You can't grow unless you step out of your comfort zone. That means exposure to the best industry minds and clients with open minds (and checkbooks). When it comes to tackling the proverbial 'big hairy, audacious goals' and complex projects, you can start with boutiques like ghSMART and Clearview Healthcare Partners. The former returns to the top spot with a near identical score to 2020. Clearview Healthcare Partners, on the other hand, saw its score increase from 9.326 to 9.610. This year's top performers remained the same among the Top 6, though Putnam and McKinsey each lost a slight among of ground.