The Alliance has demonstrated in pilot initiatives that collaborative use of blockchain technology can help improve the efficiency of updating directories people use to select health care providers. Providing consumers accurate information – when they need it – is essential to a high-functioning health care system.
Federal regulations require insurers to maintain directories that contain up-to-date demographic information about physicians and other providers, such as name, address, specialty and phone number. Typically, each insurer maintains its own directory, which can be a time-consuming and expensive endeavor. If the information in these directories is inaccurate, it can delay claim and payment processing and can lead to fines from the Centers for Medicare and Medicaid Services (CMS). Roughly $2.1 billion is spent annually across the healthcare system chasing and maintaining provider data. Still, a review completed last year by CMS found that 52 percent of provider directory locations listed had at least one inaccuracy.
This pilot will examine how sharing data across healthcare organizations on blockchain technology can improve data accuracy, streamline administration, reduce costs, and improve access to care.
In its pilot, the Alliance used its blockchain functionality to identify up to 88% of necessary demographic data corrections across the Alliance members’ shared data for two of the most common errors in care provider directories: