ProviderTrust, Inc (“ProviderTrust” or the “Company”), the leading provider of healthcare compliance screening, monitoring, and verification tools to acute a...

What 150 healthcare executives really think about provider eligibility data. Provider eligibility data touches nearly every corner of a healthcare organization. It underpins some of the most consequential decisions an organization makes - from hiring and credentialing to payments and network management. Yet, managing it well remains a persistent challenge for most organizations. To understand why, Healthcare Dive, in partnership with ProviderTrust, surveyed 150 C-suite executives from hospitals, health systems, and payers. The findings reveal an industry that knows what it needs, is actively working toward it, and still has meaningful ground to cover. Here are five things every healthcare leader should know: 1. Provider eligibility data is an enterprise-wide responsibility, but most organizations still run on fragmented data. Almost every department in a healthcare organization interacts with provider eligibility data. Data governance and credentialing each came in at 99 to 100% in its survey. IT, HR, compliance, and billing all followed closely behind. The problem isn't access to data. It's the consistency of the data. Only 13% of organizations have all departments sharing the same provider eligibility data. Another 47% share data across most departments. The majority of healthcare organizations are operating on different versions of the truth. The same fragmentation shows up in workflow software. Just 6% of organizations have all departments using the same tools. Nearly 4 in 10 are operating with meaningful workflow fragmentation across teams that depend on the same underlying data. 2. Confidence in data quality and governance looks solid on the surface. The details tell a different story. Sixty-four percent of executives say they are extremely or very confident in the quality of their provider eligibility data. That's a solid majority. But only 23% are extremely confident. More than one in three executives fall into "somewhat confident" or "not too confident" territory. They point to familiar culprits: inconsistencies across data sources, processes that aren't fully automated, and out-of-date third-party data. The confidence gap is even wider when it comes to governance. Only 18% of executives are extremely confident their organization's governance approach is the best it can be. Another 30% are only somewhat confident. The top governance challenge, cited by 57% of respondents, is keeping up with changing regulations. Monitoring data frequently enough (40%) and dealing with operational inefficiencies (37%) follow close behind. These concerns point to key structural vulnerabilities in how organizations manage some of their most critical provider data. 3. Nearly every healthcare organization is consolidating to eliminate unnecessary data silos. 92% of executives say their organizations have sought to consolidate provider data redundancies in recent years. Ninety-three percent say the same about workflow software vendors. These active, organization-wide initiatives have a straightforward driver. When data lives in silos and vendors multiply, errors compound. Teams duplicate work. Departments operate on different information. Compliance becomes harder to track. Consolidation is the response to a system that has grown too fragmented to manage efficiently and effectively. Executives are clear about what they want from consolidation. Seventy-four percent see consolidated provider eligibility data that plugs into multiple workflows as extremely or very valuable, and 76% say the same about a single platform managing operations across departments. They are equally clear about what they need from a vendor to get there. Implementation support ranks first (49%). Security and privacy rank second (45%). Cost comes after both. Organizations know that consolidation only works if the solution actually gets adopted. 4. The path to an interconnected data exchange is clear. The perceived barriers are real. Most healthcare leaders understand where provider eligibility data management needs to go. Getting there is another matter. Half of executives expect integration complexity to be the top barrier to implementing an interconnected eligibility data exchange. Forty-six percent point to the inability to find a single data source that serves multiple needs. Resistance to change among staff (33%) and confusion over data ownership (25%) round out the list. These challenges are connected. Fragmented systems are hard to integrate. Siloed vendors create conflicting data ownership. Manual processes slow adoption. The barriers to an interconnected exchange are, in many ways, the same problems organizations are already trying to solve through consolidation. Recognizing that connection is the first step. Then, building towards a solution that addresses both is the next one. 5. An interconnected eligibility data exchange is where this industry is headed. Almost no one is there yet. The goal is straightforward: one verified database that every department relies on for provider eligibility data. There are no competing versions of the truth and no manual reconciliation is required. Every department draws from the same verified, real-time database. That's the concept of an interconnected eligibility data exchange. Executives understand it. Most of them want it. Only 11% have implemented one, 41% are in the process of building toward it, and another 43% are actively considering it. In total, 95% of healthcare organizations are either building or planning for this model. The anticipated opportunities are significant: faster credentialing (45%), real-time data updates (45%), operational efficiency (44%), and improved data quality (43%). For organizations that invest in the infrastructure to get there, the upside is substantial. Get the full picture. These five findings are just the start. The full report goes deeper on data governance challenges, workflow fragmentation, vendor consolidation priorities, and what it will take to build a true interconnected eligibility data exchange. Ready to stop managing risk in a spreadsheet and start partnering with a team that lives for data integrity? See how DynamicNPI(R) can help your organization get there faster at providertrust.com.

ProviderTrust, a healthcare data and technology company, has partnered with background screening firm J.D. Palatine to integrate pre-hire screening with automated eligibility verification for healthcare workforces. The collaboration combines ProviderTrust's licence and credential verification with JDP's background screening capabilities into a unified workflow. The integration embeds eligibility checks directly into the hiring process, simultaneously running background checks and primary-source verifications against federal and state exclusion lists. This eliminates fragmented systems that previously required HR teams to manage separate workflows for criminal checks, identity verification and licence verifications. The partnership aims to accelerate hiring timelines, reduce costs associated with multiple vendors, and improve candidate experience whilst maintaining regulatory compliance. Both Nashville-based ProviderTrust and JDP plan to extend the service to include continuous monitoring throughout employees' tenure.