Provider Data Has Become Infrastructure
Every health plan is investing in digital transformation, AI, and better member experiences. Yet all of those initiatives ultimately depend on one thing: confidence in the underlying provider data.
At H1, we’ve spent years helping health plans build that foundation. Working alongside some of the country’s largest organizations has shown us that the plans making the greatest progress aren’t simply improving directory accuracy; they’re rethinking how provider data is managed across the enterprise. This guide shares some of those lessons.
The Problem
Most plans are auditing the wrong thing at the wrong time. Five or more vendors. No single source of truth. Data audited after it fails not before. The plans pulling ahead aren’t auditing after the fact. They score every record at intake, maintain it continuously, and give every team one source of truth to read from.
About 30% of providers change their address every year. By the time many health plans complete a directory audit, a significant portion of that information is already out of date, which leaves plans perpetually chasing information that may have changed months earlier.
Who We Are
H1 is the intelligence layer behind the industry’s most accurate provider directories.
- Our provider data serves 9 of the 10 largest health plans
- We power 70% of all digital health apps
- 190M Americans rely on our doctor intelligence
- Our database houses 7M U.S. provider profiles
In 2025, H1 acquired Ribbon Health and Veda, which were then unified into a single data infrastructure. Our integrated provider data insights have delivered:
The Solution
By creating one connected provider record where every field is a dimension of the unified profile, you only have to derive the information once to make it consistent everywhere.
Three Provider Use Cases You Can Fix Now
Bad provider data slows roster work, breaks directory trust, and sends members to the call center. H1 helps leading health plans solve these issues at scale, and can help your teams fix them too.
Fix bad directory records
See which provider listings to trust, fix, or remove before members find the wrong care.
Clean rosters faster
Turn roster files from many formats into clean provider data teams can use.
Cut avoidable member calls
Fix wrong phone numbers, bad locations, and dead-end searches before they become support tickets.
What Our Customers Have Seen
1. Completed Ahead of a CMS Audit Cycle:
Directory accuracy improved from 32% to 80% (47+ points) in 90 days. Millions of duplicate records resolved.
2. Top National Health Plan:
85% CMS measured accuracy. Ghost network listings removed. Call center traffic cut 20%.
3. Large National Medicare Advantage Plan:
41% reduction in support tickets year-over-year as accuracy reached 90% Absorbed 5x member growth.
4. National Payer Dashboard:
Reduced roster processing time from 8.2 hours to 6 minutes with 800% rosters automated in month one. 64,000 staff hours freed.
Accuracy Scores Go Public in 2029
The data you have today is what you will be scored on.
2028 compliance takes effect ahead of 2029 public accuracy results, which means by 2027 you must be thinking about how to improve.
