Introduction
Provider eligibility data serves a critical role across the administrative and operational functions of a healthcare organization. It helps inform who gets hired, who gets credentialed, who gets paid, and who stays in your network. It touches credentialing teams and compliance officers, billing departments, and Human Resources. It flows through electronic health records, revenue cycle systems, and HRIS platforms.
So why is managing it still such a challenge?
To find out, Healthcare Dive, in partnership with ProviderTrust, surveyed 150 C-suite executives from hospitals, health systems, and payers. The results surface a telling tension: 92% of organizations have actively sought to consolidate provider eligibility data, yet only 23% of executives say they're extremely confident in the quality of what they have.
This report explores what the data tells us about where the industry stands, where it's headed — and what it will take to get there.
About the Survey
The survey was conducted online in early 2026. A total of 150 C-suite healthcare executives participated, all of whom worked for organizations with 1,000 or more employees.
Respondents represent two types of organizations:
Hospitals or health systems
Respondents represent organizations of varying sizes:
Health insurance companies
1,000 to 9,999 employees
10,000 to 49,999 employees
50,000 to 99,999 employees
100,000 or more employees
Contents
SECTION 1
Almost Everyone Touches It, But Almost No One Shares It
Provider eligibility data is an enterprise-wide responsibility, but the enterprise is siloed.
SECTION 2
Confidence But With Caveats
Most leaders trust their provider eligibility data. But the key is understanding why— and why it also falls short.
SECTION 3
The Workflow Problem Mirrors the Data Problem
Fragmented data leads to fragmented workflows.
SECTION 4
Consolidation Of Data Is Already Happening
The push to streamline isn't a future initiative. It's underway.
SECTION 1
Almost Everyone Touches It, But Almost No One Shares It
Provider eligibility data is an enterprise-wide responsibility, but the enterprise is siloed.
SECTION 2
Confidence With Caveats
Most leaders trust their provider eligibility data. But the key is understanding why.
SECTION 3
The Workflow Problem Mirrors the Data Problem
Fragmented data leads to fragmented workflows.
SECTION 4
Consolidation Of Data Is Already Happening
The push to streamline isn't a future initiative. It's underway.
