What Makes TP a Leader in Everest Group’s 2026 Healthcare CXM Intelligent Operations PEAK Matrix Assessment?

The independent assessment evaluated 24 healthcare CXM providers based on market impact, vision, service capabilities, innovation, value delivered, and global delivery strength.

Everest Group recognized TP for its diversified payer and provider expertise, account responsiveness, onboarding agility, operational flexibility, broad delivery footprint, and investment in agentic AI-enabled healthcare workflow orchestration. (You can read our press release here).

For payers and providers, the recognition reflects a larger shift in healthcare outsourcing. Organizations are moving beyond traditional staffing models and isolated automation toward outcome-aligned partnerships that connect member and patient interactions with the operational processes behind them.

Read the Everest Group Healthcare CXM Intelligent Operations PEAK Matrix® Assessment 2026 to double-click into why TP was named a Leader and what healthcare organizations should prioritize when selecting a CXM partner.

How is healthcare CXM becoming more complex?

Healthcare organizations (HCOs) are under pressure to create simpler, more personalized member and patient journeys while navigating fragmented data, regulatory scrutiny, workforce constraints, and siloed operations.

Disconnected clinical, administrative, and engagement systems can create friction across enrollment, registration, eligibility and benefits verification, prior authorization, appointment scheduling, claims, billing, care coordination, appeals, provider support, and post-discharge follow-up.

At the same time, people increasingly expect healthcare interactions to provide the accessibility, transparency, and convenience they experience in other industries. 

Trust remains a critical challenge. Forrester found that only 54% of health insurance customers and 25% of noncustomers considered health insurers trustworthy. Among consumers able to switch plans, those with low trust were 10 times more likely to leave their insurer than those with high trust.

These findings reinforce why healthcare CX cannot be managed as a collection of disconnected calls, chats, and transactions. Every interaction can affect trust, particularly when someone is trying to access care, understand coverage, resolve a bill, or navigate an unfamiliar process.

Improving healthcare CX therefore requires more than adding another service channel. It requires connected journeys, clear communication, secure data practices, knowledgeable people, and consistent execution across front- and back-office operations.

What is intelligent healthcare CXM?

Intelligent healthcare CXM combines healthcare expertise, AI, automation, analytics, digital platforms, and human judgment to improve the complete member or patient journey.

Traditional automation typically focuses on individual tasks. Intelligent operations connect those tasks across channels, systems, functions, and teams.

Everest Group’s healthcare CXM value chain spans member and patient enrollment; eligibility and benefits verification; prior authorization; appointment scheduling; patient, member, and provider support; nurse triage and care coordination; billing and payment collections; claims inquiries and processing; appeals and denials; provider credentialing; outbound engagement; and post-discharge follow-up.

AI can support these processes through interaction summarization, real-time information retrieval, expert guidance, routine administrative automation, next-best-action recommendations, risk-based routing, quality controls, and front-to-back-office workflow coordination.

Human expertise remains essential when interactions require empathy, interpretation, healthcare knowledge, or judgment. A Gartner poll of 163 customer service and support leaders found that 95% planned to retain human agents as organizations define the appropriate role of AI and pursue digital-first, but not digital-only, service models.

For HCOs, the objective should not be automation for its own sake. It should be to automate appropriate work while giving healthcare experts more time, context, and insight to manage complex and sensitive interactions.

What do healthcare organizations prioritize when selecting a CXM partner?

According to Everest Group, HCOs are raising their sourcing standards. Buyers increasingly expect partners to deliver measurable efficiency while also providing the expertise, technology, resilience, and implementation discipline required to support intelligent healthcare CXM.

• Cost efficiency: Buyers expect savings through automation, workflow optimization, workforce productivity, and flexible delivery models without compromising compliance, quality, continuity, or customer outcomes. 
• Healthcare domain expertise: Partners must understand healthcare processes, regulations, terminology, customer populations, and operating requirements to provide accurate, compliant, and context-aware service. 
• Next-generation technology: AI, automation, and analytics are becoming core sourcing requirements. Buyers expect providers to demonstrate how technology can modernize processes, improve interactions, and create sustainable value. 
• Relationship and implementation management: HCOs value responsive account management, flexibility, transparency, effective knowledge transfer, disciplined deployment, and the ability to implement new models with minimal disruption. 
• Talent and workforce management: Technology does not eliminate the need for skilled healthcare talent. Buyers continue to prioritize strong recruitment, training, retention, workforce planning, and quality management.

Together, these priorities point to a broader requirement: HCOs need partners that can integrate technology, healthcare expertise, and human judgment within a scalable intelligent healthcare CXM operating model. 

How does TP address these priorities?

Everest Group positioned TP as a Leader based on four strengths that closely align with what HCOs need to advance intelligent healthcare CXM.

1. Broad payer and provider expertise: TP supports Medicaid programs, commercial health plans, and hospital systems, providing the domain knowledge required to manage interactions involving benefits, claims, billing, authorizations, scheduling, care navigation, provider operations, and compliance. 
   
   
2. Operational agility and responsiveness: HCOs highlighted TP’s account responsiveness, onboarding agility, and operational flexibility. TP adapts its delivery model to each client’s technology environment, regulatory requirements, customer needs, transition requirements, and modernization priorities. 
   
   
3. Global scale with local alignment: TP supports more than 290 HCOs across over 30 countries through onshore, nearshore, and offshore delivery. This scale helps clients balance regulatory requirements, language needs, talent access, resilience, business continuity, and cost efficiency while retaining the local knowledge needed to serve different populations. 
   
   
4. Healthcare-focused AI innovation: Everest Group recognized TP’s investments in healthcare-specific innovation, including agentic AI-enabled orchestration for regulated workflows such as prior authorization and risk scoring. These capabilities help automate routine work, guide experts through complex processes, strengthen compliance, improve workflow consistency, and create better member and patient experiences. 

Read the Everest Group Healthcare CXM PEAK Matrix report

Discover how Everest Group assessed the healthcare CXM market, what healthcare buyers should prioritize, and which capabilities earned TP recognition as a Leader.

Read the full Everest Group Healthcare Customer Experience Management Intelligent Operations PEAK Matrix® Assessment 2026.