The platform transforms claims lifecycle management by combining various internal business processes into a single, shared, and scalable network
Based on its recent analysis of the North American blockchain technology market for healthcare billing and claims adjudication, Frost & Sullivan recognizes Change Healthcare with the 2019 North American Enabling Technology Leadership Award. The Intelligent Healthcare Network™ with Blockchain technology can help expedite claims processing while lowering administrative costs for the healthcare industry. Helping to enhance communication and data exchange across the medical claims management lifecycle, the technology will streamline and track interactions and events accurately and helps to relay information reliably to all stakeholders in the shortest time possible.
“Change Healthcare pioneered the implementation of enterprise-scale blockchain technology in healthcare with the Intelligent Healthcare Network. Beyond driving next-level healthcare IT innovation, the company serves as a clearinghouse for insurance claims by having both healthcare providers and insurers as clients,” said Kamaljit Behera, Industry Analyst. “In 2018, it commercially deployed the first enterprise-scale blockchain network for healthcare. The network, designed to improve claims lifecycle management, exhibits industry-leading transparency, process integrity, and efficiency for better auditability and traceability around the claims management process.”
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Change Healthcare used Hyperledger Fabric 1.0 open-source blockchain architecture of the Linux Foundation as the foundation for its blockchain application design and development. The network was deployed on scalable Amazon web-based cloud services; this is significant since Change Healthcare processes 14 billion healthcare transactions per year. The system can be capable of processing more than 50 million claim events per day and up to 550 transactions per second. It can also streamline network communications, create crowd-managed policies, automate audits and reporting, and enforce security measures for enhanced revenue cycle management (RCM). For B2B clinical data exchanges, its blockchain could instantly validate data asset integrity, develop a global data-sharing repository, and automate data and events exchange.
Change Healthcare will apply distributed ledger technology (DLT) to connect stakeholders in the medical billing process to communicate and collaborate seamlessly. Its vision is to improve provider liquidity through real-time exchange and unified information sets, seeking to decrease billing and insurance-related (BIR) costs. For example, while traditional insurance eligibility checks span 7 to 14 days, a blockchain-enabled smart contract can reduce the response time to minutes for routine medical checks like mammograms. Speedy claims authorization accelerates payment disbursement, allowing hospitals and clinics to collect payment immediately at the point of care the very same day.
“Despite blockchain technology’s nascence in the healthcare space, Change Healthcare’s early success could have the potential to disrupt the current claims lifecycle management market,” noted Behera. “Besides, the company’s move to further integrate blockchain with RCM, clinical data exchange, and patient and caregiver engagement use-cases can enhance market adoption and endow it with a unique competitive advantage.”
Each year, Frost & Sullivan presents this award to a company that has developed a pioneering technology that not only enhances current products, but also enables the development of new products and applications. The award recognizes the high market acceptance potential of the recipient’s technology.
Frost & Sullivan Best Practices awards recognize companies in a variety of regional and global markets for demonstrating outstanding achievement and superior performance in areas such as leadership, technological innovation, customer service, and strategic product development. Industry analysts compare market participants and measure performance through in-depth interviews, analysis, and extensive secondary research to identify best practices in the industry.
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