JULY 2025

Symphony Newsletter

This summer, we have lots of exciting news to share. Symphony officially began powering Covered California's online provider directory, Shop and Compare, helping nearly 2 million enrolled consumers access more accurate information. CMS also announced their intention to create a national provider database, and Symphony is sharing insights from our success as California's statewide provider directory utility –– which includes presenting at The California Association of Health Plans (CAHP) Annual Conference this October.

Read on for regulatory and product updates, including our progress towards a network granularity solution. Finally, we are excited to welcome Torrance Memorial IPA as the newest Symphony participant!  

Symphony now live as provider directory data source for Covered California 

In May 2025, the Symphony Provider Directory began powering Covered California’s online provider directory, Shop and Compare. All 12 Qualified Health Plans (QHPs), covering about 100,000 individual providers, are actively exchanging data through Symphony to improve the accuracy of information consumers need to make important decisions about their healthcare coverage.   

“Our goal is to remove all hurdles for all Californians seeking health care coverage and make it easy for them to find the care they need. We are excited to be able to give our enrollees information on which providers are available in different networks, which will empower more Californians to take control over their health care.” 

- Jessica Altman, Covered California Executive Director 

Remaining nimble to address regulatory changes 

CMS’ path to create a national provider directory 

In June 2025, CMS announced their intention to create a national provider database to ensure accurate Medicare provider data. In one report, CMS concluded: 

“Through the insight gained from our reviews, it has become clear that a centralized repository for provider data is a key component missing from the accurate provider directory equation.”

- CMS Provider Directory Review Report   

Currently, CMS is testing this approach with Oklahoma’s QHPs with the goal of enhancing health information exchange and reducing administrative costs. Symphony responded to their June RFI, offering insights from our experience as a functional statewide utility in California. Symphony manages about 600,000 unique provider records sourced from most major health plans and provider groups in California and identifies over 100,000 data discrepancies each month on average. Additionally, Symphony enables the consumer-facing provider directory search tool for Covered California and can apply this experience beyond the state.  

We’ll be discussing these efforts at the CAHP Annual Conference this fall (details below!)  

SB 137 Comment Periods 

Since Symphony launched in 2019 to address SB 137, we have regularly shared our expertise and learnings with the industry. This year, we provided feedback during DMHC’s SB 137 public comment periods to reinforce the importance of standardizing network definitions and provide considerations on the practical application of new requirements. 

Watch IHA’s Annual Health Policy Webinar for more 

We discussed these topics and more at our annual Health Policy Webinar on July 9. For additional details and insight into California budget updates, upcoming legislation, and other regulatory developments, watch the recording here:

Standardizing network granularity to improve data accuracy and exchange 

Across the industry, the lack of consistency and standardization in capturing complex IPA and provider group relationships contributes to persistent directory inaccuracies. We’ve heard your frustrations and are developing a standardized solution to better align these complex network connections. So far, we've completed in-depth reviews of over 10 health plan roster templates and gathered input from 5 health plans and 7 provider organizations. What’s next:  

• End of July - Mid August: Assess client specific impacts on the proposed solution and socialize initial design for feedback
• End of August: Finalized design and client roll out plan 

We appreciate all the valuable feedback from clients and Data Governance Committee members that we’ve captured so far – please reach out to your Client Success Manager if you have any questions or additional insights.  

Enhancing Symphony for dental plans and providers  

On July 16, Symphony presented at the California Association of Dental Plans’ Annual Conference in Costa Mesa, California. General Manager Jacqui Darcy discussed how Symphony is helping improve provider directory accuracy and standardization across the industry, highlighting learnings from the dental focus groups that Symphony hosted.  

Anthem Provider Incentive Program 

We partnered with Anthem to launch an incentive program that enables providers to receive incentives for contracting with Symphony and completing attestation every 90 days in 2025. We are looking to expand in 2026 with other health plan partners and by potentially including Symphony measures in AMP’s incentive design. Please reply to this email or reach out to your CSM if you’re interested! 

Upcoming Events

CAHP Annual Conference | September 29 – October 1, 2025 | Palm Desert, CA 

Symphony is hosting a session, “National and State Efforts to Improve Provider Databases.” It will feature CMS, a national health plan, and other experts to discuss federal developments and how California has improved directory data exchange and accuracy by bringing health plans and providers together to solve the problem. 

You can also stop by our booth during the conference to chat with the Symphony team. Stay tuned for more information!