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CRUSH compliance refers to CMS requirements for standardized reporting of provider network and directory information by health plans. These guidelines are intended to make provider data more accurate, timely, and easier for regulators to review across Medicare Advantage and related programs. This is a CMS reporting framework designed to improve consistency in provider data submissions.

As of July 1, 2025, NCQA updated its credentialing standards, which are currently undergoing active audits. If your credentialing program has not been updated to reflect the new PSV timelines, monitoring requirements, and documentation standards, you risk failing your next NCQA review. Organizations undergoing their 2026 review cycles are failing surveys due to these new requirements.

What does it actually take to close the gap between the technology available today and the way health care organizations actually operate? At Blueprint 2026, CertifyOS's Anshul Sheopuri sat down with Samir Deshpande—former CIO of Humana and Capital One—and Rajat Puri, CEO of Primera and founder of a 27,000-person health care operations organization, to find out. Here are five ideas that cut through.

At Blueprint 2026, three of healthcare's sharpest minds sat down to wrestle with a question the industry has been circling for decades: what will it actually take to fix provider data? Here are the five moments that cut through the noise.

CertifyOS and Assured are often evaluated simultaneously, but they are designed to solve different aspects of provider data and credentialing workflows. Although their capabilities overlap, the platforms are not interchangeable.

We’ve all heard increasing rumblings about the growing administrative burden in healthcare, but the numbers really put it in perspective:

Provider Data Management (PDM) was once a small-scale administrative function but has now become a foundational part of healthcare operations, influencing everything from claims processing and member experience to compliance, quality scores, and patient outcomes. As site provider networks expand, affiliations multiply and care delivery grows more complex, the systems responsible for managing provider data have struggled to keep pace.

For payers, every hiccup in provider data management (PDM) aggravates an already stressed system. Errors in provider directories or credentialing data lead to provider and member abrasion and denied claims. Operational breakdowns increase administrative costs and workforce attrition. And evolving regulatory requirements, from NCQA standards to the No Surprises Act and Transparency in Coverage rules, raise the stakes even higher.