How do providers get better access to patients, deliver the best possible care, and get paid for their services in an accurate and timely fashion? The answer could be found in a game-changing technology called blockchain.
Blockchain is one of the hottest topics in healthcare today because of its promise to improve transparency, drive clinical quality, relieve administrative burdens and reduce costly waste within the system.
One need only look at the financial services industry to understand the value of blockchain technology. Initially used to lower the worldwide cost of cross-border payments, security trading and compliance, blockchain technology now has the potential to save the banking industry an astounding $20 billion by 2022, according to estimates by the management consulting firm Accenture.
What makes the technology so desirable for healthcare providers is its ability to eliminate the dependence on a centralized clearinghouse and ensuring that the information is timely and accurate across all participants in the “chain,” In short, blockchain technology could unlock the value of interoperability and allow for true coordination of care administration by replacing duplicative processes with a synchronized model that is efficient and effective. In addition, it creates a permanent record of online transactions that can be securely stored and selectively shared with targeted users via a network of personal devices.
This fall, Arizona Care Network, an accountable care organization (ACO) based in Phoenix, and its partner Solve.Care will put blockchain technology to the test. The two organizations will pilot a proprietary platform built by Solve.Care using blockchain technology, along with cloud computing and cognitive learning capabilities that serve as the foundation for smart decentralized healthcare applications called Care.Cards.
The pilot will occur in two phases: ACN Care.Wallet will be used to display provider quality data and distribute provider rewards and incentives to Arizona Care Network’s 5,500 physicians in a timely, convenient and transparent way. That will be followed by a Phase II launch of a Care.Wallet application that automatically and continuously synchronizes benefits information, including deductibles and co-pays, along with co-insurance and out-of-pocket expenses for the network’s nearly 300,000 member patients. Patients can use Care Card applications for immediate authorizations, to schedule appointments with physicians and share accurate benefits information.
Embracing disruptive technologies like blockchain has never been more important in healthcare. Consider that in 2015, administrative costs accounted for between seven and as much as 30 percent of the more than $3 trillion healthcare spend. The culprit is a dated third-party administration and payment model that is plagued by inefficient processes, data system silos and a duplication of efforts.
Along with its administrative flaws, the model makes navigating the healthcare system a dizzying, laborious and frustrating process that requires considerable manual effort of everyone from patients and doctors to eligibility workers, case managers, billing agents and others.
Blockchain technology enables patients to access providers, understand their benefits and costs of treatment, and eliminate duplicative paperwork associated with insurance billing and payments. Best of all, a platform using blockchain technology such as Solve.Care can have a significant positive effect on clinical outcomes by giving doctors a 360-degree view of a patient’s care, enabling the entire medical team to communicate, coordinate and eliminate unnecessary processes and procedures that drive up healthcare costs.
Providers stand to benefit from platforms using blockchain technology, too, by getting patient records and benefits details in real time, plus access to immediate, actionable data that could positively impact patient care.
The advent of new technologies come with an opportunity. It is up to industry leaders to seize this opportunity as a means of making healthcare and benefits administration better for all.
David Hanekom, M.D., is CEO of Arizona Care Network, a physician-led and governed accountable care organization that improves clinical outcomes and reduces costs by actively managing care for its 300,000 member patients.
Pradeep Goel is CEO of Solve.Care Foundation, an international company that aims to revolutionize the administration of healthcare and other benefits programs globally using groundbreaking innovations.
