Payment process, by
default, is very complicated in healthcare systems as it involves interplay of
many stakeholders, such as healthcare providers, hospitals, patients and
payers. As quoted by Warren
Buffet finding a best mode of payment is “tapeworm of the American economy and the
No. 1 problem of America and American business in context of USA. It comes down
to development of optimized process which reduces gaps in the monetary and human
resource expenditure. In the USA alone, frauds in healthcare payments account
to losses of around $30 million in 2016. Even more startling results have come from a 2014
NIH study by physicians and health policy makers at Harvard Medical School and
UCSF that in 2012 close to $375 billion were lost in medical billing and health
insurance related paperwork. It clearly showed extent of waste resulting from
the poorly optimized financing processes.1
Other resource wastage is high administration cost which is employed to do
patient related paper work which has very little pay off eventually.
Blockchain technology which is
a distributed ledger can potentially provide a robust framework to solve these
issues and save significant resources. Blockchain will automate the complex medical
claims procedure eliminating the needs of intermediaries, or duplicated
approval process. Automation will also reduce the administration cost
associated with document processing.
Gem Health, a company which
provides blockchain application services has teamed up with Capital One to
develop blockchain-based healthcare claims management solutions.2
Our interview panellists also
cites that introduction of blockchain in healthcare with enhance speed,
accuracy and safety of payment processes. Few points which are shared with us
As accurate patient data will
be available Real – Time, payment processing will be done very quickly.
All the stakeholders will
benefit from secure and faster payments which will lead to increased
productivity primarily by hospitals.
Currently, fraudulent activities
in insurance payment lead to higher premium to patients and greater scrutiny of
the documents given by the hospitals or labs. Blockchain will reduce the
fraudulent activity which may lead to reduction of premiums.
Blockchain will decrease
repeated transaction from insurance companies to bank (Hospital/ Patient
payment), it will lead to significant savings for insurance companies as less
bank transaction charges will be levied.