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Analysis

Could Blockchain Improve Accuracy of Provider Directories?

By Gregory A. Freeman  
   May 02, 2018

"When they go to the provider they think is in-network and then weeks later they receive a bill for out-of-network services, you end up with effects that go beyond just the initial hit to the pocketbook of that consumer. The experience undermines the whole effort to promote value-based care and get people involved in that decision-making, because people talk to their friends and family about their bad experience," he says.

If the pilot is successful, using blockchain to address the provider directory may be just the first step, Pajak says. Once the insurers prove the concept with improved accuracy in the directory, the technology also could be used to address cost transparency, he says.

Healthcare is one of the few business transactions in which the consumer often does not know the actual cost of the service until afterward, Pajak notes, despite much lip service in recent years about improving transparency.

Efforts to improve transparency have been hampered by the same sort of data-gathering burden that results in incomplete and inaccurate provider directories, he notes.

"If you take the blockchain technology beyond the provider directory and address transparency, that's where you really have the potential to affect costs in the future," he says. "Having insurers collaborate like this to build a single ledger of providers is something that we could build on in the future and do greater things."

Gregory A. Freeman is a contributing writer for HealthLeaders.

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