Competing plans share much of the same providers. SharedCred coordinates one governed evidence packet and one recredentialing clock. Every plan keeps its own decisions.
THE MARKET PATTERN
Your network is part of a broader national pattern. In a study of 1,192 health-plan networks, researchers found that competing insurers shared much of the same provider population. Narrow networks were often among the most overlapping, not the least. A plan can build a focused, differentiated network and still share much of its provider population with the plan across town. Source: Graves JA et al., JAMA Network Open, 2020, based on 2019 directory data. These figures measure provider participation overlap, not credentialing duplication.
of primary-care providers were shared, on average, between competing plan networks.
of cardiology providers were shared, on average, between competing plan networks.
of general acute-care hospitals were shared, on average, between competing plan networks.
health-plan networks analyzed in the study, using 2019 provider directory data.
The same providers appear across competing networks. Each plan still collects the same evidence, verifies it separately, and runs its own recredentialing clock for many of them.
THE COST OF REPEATING
The repeat work carries a measured cost on both sides of the transaction. The figures below come from CAQH analysis of provider data maintenance and credentialing burden, drawing on Booz & Company and MGMA estimates published in a CAQH issue brief (2011). They describe industry-wide database maintenance cost and credentialing application volume. They are not savings attributable to any single program or vendor.
spent annually by payers maintaining provider databases, per a Booz & Company analysis cited by CAQH.
of those provider-database maintenance costs could be offset by integrating with an external single source of truth, if one existed. CAQH estimate.
credentialing applications submitted per physician each year by practices, per MGMA research cited by CAQH.
per physician per year in support staff and physician time spent on credentialing applications, per MGMA data cited by CAQH.
Each plan runs its own primary source verification, in parallel
Providers receive separate outreach from every plan they participate in
Recredentialing dates are scattered across plans and hard to align
Repeated requests and conflicting deadlines add avoidable delay
Verification standards and audit trails differ from plan to plan
Every plan rebuilds the same evidence file from a blank start
One governed evidence packet, source-verified to a standard participating plans agree in advance
Consolidated provider intake and one coordinated outreach per cycle
One coordinated recredentialing event across participating plans
Fewer repeated requests and fewer conflicting deadlines for the provider
Full evidence provenance and audit visibility built into the model
Each plan starts from a governed packet and applies its own checks
WHY THE WORK REPEATS
Duplication in credentialing is not only a data problem. It is how the work is organized: evidence gathered in parallel, clocks set independently, and economics that attach a new cost to every repeat. CAQH describes credentialing as fragmented across a multiplicity of platforms that do not communicate with one another, forcing providers and plans to repeat the same data-collection work across multiple systems. Automation inside a single plan makes that plan faster. It cannot coordinate the same work across plans.
The same license, education, and professional history are collected and verified separately by each plan. CAQH notes that providers are asked to submit the same data to health plans, hospitals, TPAs, CMS, Medicaid agencies, and state medical boards through separate, disconnected processes.
The same provider can recredential on a different timeline for every plan, creating overlapping requests and conflicting deadlines. CAQH describes the fragmented process as adding administrative burden and slowing the exchange of accurate provider information between the organizations that need it.
Per-event models attach another cost to every separate credentialing event, giving plans little incentive to coordinate across organizations.
Single-plan automation speeds up the work inside one plan. Coordinating the same work across plans requires a shared operating layer.
Evidence is source-verified once to a standard participating plans agree in advance, then made available to those plans as one governed packet.
Recredentialing rosters are consolidated so one coordinated event can replace many separate ones on many separate dates.
Providers complete one request-to-join submission that participating plans draw from, reducing duplicate data entry at intake.
The source, verification method, timestamp, and use constraints travel with every element. Nothing arrives without a trail.
Restricted sources, including NPDB, remain subject to each plan's policy and applicable law. They are never pooled.
Plans can see what was checked, how it was checked, and when. Status reporting and change management are part of the model from day one.
THE VERIFICATION STANDARD
SharedCred is a governed operating model, not a file drop. Participating plans agree the verification standard in advance, and every element of the packet carries the information a plan needs to inspect it, evaluate it, and decide how it can be used.
Required data elements are verified at the source rather than accepted secondhand.
Built around NCQA credentialing and recredentialing requirements.
Verification across every active state license a provider holds.
One agreed verification standard applied across lines of business.
Coverage across specialties and license types.
Standardized documentation and traceability, structured for regulator review.
PSV
Verification method
Verified at the primary source, not accepted secondhand
NCQA
Standard alignment
Built around NCQA credentialing and recredentialing requirements
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State coverage
License verification across every state a provider is licensed in
