How Payers Can Use Salesforce for Smarter Provider Network Analytics in Value-Based Care

When Data Becomes a Roadblock

Many payers in the U.S. are racing to make value-based care work, rewarding providers for quality and outcomes, not just the number of procedures. But there’s a problem: too much data and too little visibility.

Provider information is spread across claims systems, credentialing tools, call center platforms, and spreadsheets. Each team has its own version of “truth.” The result? Disconnected insights, missed opportunities, and a slower path to value-based performance.

(Resource Note: For a deeper look at solving data silos at the source, review our guide: Stop Data Fragmentation: The Executive Guide to Seamless EHR/EMR Integration with Health Cloud.)

That’s where Salesforce provider network analytics comes in, giving payers a connected view of providers, performance, and contracts in one place.

Step 1: Understanding What Provider Network Analytics Really Means

In simple terms, provider network analytics helps insurers understand which doctors and facilities are performing well, where care quality can improve, and where costs are rising.

It’s about connecting data from different, siloed systems to answer critical operational questions like:

• Which providers are consistently meeting quality goals?

• Where are care gaps or unnecessary costs happening?

• How effective are our value-based contracts and incentives?

The goal isn’t just to build reports. It’s to turn data into decisions that improve patient outcomes and financial performance.

Step 2: Why Salesforce Fits This Challenge

Salesforce has evolved into much more than just a CRM. It can now function as a complete provider intelligence hub for payers through its robust healthcare ecosystem: Health Cloud, Data Cloud, MuleSoft, and Tableau (Einstein Analytics).

Here’s how each piece contributes to solving the data fragmentation challenge:

Salesforce Component	What It Does	In Simple Terms
MuleSoft	Connects Salesforce to external systems like claims, credentialing, and EMRs.	Like the plumbing that lets all your systems talk to each other.
Data Cloud	Brings data from all these systems into one unified space.	Think of it as a “data warehouse” inside Salesforce that keeps everything consistent.
Health Cloud	Gives users a 360° provider view with all related data and metrics.	The front-end dashboard your business teams actually see and use.
Tableau / Einstein Analytics	Turns data into visuals, reports, and predictions.	The “brains” that show trends and predict outcomes.

These layers work together to make Salesforce a single place where payers can analyze, manage, and act on provider performance data in real time.

Organizations leveraging Health Cloud have seen a 45% improvement in provider data accuracy through centralized management.

Step 3: The Discovery Process - Where It All Starts

Before any integration begins, a payer’s IT and business teams must conduct a thorough discovery phase. Think of this as building the blueprint before construction starts.

This is where you figure out:

• Where your provider data lives (claims, credentialing, directories, etc.).

• What systems absolutely must connect to Salesforce.

• What business goals the analytics must support (quality scores, cost containment, contract compliance).

  
  

Without this blueprint, integrations often fail later because teams don't fully understand their data landscape or daily workflows.

Step 4: Bringing It All Together - The Integration Layer

Once discovery is complete, MuleSoft acts as the crucial integration engine.

It moves data between Salesforce and your legacy systems safely and consistently. For example: claims data flows in from a legacy database, credentialing data arrives from a vendor system, and performance data comes from an external analytics source.

MuleSoft standardizes this data and sends it to Data Cloud, where it’s harmonized (fields matched, duplicates removed, formats standardized). From there, Health Cloud and Tableau visualize it in dashboards and scorecards.

This architecture ensures all teams, operations, contracting, quality, and provider relations, see the exact same trusted data.

Step 5: From Data to Action

Once your data is unified and analyzed, you can start building actionable workflows directly inside Salesforce:

• Alerts when a provider’s quality score drops below a threshold.

• Tasks for provider engagement teams to schedule performance reviews.

• Dashboards showing real-time network coverage and leakage.

• Predictive models to identify which providers are likely to underperform before major issues arise.

  
  

This is how payers move from simply "looking at reports" to "running operations based on insights."

Download our step-by-step implementation playbook

The Payoff - Building a Smarter, Connected Network

With Salesforce as the foundation, payers gain:

• A complete, 360-degree view of provider performance.

• Faster decisions with near real-time analytics.

• Consistent data across every team and system.

• Better collaboration with providers on shared value-based goals.

  
  

It also significantly reduces time spent on manual data reconciliation and gives executives the confidence that the numbers they see are accurate and actionable.

In Summary

Provider network analytics is not just a technical project. It’s the foundational strategy for how payers will succeed in value-based care.

By leveraging Salesforce’s powerful ecosystem: Data Cloud, MuleSoft, Health Cloud, and Tableau, CIOs and program leaders can connect the dots across disparate data sources, automate the flow of insights, and make VBC performance truly measurable.

If your Salesforce system isn’t yet set up to connect your provider and claims data, this might be the best time to start with a focused discovery phase. Even small integrations can reveal powerful insights for your network teams. Contact AlliedGeeks to begin mapping your data landscape today.