Healthcare Insurers Looking to Blockchain to Track Provider Information


The United States’ health insurance industry is a bonafide mess. Two major healthcare insurers, however, are looking to blockchain technology to help clean up inaccurate provider lists.

An Emergency Situation

American for-profit healthcare companies UnitedHealth Group and Humana are initiating a pilot program to examine whether or not blockchain technology — the underlying technology behind Bitcoin — can help track provider information.

Healthcare insurers look to blockchain

As noted by CNBC, the ability to find an in-network doctor approved by one’s health plan is crucial, as such a feat can significantly cut down on medical bills. However, provider lists are rarely kept up to date, adding additional costs not only to the patient but also to insurers and contracted doctors. Explained Mike Jacobs of UnitedHealth Group’s Optum Division:

From the perspective of the provider organizations … [they] can work with up to dozens of insurance plans, and each of the plans are individually requesting or verifying the provider information.

CNBC also notes that “the administrative costs of updating and tracking down that information are estimated to be more than $2 billion dollars a year for the health-care industry.”

Healthcare insurers look to blockchain

Nevertheless, inaccurate provider contact information was found on almost one-half of all provider listings for Medicare Advantage plans — an issue that is arguably inexcusable. Claims Jacobs:

That’s such a large issue that it’s really affecting access to care for many patients.

Blockchain to the Rescue

UnitedHealth Group and Humana – rivals in the Medicare space – are looking to potentially cure inaccurate provider lists with some proverbial blockchain medicine.

The two major health insurers are initiating a pilot program to study the positive potential of applying blockchain technology’s decentralized ledgers to what is currently an unorganized mess of incorrect information. (Spoiler alert: blockchain technology will probably be beneficial.)

Both companies will also include Quest Diagnostics and Multiplan in their pilot program.

It’s worth mentioning that the companies’ pilot program is not necessarily one aimed at providing a solution for patients. As noted by CNBC, the insurers are most likely looking to prevent potential fines from the Centers for Medicare and Medicaid Services (CMS), which is considering penalizing insurers upwards of $25,000 per day for featuring provider lists with incorrect information.

Do you think the blockchain can help clean up provider lists? Are there any other aspects of the United States’ messy health insurance system which could be cleaned up with Bitcoin’s underlying technology? Let us know in the comments below!

Images courtesy of Shutterstock and Pixabay.

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Written by Adam James @ April 4, 2018 Adam James

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