AIS Health Plan Week Highlights CAQH Work on Provider Data

April 2017

CAQH efforts to convene the industry to solve provider data challenges were discussed in a recent article in AIS Health Plan Week. The article explored the problem from different stakeholder perspectives amid a changing healthcare environment and increased regulations for directory maintenance.

The healthcare industry spends a collective $2.1 billion on inefficient processes maintaining provider data, two-thirds of which are health plan expenses. The lack of trusted sources of information have led to the proliferation of highly-individualized databases and tools, which have, over time, increased costs and increased the administrative burden for both health plans and healthcare providers.

Growing out of the Provider Data Summit convened last fall by CAQH, which brought together more than 100 industry leaders to tackle the problem, the organization has formed a multi-stakeholder Provider Data Action Alliance to continue the work. The group is charged with developing a roadmap of actionable strategies and building industry consensus for mutual solutions.

“Building up that handshake between providers and health plans around data quality is a first step,” said Atul Pathiyal, Managing Director of CAQH Solutions. “Providers and health plans need to develop a shared understanding of what is high quality data and their respective roles in pursing the goal.”

Learn more about CAQH efforts to improve healthcare provider data at

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