The future of value-based care is on the blockchain

Since the Affordable Care Act was passed in 2010, we continue to hear more and more about value-based care. Even with all the uncertainty surrounding the Affordable Care Act with the current administration, there remains a movement toward this model that incentivizes providers for the value of care they deliver, the outcomes, as opposed to the number of procedures done or patients seen. The US spent ~18% of the country’s GDP on healthcare in 2017 with fee-for-service models being partly to blame.[1] The movement to value-based models has become a mindset of quality over quantity, and it is changing the structure of reimbursement in health systems and physician offices throughout the country. Aetna defines value-based as the right treatment at the right place at the right time.[2] Dr. Donald Berwick, former CMS administrator, used the term “Triple Aim” in relation to value-based care, referring to: reducing the cost of healthcare, enhancing the patient experience, and improving population health.[3]

Value-based care is driving improvements by demanding better care at lower cost. With stricter and increasing quality measures, providers and health systems that can’t achieve the required scores face financial penalties and lower reimbursement that create significant financial burden. It is anticipated that the transition from fee-for-service models to value-based reimbursement will take time. Health Catalyst’s Bobbi Brown and Jared Crapo even contemplate a time when total revenue will likely decrease because the pressure on a hospital’s fee-for-service revenue will increase faster than it can grow through value-based reimbursement. They note that one of the primary keys to transitioning is improving operating costs to delivering care more efficiently.[4]

CMS Administrator Seema Verma said, “…we will not achieve value-based care until we put the patient at the center of our healthcare system. Until patients can make their own decisions based on quality and value, health care costs will continue to grow at an unsustainable rate.” CMS announced their MyHealthEData Initiative led by White House Office of American Innovation in March 2018, giving patients access and more control to share their data. “CMS will be promoting the use of application programming interfaces (APIs) and other emerging tools and standards to expand interoperability and data sharing in service of patient empowerment and clinical value”, but they won’t be using blockchain.[5]

Teledactyl Blockchain, LLC is developing a Personal Health Record (PHR) blockchain platform with an option for an alternative method of payment through the teledactyl token and an innovative expansion of telemedicine. Teledactyl gives the patient direct control over his or her own information and the ability to share with providers across offices and health systems, improving care coordination, reducing waste in unnecessary or repetitive treatment, and restoring the patient provider relationship. It is a decentralized, secure, platform that allows for immutable transmission between patients and providers in the office or by bringing treatment to the patient virtually. Teledactyl also focuses on provider needs, not billing like systems used today. The metadata attached to each transaction provides healthcare providers with access to a patient’s entire history in one location, allowing them to make informed treatment decisions and reducing errors while improving the quality of care outcomes. Providers can have more control over their fees using teledactyl tokens, increasing adoption of shared savings models or bundled payments and changing current volume-based models to a patient-focused model.

Teledactyl will become synonymous with value-based care as the essence of Teledactyl is its ecosystem, providing more value in care per token than dollars. Patients are empowered to take control of their medical decisions. Providers are enabled to make informed treatment decisions, focusing on the patient as opposed to administrative obstacles. Value-based care is the goal because health is the ultimate goal.