During a featured panel discussion hosted by Kyruus Health at Becker’s Spring Payer Issues Roundtable, leaders from Highmark Health, Allegheny Health Network, Corewell Health and UCare came together to dissect one of healthcare’s quietest crises: provider data inaccuracy.
The panel explored how poor data erodes trust, delays care and strains payer-provider partnerships — and what health plans can do to fix it.
Below are four takeaways from the conversation.
Note: Quotes have been edited for length and clarity.
1. Bad data breaks the member journey
“People do want to know the phone number and address for their clinician, but that’s just table stakes,” said Pritee Subramany, vice president of product management at Highmark Health. “They want to know a provider’s care style, their specialty and whether they offer virtual visits.”
Ms. Subramany described a friction-filled journey when members encounter outdated directories, make a call and discover a provider is unavailable or out-of-network, which amounts to a barrier to care.
2. Data discrepancies damage brand trust
Joseph Seliski, a digital health and technology leader at Allegheny Health Network, emphasized the reputational cost of data inconsistencies. “Before we really started focusing on building trust, there was a lab that Google said was open but the website said it was closed. That really erodes trust,” he said. “Now we’re focused on seamless care navigation.”
3. Engagement starts with physician buy-in
Panelists agreed that provider engagement is essential — but difficult. “Physicians will probably not engage on this topic until you show them that their profile may not be complete or accurate,” said Paul Merrild, president at Kyruus Health.
Holly Sullivan, vice president, brand, marketing and consumer experience at Corewell Health, said more than 90% of profiles for physicians serving Corewell’s members are now reviewed after dashboards made data visibility tangible to clinicians.
4. Payer-provider collaboration is possible
When asked about collaboration between payers and providers to get members accurate information and physician ratings, Dan Sarles, provider data and network analytics senior manager with Ucare, said his organization has had success partnering with provider teams that oversee credentialing and payer enrollment. To work well with these teams, the scoring methodology for direct provider reviews must be “very transparent,” Mr. Sarles said.
