Nearly All Health Systems and Health Plans Need Better Provider Data. Few Have It, and AI Investment Is at Risk.

New research from Sage Growth Partners, commissioned by Verato, surveyed 151 health system and health plan executives on the provider data gap stalling network growth and AI investment.

BALTIMORE, Sept. 10, 2026 /PRNewswire/ -- Health systems and health plans rank network and market expansion as the strategic priority that would benefit most from better provider data. Only 42% of health systems and 32% of health plans say they use data most effectively for market expansion. That gap sits at the center of Provider Data: The Foundation Health Systems and Health Plans Haven't Built Yet, new independent research from Verato®, the identity intelligence company, released today.

Sage Growth Partners independently recruited, screened, and surveyed 101 health system leaders and 50 health plan leaders, 77% and 72% of whom sit at the vice president level or above. Every health system participant works for an organization with at least $1 billion in annual net patient revenue, and 58% of health plan participants cover one million or more lives. The research was double-blinded: participants did not know who commissioned it, and Verato does not know who responded.

Leaders overwhelmingly recognize that provider data underpins their strategies, but most still manage it across fragmented systems, diffuse ownership models, and manual processes that leave records inaccurate and out of date.

Provider Data Is a Strategic Priority Most Can't Yet Deliver On

Both audiences say accurate provider data is now foundational to reaching their goals, yet few have the single source of truth needed to get there.

• 85% of health systems and 78% of health plans say achieving their top strategic priorities will require accurate, timely, and accessible provider data.
• Only 28% of health systems and 36% of health plans have a fully implemented and maintained "golden record," or single source of truth, for provider data.
• Only 12% of both health systems and health plans say their data quality is excellent. 
• Only 42% of health systems and 32% of health plans say they use data effectively for network and market expansion. Yet, that's the top priority for both groups among use cases that would benefit from network-wide visibility.

Inaccurate Provider Data Is a Daily Problem

• 92% of health systems and 98% of health plans encounter provider data inaccuracies at least monthly, and often several times a week.
• 88% of health systems and 78% of health plans say inaccurate or incomplete provider data negatively affects their ability to achieve strategic priorities.
• Common errors include duplicate records, outdated locations, providers listed as active who are no longer practicing, and inconsistent specialty information, driving administrative waste across credentialing, panel reconciliation, and claims rework.

AI Ambitions Rest on a Provider Data Foundation That Isn't Ready

• 78% of health systems and 70% of health plans rank AI as the top technology area their organizations will invest in over the next one to three years.
• Those investments will run on records leaders already distrust: fewer than half say their organizations use data effectively for core functions, including revenue cycle management (41% of health systems) and claims adjudication (48% of health plans).

"Provider data is the foundation of almost all strategic bets a health system or health plan makes," said Jason Bihun, President, Commercial Operations, at Verato. "Network growth plans, claims processing, and revenue cycle workflows, with and without AI, run on that same data. Get it wrong, and each process inherits the error. Verato exists to address the foundational data, so all processes and workflows can deliver."

From Provider Data to Network-Wide Visibility

Fixing provider data is the entry point to network-wide visibility, and to a smaller technology footprint. 85% of health systems and 78% of health plans say network-level insight technology could let them retire at least one existing system, and roughly half (49% of health systems and 46% of health plans) put the number at three to five. Fewer systems mean lower subscription and maintenance costs, plus unified data that can finally be used strategically.

The research concludes that reaching those goals depends on sequence.

"Organizations must first resolve fragmented records into a single, accurate provider identity, then keep core attributes, such as locations, phone numbers, and specialties, continuously current. Only then can they layer in the network-level dimensions that make provider data strategic, including clinical activity, referral patterns, compliance, and health plan relationships," said Dan D'Orazio, CEO, Sage Growth Partners.

Download the full report, Provider Data: The Foundation Health Systems and Health Plans Haven't Built Yet

About Verato

Verato®, the identity intelligence company, solves the problem that drives everything else: Knowing Who Is Who™. Proven in healthcare. Trusted everywhere.

Verato MDM Cloud™ is the identity foundation that delivers exceptional experiences, fuels business growth, and powers AI-native efficiency, all from a single, accurate, and complete view of every person, provider, and organization across your system silos. By resolving who's who once, enriching that data with native integrations and real-world context, and activating it everywhere it's needed, Verato future-proofs your data for AI so every application, agent, and analytic system operates on a foundation it can trust. Learn more at verato.com.

About Sage Growth Partners

Sage Growth Partners is a growth strategy and marketing firm with deep expertise in market research, go-to-market strategy, and marketing communications. Founded in 2005, the company's extensive domain experience ensures that organizations thrive amid the complexities of a rapidly changing marketplace. Sage serves clients across the full healthcare spectrum, including GE HealthCare, Press Ganey, LexisNexis, ProgenyHealth, HMR Veterans Services, Eagle Telemedicine, Philips Healthcare, Cecelia Health, and Xealth. For more information, visit sage-growth.com.

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Sage Growth Partners
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SOURCE Sage Growth Partners