New Report Finds 85% of Health Plan Leaders Struggle with Unreliable Provider Data, Stalling AI Integration

BOSTON, Nov. 18, 2025 /PRNewswire/ -- Kyruus Health, the leading care access platform, today released a new report, "From Crisis to Control: Executive Insights to Transform Care Guidance with Data and AI," revealing significant foundational challenges preventing health plans from meeting member expectations. The research, based on a survey of 100 senior leaders at U.S. health plans, found that while 100% of executives believe AI will be critical to their network strategy within a year, inaccurate provider data is a primary obstacle to progress.

The report, conducted in August 2025 by Wakefield Research, found that 85% of health plan leaders struggle with provider data inaccuracies, with an average of 19% of their data considered unreliable. This data crisis forces the majority of plans (77%) to perform manual data updates "all the time" or "often," consuming resources that could be directed toward innovation.

The research highlights a critical disconnect: while plans aim to reduce medical spending (45%) and support value-based care (44%), they are hindered by internal barriers. Nearly half of the leaders surveyed cited resistance to change (47%) and the lack of a clear strategy (46%) as the biggest obstacles to implementing an effective member steerage and navigation strategy.

"This research exposes a foundational crisis in healthcare. Health plans have a massive opportunity to guide members to high-quality, cost-effective care, but they are building on a house of cards if their provider data is inaccurate, incomplete, and lacks the critical information members need to shop for and select care," said Morgan Beschle, Vice President of Product at Kyruus Health, a RevSpring Company. "To truly create the seamless experience members expect, leaders must first focus on transforming their data foundation and the information members need to select the right care. Only then can they bridge the gap between plan capabilities and member needs, and harness powerful tools like AI."

Key findings from the report include:

• The AI Paradox: While all (100%) health plan executives agree AI is essential for the future, only 16% report using it widely for member guidance today.
• Foundational Focus: Health plan leaders are prioritizing foundational improvements over advanced tools. Improving provider data accuracy ranks as the top investment priority (26%) for member guidance, ahead of implementing more advanced AI (14%).
• Top Priorities: The leading drivers for implementing a steerage strategy are reducing medical spend while maintaining quality (45%), supporting value-based care arrangements (44%), and enhancing the member experience (42%).

The report concludes with a three-pronged recommendation for health plans to transform their data foundation, power a seamless member experience, and enable proactive, agentic guidance. Download the full report for more insights.

ABOUT KYRUUS HEALTH
Kyruus Health, a RevSpring company, is the leading care access platform on a mission to connect people to the right care. The company connects over 500,000 providers across 1,400 hospitals and 550 medical groups, and members across 100 health plan brands, so every stakeholder can access and harness the most accurate, comprehensive, and contextually relevant information. By enabling informed decisions and confident action, the care access platform supports healthier outcomes, reduces friction in healthcare, and grants more time back in everyone's day. To learn more, visit KyruusHealth.com or follow us on LinkedIn.

MEDIA CONTACT
Ashley Dauwer
Corporate Marketing and PR Manager, Kyruus Health
[email protected]

SOURCE Kyruus Health