthcare, nThrive, Optum, Cognizant and R1 RCM. Additionally, AGS, Excela Technologies, GeBBS and Omega Healthcare were identified as 2020’s “Star Performers.”
Healthcare Provider Digital Services
Optum was recognized as a Leader for:
- In-depth understanding of the health care continuum
- Distinct focus on driving end-to-end positioning
- Investments in developing thought leadership
- Significant focus on co-innovation and strategic acquisitions
Among 22 competitors, Optum achieved the top category of Leader for value delivered to clients.
“Healthcare providers are finding it hard to navigate the pandemic due to significant technical debt and dated legacy systems. They are balancing their cost take-out initiatives with investments in digital transformation to stay financially afloat and prepare for operations in a post-pandemic landscape. While the immediate focus has shifted to virtual care, healthcare providers are also investing in improving patient and clinician experience. Optum’s innovative and customer-centric solutions are helping its customers enhance patient experiences and reduce the cost of care, and have helped position it as a Leader on Everest Group’s Healthcare Provider Digital Services PEAK Matrix Assessment® 2020.” Chunky Satija, Practice Director, Everest Group
This graphic represents the Everest Group 2020 Peak Matrix for Healthcare Provider Digital Services. Ranking 22 vendors against both the impact they create in the market and their ability to successfully deliver services, the graph plots each company on a chart. The four lowest ranking vendors are identified as “Aspirants,” and from left to right (lowest to highest ranking) they are: Hexaware, HTC Global Services, EPAM and Capgemini.
The 12 middle performers, or “Contenders,” are: Infostretch, GAVS, Infinite, Tech Mahindra, Virtusa, Citius Tech, emids, HCL Technologies, Wipro, ATOS, IBM and DXC Technology.
The six top performers were identified as 2020’s “Leaders.” They are: TCS, NTT, Deloitte, Accenture, Cognizant and Optum. Additionally GAVS and TCS were identified as 2020’s “Star Performers.”
Healthcare Payer Operations Services
Optum was recognized as a leader for:
- Pioneering use of intelligent automation to solve enterprise issues
- Unparalleled ITaaS and BPaaS platforms and tools
- Continued investment in technology and innovation to advance capabilities
Among 29 competitors, Optum achieved the top category of Leader for value delivered to clients.
“Optum enjoys a strong position in the healthcare payer market. Over the years, the service provider has created a comprehensive library of technology-enabled services for not only traditional outsourcing segments such as claims, but also emerging ones, such as population health, risk & quality management, and payment integrity. Its continued investments have helped Optum maintain its market leadership.” Manu Aggarwal, Vice President, Everest Group
Healthcare Payer Payment Integrity Solutions
Optum was recognized as a Leader for:
- Strong base of end-to-end services
- A consult-to-operate engagement approach
- Continued investment in technology to advance capabilities
Among 11 competitors, Optum achieved the top score for value delivered to clients.
“Optum’s extensive pre-submission, pre-payment, and post-payment integrity solutions portfolio complemented with Equain’s solutions has made it a partner of choice for healthcare firms. Additionally, their healthcare lineage coupled with the ability to operate as a strategic partner for clients has strong advantages.” Abhishek Singh, Vice President, Everest Group
Healthcare Payer Digital Services
Optum was recognized as a Leader for:
- Distinctive healthcare expertise
- Top score in client value delivered
- Strong market impact in healthcare digital technology thought leadership.
Among 23 competitors, Optum was the only health services company to achieve this distinction.
“The healthcare industry is experiencing fundamental changes – including a shift from a volume- to a value-based care model, the entry of technology players, and the increasing importance of patient centricity. As a result, payers are adopting digital technologies to enhance their operating models and optimize costs. They are looking for service providers to help navigate challenges such as siloed operations, disconnected information systems, and fragmented member information, to truly focus on breakthrough innovation and value-based care outcomes. With its healthcare lineage, focus on technologically advanced and customer-centric solutions such as MyScript Finder™, and machine assisted prior authorization, Optum is helping payers transform the cost of care and provide superior experiences to their members.” Abhishek Singh, Vice President, Everest Group