Healthcare insurance companies Aetna, Anthem, HCSC, and non-profit healthcare organizations Sentara Healthcare and Cleveland Clinic have invested in and launched a member-based utility network venture alongside IBM and PNC Financial Services. The venture, Avaneer Health, aims to eliminate inefficiencies in the American healthcare system through blockchain solutions.
The insurance companies, IBM, and PNC had previously formed the Healthy Utility Network looking to drive digital transformation in the healthcare industry. The consortium’s initial projects included claims and payment processing, health data exchanges, and provider directories. Avaneer Health is an extension of the consortium.
For those not familiar with the US healthcare system, the central role of health insurance creates a significant amount of bureaucracy that blockchain can help address.
One example is provider directories. Insurers will only make payouts to approved medical clinics and hospitals and need to keep up-to-date provider directories. It’s not just a matter of approving a clinic. They have to have a list of current staff, the licenses and qualifications and any changes. This involves sharing dynamic data between organizations, something for which blockchain is particularly useful.
Another example is checking eligibility. When a patient plans to have a procedure, they have to be sure that their insurer will cover the costs. For minor things, it’s not unusual for the health provider to massage the ‘code’ used for the procedure into one they know will be approved by the insurer. That approval process can take a week or two. But automation that uses blockchain can speed it up.
Avaneer Health may address these matters, although official announcements and demonstrations will only be revealed at the 2021 HIMSS Global Health Conference & Exhibition in August.
The board of directors has appointed Stuart Hanson as Avaneer’s CEO. Hanson joins the venture from a position at JPMorgan as a senior healthcare industry executive where he was involved in the healthcare payments business. He has also previously worked at Change Healthcare, which was awarded the 2019 North American Enabling Technology Leadership Award for its blockchain-based healthcare billing and claims solution.
“This utility network will provide the answers needed to deliver outstanding care and service to people, which today are opaque and in latent silos,” said Sentara Healthcare VP Tim Skeen. “Avaneer Health has the potential to change every aspect of the healthcare experience.”
Meanwhile, Aetna is also part of the Synaptic Health Alliance consortium alongside insurers Humana and UnitedHealth Group, which was working on a blockchain-based provider directory back in 2018. Another healthcare consortium that includes Blue Cross is Coalesce Health Alliance, launched in 2019 to explore healthcare data exchange through blockchain.