Build or Buy Is the Wrong Question for Provider Data

For health plans, provider data has quietly become one of the most critical—and most fragile—foundations in the enterprise. What was once treated as a compliance function now directly impacts claims accuracy, network adequacy, member experience, and financial performance. Yet many organizations are still debating provider data strategy as a simple build-versus-buy decision, even as the complexity and regulatory velocity of the space continues to accelerate.
What leading plans are discovering is that neither approach works in isolation. Internal builds are slow, expensive to maintain, and difficult to future-proof, not to mention there are no shared benefits that one gets from the network effects when part of an ecosystem. Pure vendor dependency can limit flexibility and create long-term architectural risk. Instead, the most successful organizations are adopting a hybrid, composable model enabling them to retain control over governance, data standards, and integrations while partnering for functions that benefit from shared infrastructure, automation, and continuous regulatory updates.
Download our latest whitepaper for insights from payer executives and architects about how to design provider data ecosystems that deliver faster time to value, lower total cost of ownership, and long-term resilience.
RELATED ARTICLES
- BlogEvery industry has its own “why hasn’t anyone solved this yet?” problem—the kind that sounds simple in theory but becomes remarkably complex at scale. Healthcare, unsurprisingly, has more than its share of these challenges.
- BlogHealthcare organizations are under growing pressure to onboard providers faster, reduce administrative burden, and maintain compliance across increasingly fragmented systems. In this fireside chat, Nick Helfrich of CertifyOS and Mark Wankier of Select Health explore why traditional credentialing models no longer scale — and how shared approaches to provider data and credentialing can unlock meaningful operational gains.
- BlogAcross healthcare, administrative burden is one of the biggest barriers to progress. Providers want to spend more time caring for patients and less time navigating paperwork. Hospital systems are under pressure to streamline workflows, control costs, and improve access and experience. Health plans, which finance much of patient care and connect providers, systems, members, and regulators, face growing operational demands of their own.