Clinical and care management has undergone a fundamental shift in recent years, moving from reactive, utilization-focused models to proactive, patient-centered approaches that prioritize prevention, personalization, and care continuity. The integration of technologies such as generative AI, automation, analytics, and digital triage tools has enabled more precise risk stratification, faster prior authorizations, and smarter care coordination. Organizations are embedding clinical decision support tools and virtual care capabilities across the care continuum, improving both outcomes and operational efficiency. Looking ahead, the future of clinical and care management lies in building intelligent, scalable ecosystems where data flows seamlessly across providers, payors, and patients. This will be driven by AI-powered population health tools, adaptive care pathways, and real-time clinical insights that enable early interventions and reduce unnecessary utilization, ultimately reshaping how care is delivered and managed.
Both demand- and supply-side trends are covered in Clinical and Care Management Business Process Transformation 2025 Market Insights™ and Clinical and Care Management Business Process Transformation 2025 RadarView™, respectively. These reports present a comprehensive study of clinical and care management service providers and closely examine the market leaders, innovators, disruptors, and challengers.
Avasant evaluated 42 providers using three dimensions: practice maturity, domain ecosystem, and investments and innovation. Of these providers, we recognized 18 that brought the most value to the market over the past 12 months.
The RadarView recognizes platform providers in four categories:
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- Leaders: EXL, Optum, Sagility, Cognizant, and Accenture
- Innovators: Wipro, Omega Healthcare, Shearwater Health, and HCLTech
- Disruptors: Accolade, Acentra Health, Conduent, CareCentrix, and Health Advocate
- Challengers: Quantum Health, Telligen, and EviCore
The following figure from the full report illustrates these categories:
“Health systems are shifting from fragmented workflows to unified platforms, integrating telehealth, EHRs, and patient tools,” said Matthew Barlow, partner at Avasant. “This enables personalized care, real-time communication, and more efficient, transparent, patient-centric clinical management.”
The full report provides several findings and recommendations, including the following:
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- Generative AI is transforming clinical operations by enhancing efficiency, bridging workforce gaps, and enabling a shift to value-based, whole-person care.
- AI-powered, zero-touch automation is replacing manual processes to improve care accuracy, speed, and outcomes at scale.
- Integrated, whole-person care models combining digital tools, clinical teams, and SDOH insights are improving population health while reducing costs.
- Telehealth adoption is accelerating, with investments focusing on AI-driven RPM platforms for proactive and personalized chronic care.
- FHIR-based interoperability is becoming foundational for seamless data exchange and coordinated care across fragmented health systems.
“The rise of generative AI-powered clinical management is enabling healthcare providers to identify high-risk patients months before acute episodes,” said Aditya Jain, Research Leader at Avasant. “This is shifting the market from reactive hospitalizations to preventive outpatient care, reducing costs and improving quality of care.”
The RadarView also features detailed profiles of the top 18 service providers, including their solutions, offerings, and experience assisting enterprises in their clinical and care management services transformation journeys.
This Research Byte briefly overviews Avasant’s Clinical and Care Management Business Process Transformation 2025 Market Insights™ and Clinical and Care Management Business Process Transformation 2025 RadarView™. (Click for pricing.)