The level of uncertainty around what a patient owes—a problem that doesn’t exist in the retail world—has plagued the healthcare industry for decades. Because of the complexities in healthcare coverage, traditional eligibility transactions (270/271) are limited in their ability to support consensus, full transparency, and the real-time exchange of information between entities.
Up until recently, however, it was the best option we had. It’s no wonder patients have been reluctant to pay up front, preferring to wait until they see what their health plan will pay.
This well-documented problem leads to excessive billing and collection costs as well as disproportionate bad debt expenses in healthcare.
But that’s just the tip of the iceberg. Inaccurate or incomplete information can lead to long delays in reconciliation. Imagine the patient who has finally healed from the medical procedure and has gotten on with life, only to receive an unexpected bill for something that should have been resolved months prior—something they thought had been resolved. Billing issues such as these can completely negate a positive clinical experience when it comes to patient satisfaction.
This is just one example of how our industry’s lack of administrative interoperability impacts the patient experience. Fortunately, it’s one of the problems that can be solved with a decentralized, peer-to-peer network. Multiple stakeholders can provide secure access to the data needed to create the full view of eligibility and coverage. In effect, everyone—payers, providers, and patients alike—can have timely access to accurate, complete patient data, even before a patient presents for care.
This is the topic of this month’s newsletter—how administrative interoperability, or today’s lack thereof, impacts the patient and how a decentralized, peer-to-peer network can help solve this problem and many others.
You’ll want to read until the end to learn more about the origin of Avaneer Health.
Stuart Hanson
CEO, Avaneer Health
In This Issue
- How a Decentralized Network Accelerates the Business of Healthcare and Creates Better Care Experiences
- Blockchain Allows Data to be Decentralized [Podcast]
- Unlocking interoperability for digital transformation
- Q&A with CIO Donna Roach on what’s stalling healthcare data-sharing
- Industry Voices—Can care at home succeed in the long term? Not without interoperability
- What’s the Origin of Avaneer Health?
Featured Content
How a Decentralized Network Accelerates the Business of Healthcare and Creates Better Care Experiences
Becker’s Hospital Review
All major stakeholders in the healthcare industry—payers, providers, vendors and patients—benefit when we prioritize data fluidity to reduce costs and improve processes, productivity and, ultimately, patient care. The most effective way to achieve a more efficient data exchange is through a decentralized network that connects all stakeholders safely and securely for permissioned, timely access that’s needed.
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Blockchain Allows Data to be Decentralized [Podcast]
cdo magazine
Healthcare is at an inflection point, and blockchain is at the center. The healthcare sector as a whole is better positioned than ever before to leverage blockchain as a way to solve for problems that have existed for decades and that we previously thought were unsolvable. At its core, blockchain can provide a safe, immutable agreement system that enables multiple entities to work together without opening themselves up to risk, to remove redundant, manual processes and drive a better patient care experience.
Listen to the Podcast
Industry Insights
Unlocking interoperability for digital transformation
MedCity News
Healthcare organizations need to find ways to build trust and enhance “coopetition.” Blockchain has the capacity to change that mindset while providing security, transparency, and mutual benefits for all stakeholders. “When payers and providers work together to create joint processes and execute on a shared network, inefficiencies can be eliminated.” It also enables organizations to achieve their business goals while improving the patient experience.
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Q&A with CIO Donna Roach on what’s stalling healthcare data-sharing
Becker’s Health IT
The lack of interoperability between health systems is a problem we’re all aware of. Cost of care goes up while quality of care goes down. Even sharing data within a single enterprise can be challenging. While things are changing and most entities understand the need to embrace interoperability, there are still several barriers to moving the needle forward.
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Industry Voices—Can care at home succeed in the long term? Not without interoperability
Fierce Healthcare
As more care moves into the home, the need for interoperability increases. At-home platforms, hospital EHRs, wearable devices, and at-home health monitoring technology all need ways to connect. While a single platform, a single solution will advance at-home care, a decentralized network could connect all stakeholders in care.
From the Avaneer Blog
What’s the Origin of Avaneer Health?
Read about how the company started and its vision
Starting from a conversation between heavy-hitters in healthcare, then building momentum as organizations that usually compete saw the value of collaboration – the origin of Avaneer Health is unique, and its potential is significant. With participation from some of the most innovative providers and payers with wide reach, Avaneer Health’s story and vision is outlined in this blog.
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