5 Key Takeaways on AI, Healthcare Costs, and Provider Data Management from Certify’s Blueprint Summit

Recently, Certify hosted Blueprint 2025, its first provider data leadership summit.

Over 65 leaders from health plans, investment firms, and large data health companies gathered in New Orleans to discuss the future of provider data management in healthcare. For two days, we heard key insights from thought leaders, discussed compelling solutions, and ate way too many plates of Louisiana crawfish.

Blueprint was created to be anything but a traditional conference. We traded stuffy auditoriums for small, intimate spaces full of lively conversations and strategic discussions. This forum allowed healthcare leaders to step away from their daily work, reflect and learn, and, more importantly, to start imagining the future.

Ultimately, we all walked away feeling excited for the future.

Yes, the challenges we are facing are both unprecedented and expected. Technology is struggling to keep up with our system's demands, costs are rising, and the political climate is unpredictable. For many, the problems we face seem to be spiraling, and lifelines seem few and far between.

Even as our modern system seems poised to crush us, innovative and passionate innovators stand in the gap. Despite pressing concerns, we are making headway. There are thousands of passionate leaders out there who are willing to do what it takes to create a better healthcare future.

It starts with the 65 leaders who joined us, who shared their thoughts and ideas, and started dreaming of what our healthcare system can be.

While it would be impossible to capture everything from Blueprint, we wanted to share some of the most critical insights we captured at the summit. And this is just the beginning. We will be continuing the conversation in the coming months, allowing healthcare leaders to further contemplate the changes necessary for progress and the steps we can take to ensure a better future.

Key Takeaway 1: It’s Time to Set a New Standard for Provider Data Management

Provider data management– the system in which networks collate and update their data on health care professionals– is messy and outdated. For example:

• When a health care provider fills out a form for a network, they fill in an average of 130 form fields.
• Each provider completes an average of 18 network forms each cycle.

If you do the math, that adds up to 2,340 data fields per provider, per cycle. If you extrapolate that across all of the healthcare systems and networks… there’s a whole lot of data to manage.

Furthermore, the processes currently used to manage that data are dated. Some systems require providers to take screenshots of their data to submit with the form. Others receive data via fax and then have an administrative team transcribe those faxes into a digital format.

At Certify, we want to set a new standard that’s tech-forward and uses the appropriate technology to ensure that health care systems and payers have what they need to manage provider data appropriately.

Our panelists believe this change could save each system upwards of $75 million a year.

Key Takeaway 2: Healthcare Costs are Rising… and AI isn’t Going to Fix It

When​​ we tell you that healthcare costs are rising fast, we’re preaching to the choir. Our rapidly aging population, coupled with new (and expensive) prescription drugs, increasing chronic disease rates, and yes, the looming healthcare administration crisis, have all led to rising costs.

Health care systems and payers are feeling the pressure.

In true 2025 fashion, the internet claims AI is the solution— but our speaker, Christopher Kerns from Union Healthcare Insights, isn’t so sure. Kerns believes that tech innovations like AI will slowly help us close the gap, but he also concedes that AI isn’t ready to take over healthcare jobs (or save systems and payers ' money) quite yet. Kerns argues that costs can only be controlled through intentional collaboration between systems and payers, where both groups find ways to reduce costs.

To learn more about innovative solutions to rising costs, read “AI Isn’t Going to Take Your Job, But It May Take Your Money… At Least for Now.”

Key Takeaway 3: AI is Here, But Not Entirely Ready for Healthcare in 2025

Anyone who has used ChatGPT in the last few months—or Zoom’s AI bot, for that matter—can tell you that AI has improved. AI gets faster, more accurate, and more efficient by the day, but it’s still not ready for the big leagues: the modern healthcare industry.

AI is good at following simple commands. Tell it to pull up the symptoms for a certain illness, or the diagnostic codes or a certain category of diseases, and it will get a perfect score every time.

But what happens when things get a bit more complex? What happens if the AI has been trained to identify, diagnose, and create treatment plans for 100 different diseases, but someone walks into the clinic with disease #101? We are simplifying things, but the ugly truth is that AI still has limitations when it comes to healthcare.

Some good news: The rise of Agentic AI systems—or AI systems that can synchronize tasks from various inputs—is making the future of healthcare interesting.

For example, AI can now “observe” a patient visit in unprecedented ways: It can “see” inside the otoscope as a doctor looks inside an ear, it can “hear” the sounds recorded by the stethoscope, and it can even glean insights from the conversation the doctor has with the patient. This multi-faceted AI is driving rapid innovation in healthcare, and could be the technology that drives healthcare in 2026 and beyond.

We’re not there yet, but an AI-driven future in healthcare is coming.

Key Takeaway 4: A Win-Win in Provider Data is Possible

In one session, Dr. Marc Overhage shared a story about a family that needed an appointment with a local neurologist who spoke Spanish, took Medicaid, and had training to treat a specific disorder. It took the family months to find a clinician that matched that profile, as provider data across networks was spotty and disjointed.

A few years later, a family needed access to a similar clinician with similar requirements. Still, with updates in provider data integrity, that family could find a provider and book an appointment within hours.

The difference? Reliable provider data.

While much of the healthcare admin world still lacks transparency regarding provider data integrity, some organizations have managed to achieve returns on their provider data investments.

In one session, Mike Kane of United Healthcare and Jamila Sykes of Highmark Health shared how their companies have invested in better healthcare administration processes and tools. In doing so, they have reaped benefits such as lower costs, higher data integrity, and, yes, ensuring that their members have access to optimal data so they can get access to the providers they need when they need them.

Kane and Sykes shared that provider data is one of the healthcare administration areas ripe for collaboration. No one is competing to have the most accurate data in their system, as all entities benefit from the most up-to-date information.

Ultimately, everyone wins—patients, providers, healthcare systems, and insurers—when provider data management is simplified and systems are in place to ensure data integrity.

Key Takeaway 5: An Investment in Modern Technology is an Investment in the Future

We’ll be blunt: Legacy technology will simply not cut it in our modern healthcare landscape. Practitioners need access to the most up-to-date tools to best serve their patients. Modern technology also saves clinicians time, helping to solve rising rates of burnout.

What’s more, health plan and system administrators need a tech-forward infrastructure to drive efficiencies. Every hour and dollar saved is time and money that can be invested in improving patients' health.

Forward-thinking organizations — payers and systems — are adopting cloud-native, API-based systems that drive outcomes without increasing costs. The truth is that investments in modern technology are investments in cost savings, modern infrastructure, provider retention, and patient health.

Blueprint left us looking forward to how our entire industry will evolve in the coming years to reshape our healthcare system. It was the fist of many opportunities for us to get together, to collaborate, and to grow.