Everest Group Names ClarisHealth a Major Contender in Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026

As payment integrity shifts upstream, Everest Group recognizes ClarisHealth’s vision for connecting prepay and post-pay into one platform

Payment integrity is moving upstream. Health plans are done waiting to claw back money after a claim releases. They want to catch the problem before it pays, and that shift is remaking what “prepay” even means.

Everest Group’s new Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026 captures that shift across 28 providers. ClarisHealth landed as a Major Contender, positioned on the strength of its vision and direction for where the market is going.

Why this market is moving upstream

Everest Group’s research ties the shift to a familiar list: rising medical costs, payment leakage, growing FWA exposure, and provider abrasion from post-pay recoveries. What used to mean standalone claims editing is now spreading into itemized bill review, clinical validation, coordination of benefits, subrogation, and fraud, waste and abuse analytics. Buyers are asking for one connected model instead of a stack of point solutions.

Sara Thomas, VP of Payer Solutions at ClarisHealth, represented the company in Everest Group’s research process and sees the same pattern in ClarisHealth’s own client conversations.

“Cost trend, leakage, FWA exposure and provider abrasion are pushing payment accuracy upstream,” Thomas said. “Health plans want to catch it before the claim releases, not chase it after. That’s also why prepay can’t stay a single feature. It has to connect to everything a health plan is already running on the post-pay side, or it just becomes one more disconnected tool.”

That connective role is exactly where ClarisHealth sees itself in this market. Pareo® isn’t built to compete as a single large-scale editing engine. It’s built to sit across a health plan’s vendors, internal audit team and data, whether that work happens before or after the claim pays.

Where ClarisHealth stands, and why

Everest Group’s Leaders tier includes large-scale pre-pay editing engines delivering savings directly and at volume today. ClarisHealth landed in Major Contenders, a position built around vision, market knowledge and delivery capability rather than editing volume.

Michael Axt, CEO of ClarisHealth, said the company is intentional about that distinction.

“Everybody in this market says they want to be prepay. We think you earn that position by mastering the full claims lifecycle first,” said Axt. “We’re honored by this recognition because it reinforces our vision and direction for where payment integrity is headed. Pareo is designed to orchestrate the complex ecosystem of data, vendors and workflows, helping health plans continuously optimize their pre- and post-pay payment integrity program performance.”

That discipline shows up in how ClarisHealth positions Pareo already: as the operational foundation connecting a health plan’s payment integrity ecosystem, not as a replacement for every vendor in it. The platform’s value has always been in bringing people, process and data together on one system of record, whether a health plan is insourcing audits, managing a stack of vendors, or starting to move work upstream.

What this means for health plans

For payment integrity leaders evaluating prepay strategy, the takeaway from Everest Group’s assessment is straightforward: the market is splitting between scaled editing platforms and connective technology that ties the whole program together. Most health plans will end up running both. ClarisHealth’s placement signals where the company intends to compete as that connective layer, backed by a vision Everest Group has now recognized independently.