How Payers Can Turn the Provider Lifecycle into a Growth Engine

Payer growth depends not just on where you expand, but how fast and effectively you can bring new providers into your network. Yet, that progress is often stalled by the provider lifecycle itself. 

A 2023 study of five major health plan organizations found that 81% of provider directory entries contained inaccuracies. A 2018 CMS study of 64 Medicare Advantage Organizations found errors in 45% of provider directories. 

At the same time, onboarding and credentialing cycles still take weeks or months to complete, resulting in delayed activation, duplicative efforts across systems and teams, increased compliance risks, and both provider and member abrasion. 

But what if the provider lifecycle could become a growth engine that accelerates expansion, improves provider experience, and delivers measurable ROI? 

Forward-thinking payer executives are turning that challenge into competitive advantage. By digitizing and unifying lifecycle workflows, they’re transforming what was once administrative burden into a strategic growth lever. 

Reframing the Provider Lifecycle as a Lever for Growth 

Payers who lead in network expansion are doing something different: they’re connecting lifecycle data, workflows, and insights into one system of intelligence. 

Here’s how they’re reframing success: 

• Automation and orchestration: Credentialing and onboarding data flow seamlessly into directories and downstream systems, and directory updates help accelerate credentialing  

• Predictive visibility: Analytics identify bottlenecks and flag at-risk providers early 

• Feedback loops: Operational metrics feed directly into network strategy and staffing forecasts 

The result is an adaptive, data-driven ecosystem that scales network growth while improving provider experience. 

The Payoff: Speed, Satisfaction, and Strategic Clarity 

1. Faster Speed-to-Market. Forecasted network needs combined with intelligent provider recruitment and automated credentialing and data verification shrink provider activation times, helping payers meet adequacy goals and move faster into new markets 

2. Lower Provider Friction. Provider requests built to address the full lifecycle process reduces back and forth for easier, faster data capture, reducing the burden on the providers. Providers interact through a familiar, multi-payer environment—building trust and engagement 

3. Operational Leverage. Centralized lifecycle data reduces rework and exception handling, while predictive analytics help leaders forecast resource needs and expansion capacity 

4. Smarter Network Strategy. Lifecycle insights inform which providers to target, when to expand, and where bottlenecks are forming, so network growth becomes proactive, not reactive 

Implementation Insights: Scaling the Right Way 

Transforming provider operations is as much about alignment as technology. The most successful payers focus on: 

1. Cross-functional collaboration across network strategy, provider ops, and IT 

2. Data cleanliness and governance as the foundation for automation 

3. Data intelligence that grants teams visibility into bottlenecks and forecasts problems to maintain and minimize time to network strength 

4. Deliberate design for processes that address a need one time across the diverse needs of multi-region and multi-specialty operations 

5. Continuous improvement through KPIs like activation time, exception rate, and provider satisfaction 

Looking Forward: The Future of Dynamic Networks 

Tomorrow’s networks will be dynamic and self-optimizing, with providers activated automatically as readiness is verified and lifecycle intelligence continuously shaping expansion strategy 

This vision is already taking shape. Payers using Availity are proving that clean, connected data and intelligent automation can make network growth predictable, profitable, and provider-friendly. 

Built for Better Provider Lifecycle 

Availity Provider Lifecycle Solutions (PLS) give health plans the technology to transform their provider lifecycle management with a streamlined, proactive, and provider friendly approach. 

Today, PLS unites two core modules designed to ease the complexity of managing provider lifecycle stages through digital, holistic offerings that engage providers where they already operate: 

• Provider Data Management (PDM): Collects and verifies provider data from primary sources, payers, and providers—guiding attestations to create a complete, attested, and up-to-date golden record. This record powers directories, credentialing, claims, and prior authorization workflows. 

• Credentialing Intake: Delivers a structured, multi-payer digital intake, prefilled by PDM data, that captures all credentialing data in one experience and routes it to the payer’s preferred CVO for validation. 

With these connected modules, payers can streamline operations, improve accuracy, and elevate the provider experience from one interoperable platform. And we continue to expand that platform—soon enrollment and network analytics products will join our suite of offerings.  

Ready to turn your provider lifecycle into a growth engine? 
See how Availity’s Provider Lifecycle Solutions help payers accelerate onboarding, improve data accuracy, and scale with confidence at www.availity.com/provider-lifecycle-solutions. 

Curtis Miller is Vice President, Product Management, Provider Data Management