Blockchain Pilot Launched By US Health Insurance Titans

Announcements, Blockchain | April 4, 2018 By:

Five healthcare organizations are joining forces to improve inaccurate doctor directories of health plans using blockchain technology.

Humana, MultiPlan, Quest Diagnostics, and UnitedHealth Group’s subsidiaries Optum and UnitedHealthcare are launching a blockchain pilot to explore how the technology could help ensure the most current health care provider information is available in health plan provider directories.

Quest Diagnostics CIO Lidia Fonseca, who calls blockchain a “promising enabler” for data exchange, said the partnership came together after several months of discussions. Quest Diagnostics has long-standing relationships with Humana and Optum, and over time the organizations became convinced blockchain could solve some of their interoperability problems.

The organizations will examine how sharing data across healthcare organizations on blockchain technology can improve data accuracy, streamline administration, and improve access to care. Additionally, the program will explore the high cost of healthcare provider data management and assess whether improvements can be made by sharing data inputs and changes made by different parties across a blockchain, simultaneously reducing costs and improving data quality.

“With the explosion of health data, organizations need better ways to share and harness information to yield clinical and economic value,” Fonseca said. “We are connected to more than 650 (electronic health record) platforms and a majority of health systems and physicians in the US, so we bring a unique level of insight into how to connect people and organizations across health care.”

In a recent American Medical Association and LexisNexis Risk Solutions survey, 52 percent of physicians reported seeing patients each month with health coverage issues tied to inaccurate information about in-network doctors. For patients, an inaccurate directory can lead to choosing an out-of-network doctor not fully covered by their health plan. This can lead to “surprise” medical bills when care isn’t covered.

“Our effort to improve the quality of care provider data is a pragmatic and potentially effective way to leverage technology to help those we serve,” said Mike Jacobs, a senior distinguished engineer at Optum. “We envision the possibility of effecting change at scale—supporting our mission of helping make the health system work better for everyone.”

The organizations have not selected a technology partner yet, although Fonseca said they are in the process of narrowing down their selection from a group of four companies. By the end of the seven-month pilot, the organizations expect they’ll have a use case to drive other blockchain-focused pilots.