New findings from symplr’s 2025 State of Payers Survey reveal a clear disconnect: while most health plans audit provider data regularly, confidence in accuracy and consistency remains only moderate.
Audit provider data quarterly or more often
Yet most report only “somewhat confident” accuracy across systems
symplr’s 2025 payer survey shows provider data challenges remain widespread. Inconsistent data, siloed systems, and lack of standardization continue to impact accuracy, compliance readiness, and operational efficiency.
Manual reconciliation is still the primary way teams resolve discrepancies, even with technology in place.
of respondents report multiple data quality issues
Provider data inconsistency is widespread
This is a systemic issue, not an isolated one
conduct audits quarterly or more often
Audits are frequent—but confidence remains moderate:
Frequency does not equal confidence
systems used across the provider lifecycle
Multiple systems create fragmentation:
More tools = more complexity
Manual reconciliation is still the norm for many health plans.
Despite investments in technology, the most common approach to resolving provider data discrepancies remains manual review. Automation may support parts of the process, but it rarely replaces the need for hands-on effort, leaving teams to do the heavy lifting by hand. This not only slows operations but also increases administrative cost and the risk of errors slipping through.
Confidence in provider directory accuracy is lower than expected.
Health plans continue to struggle with duplicate or conflicting data, delayed updates, and synchronization issues across systems. Limited provider engagement further complicates the problem. In reality, most directory challenges aren’t directory issues at all, they stem from upstream provider data gaps that, if left unaddressed, continue to impact compliance, member experience, and operational efficiency.
Health plans are focusing on four key areas to improve provider data accuracy and operational performance:
Unified provider data management. Reduced cost and risk.
Eliminate data silos, save on costs and improve member outcomes
