INSIGHTS /
Independent Practices
/

What the CAQH to DataSpring Change Means for Your Practice

If you're not familiar with it, CAQH (Council for Affordable Quality Healthcare) is the database most practices use to store and share provider credentials with insurance companies. Instead of filling out the same paperwork for every payer, providers enter their information once through CAQH, and participating payers pull from it. It's become one of the most widely used credentialing tools in the industry.

That system just changed hands. In the first half of 2026, CAQH shifted from a nonprofit to a for-profit entity, now operating as DataSpring, powered by CAQH.

If your organization relies on the database for credentialing, payer enrollment, or provider directory accuracy, this is worth your attention.

Most of the day-to-day process will feel familiar, but the transition brings new technology, deeper payer integrations, and a few new responsibilities for your team.

At V2V Management Solutions, we've been tracking this closely. Even small shifts in credentialing can ripple into provider enrollment, claims reimbursement, and patient access.

What’s changing

DataSpring is now owned by a consortium of twelve major health insurers, including UnitedHealthcare, Aetna, Centene, Elevance Health, Cigna, and Humana. The goal is a more connected provider data ecosystem, one that improves accuracy across participating health plans. In practice, that means the information in your profile carries more weight in payer operations and directory accuracy than it used to.

They are rebuilding the platform to speed up credentialing turnaround, reduce duplicate paperwork, and streamline payer enrollment. Those are welcome goals, but any technology transition comes with growing pains: expect new workflows and occasional validation requests as things settle.

The most immediate change involves Optum. Organizations contracting through Optum may start seeing prompts to verify practice locations inside the DataSpring portal. These aren't optional. If a request goes unanswered, the location can be dropped from the Optum provider directory, which affects patient access and referrals.

What to do now

  1. Review your DataSpring account. Log in and confirm provider demographics, practice locations, and uploaded licenses migrated correctly. Catching a discrepancy now is a lot easier than untangling it during a credentialing delay later.
  2. Respond to Optum location prompts. If your providers participate with Optum, review every location verification prompt and respond to each one directly. Don't assume no action means no risk.
  3. Keep up your 120-day attestation schedule. The name changed, but this requirement didn't. Missing a deadline can still delay enrollment or leave outdated information sitting in a directory.

Accurate credentialing data isn't just paperwork. It's what keeps reimbursement on schedule, directories correct, claims from getting denied, and new providers onboarded without friction. As payers lean harder on data quality, the organizations that stay on top of their profiles will have an easier time avoiding disruptions.

What to watch

DataSpring is now owned by the same insurers who rely on the data it houses. That's not a red flag, but it is a reason to stay engaged.

Understanding who manages your provider information, and how ownership changes could shape enrollment and directory decisions down the road, is just good practice.

The shift from CAQH to DataSpring is more than a rebrand. It's a real step toward better data accuracy and payer integration across the industry. Take the time now to review your profile, respond to verification requests, and stay current on attestations. It's a lot easier than untangling a credentialing delay later.

Need help navigating the transition? V2V's credentialing team is ready to help, whether that's updating provider profiles, managing payer enrollment, or strengthening your credentialing process from the ground up.

A Thoughtful Consideration

One additional point deserves attention—not as an alarm, but as something healthcare leaders should be mindful of. With DataSpring now owned by a consortium of major health insurers, some industry stakeholders have raised questions about the long-term implications of payer ownership over a platform that houses sensitive provider credentialing and practice data. While there is no indication that the platform is being used inappropriately, the change in governance has prompted conversations about data stewardship, transparency, and potential conflicts of interest.

Our recommendation isn't to panic or stop using the platform—it's simply to stay informed. As healthcare becomes increasingly data-driven, organizations should understand who manages their information, how it may be used, and how changes in ownership could influence the future of provider enrollment, credentialing, network participation, and directory management. Staying engaged and asking thoughtful questions is simply good governance.

Share this insight
READY TO MOVE FORWARD?

Trust the Experts in Practice Transformation

Partner with advisors who know healthcare from every angle. Contact V2V to meet their qualified consultants.

©  2016–2024 V2V Management Solutions, All Rights Reserved