Build vs. 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.

Download the Build, Buy, or Partner white paper.