A group of leading health insurers including Aetna, now owned by CVS Health, launched a collaboration with PNC Bank and IBM to design a blockchain healthcare network that will improve transparency and interoperability in the industry.
The initiative—which also includes Anthem and Health Care Service Corporation—will focus on using the technology to address a range of industry challenges, including “promoting efficient claims and payment processing, to enable secure and frictionless healthcare information exchanges, and to maintain current and accurate provider directories," officials said.
The aim is to create an inclusive blockchain network that can benefit multiple members of the healthcare ecosystem in a highly secure, shared environment, they said.
IBM has been working on blockchain technology for several years, with 500 blockchain projects across multiple industries. The platform from the IBM-led group is ready for blockchain experimentation by the participating companies, according to Bill LaFontaine, general manager, intellectual property at IBM, in an interview with FierceHealthcare. That the platform is available for member companies to immediately begin blockchain experimentation differentiates the initiative from others that are at various stages of completion, LaFontaine said.
“We’re going to start enabling our members, probably by Monday, to be able to go and take a solution they have already built and start to port it to the platform, then they can decide who they want to experiment with. One of the beauties of blockchain is, not only is it a platform for innovation, it’s also a platform for collaboration,” LaFontaine said. “This is a platform where our members can begin to test out what they are doing, and I think that’s going to accelerate innovation.”
The collaboration is one of several healthcare team-ups launched in the past year with a focus on using the decentralized ledger technology for healthcare use cases.
The participating companies plan to further define the initial use cases for the health utility network. The collaboration will add additional members to the network in the coming months, the companies said, including other health organizations, healthcare providers, startups and technology companies.
They join other collaboratives testing blockchain in the healthcare industry, including the Synaptic Health Alliance, formed by UnitedHealth, Humana, Multiplan and Quest Diagnostics. Aetna and Ascension also have joined that collaborative. That alliance, which now includes three of the nation’s largest payers and a health system that employs 34,000 providers, is focused on using the distributed ledger technology to improve the accuracy of provider directories.
The IBM-led blockchain initiative will have several areas of focus, including leveraging the distributed ledger technology to facilitate the transition to value-based care, such as bundled payment arrangements, according to Barbara Hayes, general manager for payers at IBM Watson Health, in an interview with FierceHealthcare. The blockchain initiative will also look to tackle administrative waste in healthcare and target areas where there is redundancy and inefficiency, Hayes said, citing provider directories as one potential use case. Revenue cycle management, particularly prior authorization, is also an area of focus for blockchain use cases, Hayes said, noting the technology offers an opportunity to streamline the administrative process.
“We all know in healthcare there is quite a bit of waste, 40 to 50 cents on the dollar. There are a couple of different technologies to go after that waste, blockchain being one of them, and a leading technology because it’s going to be able to tackle those issues around data and access to data, the accuracy of the data, and transparency, in that collaborative ecosystem,” Hayes said, also noting that there is waste in the form of friction in healthcare that affects the patient experience.
A blockchain platform could be used to develop a longitudinal patient record, Hayes said. “Five years ago, we talked about wanting a portable health record, now it becomes a real-time health record that is actually in the workflow. That would be a tremendous advancement for healthcare,” she said.
Despite some industry criticism about the relative novelty of blockchain technology, LaFontaine contends blockchain will be valuable in healthcare. “It’s very clear that blockchain will take out inefficiencies where you’ve had manual labor trying to reconcile reports and documents; that’s a given, that’s going to happen. That is the first place where people are going to get tremendous value,” he said.