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The trusted technology partner for credentialing and
provider network management.

21/10/2026

The future of healthcare networks is moving toward greater transparency, accuracy, and accountability.

This week’s CredeMtia News highlights important developments shaping the healthcare industry, including proposed CMS reforms for Medicare Advantage provider directories, NCQA’s exploration of continuous credentialing, and new federal enforcement initiatives in Puerto Rico.

As regulatory expectations evolve, healthcare organizations face a growing challenge: ensuring that provider information is not only accurate and continuously verified, but also reflects the actual availability of care.

The future of network adequacy goes beyond the number of providers listed. It’s about building networks that patients can actually access.

📖 Want to learn more about these developments and their implications for healthcare organizations?

🔗 Read the full article by clicking the link below.
https://credemtia.com/news/weekly-impact-news-summary-credemtia-news-week-of-october-19-2026-cms-proposes-major-provider-directory-reforms-as-healthcare-moves-toward-continuous-network-integrity/

Better data. Greater access. A healthier Puerto Rico.

16/10/2026

The future of healthcare networks goes beyond credentialing.

As CMS, NCQA, and major health plans introduce new standards and initiatives, healthcare organizations face growing expectations around provider data accuracy, network integrity, regulatory compliance, and access to care.

This week’s CredeMtia News explores key developments shaping the industry, from Medicare Advantage updates and continuous credentialing to greater transparency and provider data governance.

The message is clear: A strong provider network isn’t just about who is listed. It’s about who is actually available to provide care.

📖 Want to learn more? Read the full Weekly Impact News Summary by clicking the link below.

🔗 https://credemtia.com/news/weekly-impact-news-summary-credemtia-news-october-16-2026/

Better data. Greater access. A healthier Puerto Rico.

NetworkAdequacy AccessToCare HealthcareCompliance PuertoRicoHealthcare

14/10/2026

¿Dónde están los médicos especialistas que Puerto Rico necesita?📊

Un estudio publicado en el Puerto Rico Health Sciences Journal, desarrollado por investigadores de la University of Central Florida (UCF), en colaboración con CredeMtia, revela importantes desafíos en la distribución del talento médico en Puerto Rico.

Entre los hallazgos más relevantes:

🔹 El 64% de las 25 especialidades analizadas presenta una oferta insuficiente de médicos.

🔹 El 80.77% de los municipios cuenta con cobertura adecuada en un máximo de 5 de las 25 especialidades evaluadas.

🔹 Los médicos especialistas se concentran principalmente en la región metropolitana, mientras las comunidades rurales y suburbanas enfrentan mayores dificultades de acceso.

CredeMtia contribuyó a esta investigación proporcionando datos sobre la fuerza laboral médica en Puerto Rico, reafirmando la importancia de contar con información confiable para comprender las necesidades de nuestro sistema de salud.

Esta colaboración destaca cómo la investigación, la tecnología y el análisis de datos pueden contribuir a desarrollar estrategias para fortalecer la distribución del talento médico y mejorar el acceso a los servicios de salud.

Porque construir un sistema de salud más fuerte comienza con datos confiables y decisiones basadas en evidencia.

📚 Fuente: Sulkouskaya et al., Puerto Rico Health Sciences Journal (2026).

Lee el estudio completo en: https://credemtia.com/news/the-distribution-of-specialist-physicians-in-puerto-rico-supply-and-demand-projections-of-twenty-five-medical-specialties/

08/10/2026

How effective is your provider network?🏥

As Medicare Advantage plans move toward more controlled networks for 2027, healthcare organizations face a growing challenge: ensuring that every provider in their network is accurate, active, reachable, and available to deliver care.

This week’s CredeMtia News explores key developments involving CMS provider enrollment, NPPES updates, network adequacy, and the growing importance of Effective Network Capacity.

The question is no longer simply how many providers are in a network, but how many are actually available to patients.

📖 Read the full article to discover how these changes are shaping the future of Provider Network Integrity and access to care.

🔗 Access the full article at the link: https://credemtia.com/news/weekly-impact-news-summary-credentialing-provider-data-management-network-adequacy-access-and-compliance-credemtia-news-week-of-october-5-2026/

05/10/2026

El futuro de la salud en Puerto Rico requiere conectar el talento médico con las oportunidades y los recursos que le permitan quedarse y ejercer en la isla.

Con ese propósito, el pasado miércoles, 30 de septiembre, CredeMtia y MedMatch AI organizaron “Healthcare Without Friction: From Medical Talent to Patient Access”, en el marco de la Convención de la Asociación de Hospitales de Puerto Rico.

Junto a nuestra invitada especial, Gaby Ortigoni, exploramos las lecciones de Central Florida y cómo las oportunidades profesionales, la comunidad y la calidad de vida influyen en la atracción y retención del talento médico.

Gracias a la Asociación de Hospitales de Puerto Rico, a los panelistas y a todos los participantes por enriquecer esta conversación.

Seguimos impulsando la colaboración para que estas ideas se traduzcan en mejores oportunidades para nuestros médicos y mayor acceso para nuestros pacientes.

30/09/2026

¿Cómo podemos fortalecer el sistema de salud desde la atracción de talento médico hasta el acceso de los pacientes? 🩺

¡Hoy conversamos sobre este reto en Healthcare Without Friction: From Medical Talent to Patient Access!

Acompaña a CredeMtia y a nuestra invitada especial, Gaby Ortigoni, Founder & President de GO Innovation & Growth y expresidenta y CEO de la Hispanic Chamber of Commerce of Metro Orlando.

Exploraremos las lecciones de Central Florida y cómo las oportunidades profesionales, la comunidad y la calidad de vida pueden ayudar a posicionar a Puerto Rico como un destino competitivo para el talento médico.

📅 Hoy, miércoles, 30 de septiembre
⏰ 11:30 a. m. – 1:30 p. m. AST
💻 Webinar | Evento virtual

🔗 Regístrate aquí: https://zfrmz.com/NfL32RDEkAX5toXayBsq

¡Sé parte de la conversación!

29/09/2026

Healthcare is moving beyond credentialing as a standalone process.🏥

This week’s CredeMtia News highlights developments that are reshaping how healthcare organizations manage providers across the entire network lifecycle—from credentialing and enrollment to compliance, provider data, network participation, and actual access to care.

Among this week’s key developments:

🔹 The emergence of shared credentialing models among major health plans
🔹 CMS initiatives focused on digital outcomes and provider enrollment oversight
🔹 Greater emphasis on identity, authorization, eligibility, and audit trails
🔹 Puerto Rico’s participation in the CMS GENEROUS Model
🔹 The continued shift from traditional Network Adequacy toward measurable access to care

The direction is becoming increasingly clear: credentialing is the foundation, but Continuous Provider Network Integrity is the larger objective.

Better data. Greater access. A healthier Puerto Rico.

🗞️Read more at the link: https://credemtia.com/news/weekly-impact-news-summary-credentialing-provider-data-management-network-adequacy-access-and-compliance-credemtia-news-week-of-september-28-2026/

23/09/2026

La escasez de médicos exige actuar, pero reclutar sin una estrategia clara no es suficiente.🏥

Para construir una red médica hospitalaria sostenible, primero hay que entenderla: conocer la disponibilidad real de especialistas, analizar la demanda de servicios, identificar brechas y referidos fuera de la red, evaluar riesgos y convertir esos datos en prioridades concretas de reclutamiento. Suficiencia y sostenibilidad de la red médica hospitalaria.docx

En nuestro nuevo newsletter, “Suficiencia y sostenibilidad de la red médica hospitalaria”, exploramos cómo los hospitales pueden transformar el análisis de su red médica en una estrategia de reclutamiento más informada, sostenible y alineada con las necesidades de las comunidades.

Porque el objetivo no debe ser simplemente identificar qué médicos hacen falta, sino desarrollar un plan de reclutamiento estructurado y respaldado por datos. Suficiencia y sostenibilidad de la red médica hospitalaria.docx

📖 Lee el newsletter completo en https://credemtia.com/newsletters/suficiencia-y-sostenibilidad-de-la-red-medica-hospitalaria/.

21/09/2026

📰 The healthcare industry is moving toward a more connected model of provider network management.

This week’s CredeMtia Weekly Impact News examines the CMS ACCESS Model, NCQA’s 2026 Health Plan Ratings, ongoing concerns surrounding “Ghost Networks,” Medicare Advantage provider directories, interoperability, and SICRO’s role in Puerto Rico.

The message is clear: credentialing is only the beginning. Healthcare organizations must also ensure that provider data is accurate, networks are operational, and patients can actually access care.

This is the shift toward Continuous Provider Network Integrity.

🔗 Read the full article at https://credemtia.com/news/weekly-impact-news-summary-credentialing-provider-data-management-network-adequacy-and-access-to-care-2/

PuertoRico

18/09/2026

📰 A provider network’s value depends on whether patients can actually access care.

This week’s CredeMtia News explores how CMS initiatives, HHS-OIG findings, and evolving NCQA standards are bringing greater attention to accurate provider directories, ongoing monitoring, and appointment availability.

The takeaway: credentialing, contracting, provider data, and patient access need to work together. For healthcare organizations, including those in Puerto Rico, this means moving toward Continuous Network Integrity, with reliable data and ongoing visibility into how their networks serve patients.

🔗 Read the full article at https://credemtia.com/news/weekly-impact-news-summary-credentialing-provider-data-management-network-adequacy-and-access-to-care/

Dirección

2003 Road, Suite 201 Plaza San Cristobal
Coto Laurel
00780

Horario de apertura

Lunes	08:00 - 17:00
Martes	09:00 - 17:00
Miércoles	08:00 - 17:00
Jueves	08:00 - 17:00
Viernes	08:00 - 17:00

Página web

https://credemtia.com/newsletters/, https://credemtia.com/

Notificaciones

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