As the healthcare industry grapples with achieving full interoperability and seamless data exchange, some experts are suggesting blockchain technology as a means to that end. Bruce Broussard, president and CEO at Humana, is one such leader.
In a LinkedIn post, Mr. Broussard writes blockchain could be transformational for healthcare, particularly with regard to payments and payer contracts. In a complex industry, EMRs and claims validations and information sharing are all complex. "To top it off, we're expecting hospitals, health plans and provider groups to easily exchange all their siloed data so the claims process can run more smoothly," he writes.
Blockchain may be the answer to this quandary.
Essentially, blockchain facilitates transactions between end users without requiring an intermediary. This enables the two parties — i.e. a patient and provider or a provider and a payer, etc. — to directly interact without a third party. "In a blockchain, each of the participants has both the contract and the data needed to enable transactions to take place and be shared across the network," Mr. Broussard writes.
Especially germane to healthcare is how blockchain creates a permanent record of activity. Mr. Broussard describes the process as follows: "Each completed transaction is ordered into a 'block' that's connected, or 'chained,' together as transactions are processed. Over time, this transaction history becomes very powerful because it offers transparency that was not available when transactions were processed by a collection of companies with very little financial incentive to collaboratively share data."
In a situation where a health plan and patient are dealing with a contract, the blockchain can also automatically verify and authorize information since all the necessary data is connected. It automates contractual processes, including payments. If a physician's office submits a claim for payment, blockchain can access the latest relevant information, load the contracts and facilitate an automated payment.
Mr. Broussard writes blockchain could transform the entire healthcare claims process. "There is no more back-and-forth haggling with the health plan about what was paid, why it was paid or whether it should have been paid. With transparency and automation, greater efficiencies will lead to lower administration costs, faster claims and less money wasted," he writes.
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