The Destination Is Clear, and The Journey Has Begun
An interconnected eligibility data exchange is where this industry is headed.
Imagine a single source of truth for provider eligibility data. Every touchpoint in your organization draws from the same verified database. It’s real-time data. It’s accurate. It’s shared.
That's an interconnected eligibility data exchange. When executives were asked about this model, the response was nearly unanimous. Almost no one said they didn't want it. What they said instead was that they haven't built it yet.
Only 11% of organizations have already implemented an interconnected eligibility data exchange. Another 41% are in the process of implementing it. Another 43% are still in the consideration phase, and a mere 5% have no plans to pursue it at all.
That means 95% of healthcare organizations are either building toward this model or actively thinking about it. The mission is understood. The vision is shared. The execution is the challenge.
11%
Implemented
Only 11% of organizations have already implemented an interconnected eligibility data exchange.
41%
In Process
41% are in the process of implementing it
43%
Considering
43% are still in the consideration phase
5%
No Plans
A mere 5% have no plans to pursue it at all.
The barriers that executives anticipate are practical. Integration complexities top the list at 50%. The inability to find a single data source that serves multiple needs follows closely behind, with 46% citing this concern. Resistance to change among staff (33%), questions about data ownership (25%), and implementation cost (25%) round out the top concerns.
“Some of the third-party data we rely on isn't always accurate, and managing quality becomes tougher as we expand.”
—Survey respondent
The opportunities on the other side are just as clear. Faster credentialing (45%) and real-time updates (45%) lead the list of opportunities that executives expect to realize through an interconnected eligibility data exchange. Operational efficiency (44%) and improved data quality (43%) follow closely. These opportunities align with the exact operational outcomes healthcare organizations need most right now.
Top barriers
Integration complexities
Single data source gap
Resistance to change
Data ownership uncertainty
Implementation cost
Top opportunities
Faster credentialing
Real-time updates
Operational efficiency
Improved data quality
Read more about
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 5
The Destination Is Clear, and The Journey Has Begun
An interconnected eligibility data exchange is where this industry is headed.
SECTION 6
What Progress Actually Looks Like
The organizations moving forward have a few things in common.
