In its first pilot project, announced in April 2018, Synaptic Health Alliance is tackling the high cost of healthcare provider data management, testing the premise that administrative costs and data quality can be improved by sharing provider data inputs and changes made by different parties across a blockchain.
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.
Through the “provider data exchange” enabled by blockchain technology, Alliance members were able to find and update certain demographic inaccuracies faster than they would on their own.
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.
How it works
Pilot Results
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:
- Inactive locations, which refer to sites of service where care providers were once seeing patients but are no longer doing so; and
- Address mismatches, which occur when health care organizations have differing addresses for the same care provider.
