Payment integrity attracts attention for good reason. McKinsey estimated the market at $9 billion in 2023, growing at a 7 percent CAGR — and that was before the current wave of AI investment accelerated. For founders, investors, and technologists, PI looks like a massive opportunity waiting to be seized. It is. But it is also one of the most unforgiving markets to enter — and understanding why matters whether you are building a new solution or evaluating one. The Barriers Are

Every year, the KLAS reports drop, the Everest PEAK Matrices refresh, and Gartner updates its landscape views. LinkedIn lights up. Vendors screenshot their quadrant placement. Health plan leaders forward the PDFs around with the unspoken question: Are you using the best partners? These reports are useful. They are not, however, an answer. They're an inventory. There's a meaningful difference between an inventory and an edict. An inventory tells you what's on the shelf—who's i