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How Care.Wallet leverages the blockchain — and what this use case means for healthcare.
There’s a promising new way to give physicians and clinicians better access to patient data, enable them to deliver the best possible care and get paid for their services in an accurate and timely fashion.
It’s blockchain technology.
Blockchain is one of the hottest topics in healthcare today because of its potential to improve transparency, drive clinical quality, relieve administrative burdens and reduce costly waste within the system. While the technology received criticism in the past for its lack of healthcare applications, health-tech experts say that’s changing.
One need only look at the financial services industry to understand the impact blockchain can have on healthcare. 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 $20 billion by 2022, according to estimates by the management consulting firm Accenture.
What makes the technology so desirable for healthcare professionals is its ability to eliminate the dependence on a centralized clearinghouse and ensure 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 accurate in real time. 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 can improve the revenue cycle, reimbursing healthcare practitioners and organizations more quickly and reducing the number of unpaid claims due to verification issues discovered long after care has been delivered.
Last fall, Arizona Care Network (ACN) and Solve.Care launched a proprietary platform using blockchain technology, along with cloud computing and cognitive learning capabilities that serve as the foundation for smart, decentralized healthcare applications called Care.Wallet.
Phase 1 of the Care.Wallet was deployed to ACN primary care providers, enabling them to view their performance data and compare their success to the larger network.
So far, the results have been encouraging. Just eight weeks after the Care.Wallet launch, the mobile application was in use by nearly 80 percent of eligible practices. Last October, Arizona Care Network distributed the first digital currency — Care.Coins — redeemable for U.S. dollars as part of the quarterly rewards for outstanding clinical care and high patient satisfaction.
The key to the Care.Wallet’s success is that it was designed specifically for physicians. As they used the prototype and suggested improvements, ACN responded with changes to meet their needs. The Care.Wallet contains cards that display actionable insights, which enable providers to see clinical care gaps and results for in-network care coordination and patient satisfaction.
It’s true that data gleaned from programs like Care.Wallet are critical in driving population health, but care is delivered one patient at a time. As such, the Care.Wallet’s performance card arms providers with real-time, usable information.
For example, if a provider sees on their Care.Wallet performance card that 200 of their 1,000 Medicare patients have not had their annual wellness visit, they can visit a secure portal for a list of those patients and reach out to them to schedule the appointment. As they close those care gaps and document risk scores, the blockchain technology allows the network to update the information and credit the provider’s performance toward the Provider Rewards Program. Physicians can view how all metrics were calculated, the current status and a trend line of expected success in Arizona Care Network’s Provider Rewards Program.
Getting physicians to adopt the Care.Wallet was a critical first step in making positive, measurable changes to America’s health system. This will be followed by a patient-facing Care.Wallet 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. In the future, ACN plans for patients to 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 7 and as much as 30 percent of the more than $3 trillion annual 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.
The beauty of blockchain is that it can automate archaic claims and payment systems that are expensive and resource-intensive. This undoubtedly will reap the rewards in the form of better, more cost-effective patient care and greater provider satisfaction.
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 is changing the administration of healthcare and other benefits programs globally.
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