Decentralized Healthcare Practical Use Case: Bundled Payments

By: Jake Dreier & David Akers

With our first product, ConnectingCare, we address bringing transparency to healthcare by giving healthcare professionals the ability to monitor a shared patient’s care across multiple healthcare facilities of different clinical associations. This care coordination is driven by the move in healthcare towards Value Based Care. If you want a refresher on Value Based Care, please check out my previous series which explained this in fairy tale style format here.

Bundled payments are a subset of this overall trend and are fascinating because they are at the forefront of where healthcare is heading and serve as a great use case for blockchain technology.

Bundled Payments

So what are bundled payments? Bundled payments pull together all of the healthcare needs around a specific healthcare episode and create a cap for what the cost of that episode should be. An episode could be knee replacement, spine surgery, or a pregnancy.

Bundling the payments for the entire episode means that many different providers have to work together and coordinate care for the best patient outcomes. This means they need to share the same data of their shared patient. In our product ConnectingCare, the blockchain is used to create an immutable audit trail. The immutable audit trail is important because it allows providers to prove they worked together.

With the Health Nexus protocol, healthcare providers coordinating the care of shared patients will be able to securely share care data using the protocol’s key-pair system.

Health Nexus and Bundled Payments

In bundled payments there are both retrospective payments, where total cost of care is adjusted once all of the claims data is available and then fee-for-service payments are made based on those adjustments, and prospective payments, where the cost of the entire episode is paid once, and distribution happens by the entity such as a hospital or physician group.

Step back and think about the purpose claims data actually serves: it is a way to collect data in order to make decisions around current and future reimbursements. Blockchain offers a way to not only get that data more quickly, but can also to tie the actual payment to smart contracts on the blockchain in near real time.

These two payment models, the care program coordination and compliance, and the outcome of care can be can be represented on the blockchain in the form of smart-contracts that are updated collectively by the multiple care providers a patient sees over the course of a single episode.

Using Health Nexus, care providers can create an immutable audit trail of care activity and demonstrate care in compliance with standards known to achieve best patient outcomes. A decentralized application created for bundled payments can expedite payer engagement in the care process and automate much of the process that with today’s technology is timely and manual.

The convergence of Healthcare and Technology

While healthcare is moving towards Value Based Care, the world of technology is rapidly exploring decentralized technology and how it can be applied to great effect in many different industries. Health Nexus stands apart as a new HIPAA-compatible blockchain protocol with its singular focus on meeting and exceeding healthcare regulation.

There are many things that set Health Nexus apart and make it the best choice for healthcare dapps but the future of healthcare technology belongs to those digital health companies that will create the healthcare dapps that will move the healthcare industry towards decentralized Value Based Care.

For more information about Health Nexus checkout our other articles or visit our token sale site. If you have questions about Health Nexus checkout our whitepaper or find us in our telegram group.

About SimplyVital Health:

SimplyVital Health is making decentralized technology accessible to the healthcare industry by creating Health Nexus, a healthcare-grade blockchain and paired data storage. Their principal application, ConnectingCare, augments existing hospital care systems to extract data and create care pathway flexibility, prospectively track financials, maintain immutable records, and accurately monitor analytics.