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Analysis

Could Blockchain Improve Accuracy of Provider Directories?

By Gregory A. Freeman  
   May 02, 2018

The blockchain technology will enable all five organizations of the alliance to obtain the provider information at the same time. The companies have not released details of how they will implement the technology.

"I wish we had more intel on exactly what they're going to do, but I think they're still pulling all of this together," Pajak says. "The fact that they're using blockchain is innovative and intriguing, and now we have to wait and see exactly what they're doing with it."

Errors frustrate consumers, increase costs

The alliance is an offshoot of the pressure health plans are experiencing to provide better value and less cost, Pajak says.

One of the headaches consumers face is inaccurate information about which doctors are covered in their network, which can lead to surprise medical bills and being locked into plans they otherwise wouldn't have chosen, Pajak says.

"Provider directories have not been accurate in recent years and that means it has been somewhat misleading to consumers when they were picking their plans in open enrollment. Some people choose their plan based largely on whether their particular physician is in that network, and by the time they find out the directory was inaccurate, they're stuck in that plan for the rest of the year," he explains.

"The same problem occurs once you're in the plan and you need to see a specialist, for instance, and you consult the online directory to determine who you see. The information in the online directory often is incorrect and that leads to consumer frustration, added expense, and sometimes compromises quality of care if people are discouraged from seeking the care they need," Pajak says.

Consumer engagement at stake

The blockchain pilot could lead to cost savings for the participating organizations, as well as employers, by making it possible for consumers to make more informed decisions about their healthcare.

They can't do that without accurate directories, Pajak notes.

"For consumers who are trying to do the right thing and follow this advice from their health plans and their employers, their expectation is that the data is accurate," he says.

Gregory A. Freeman is a contributing writer for HealthLeaders.

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