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Hyperledger > Case Studies > Change Healthcare using Hyperledger Fabric to improve claims lifecycle throughput and transparency
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Change Healthcare using Hyperledger Fabric to improve claims lifecycle throughput and transparency

Technology Category
  • Application Infrastructure & Middleware - Blockchain
  • Infrastructure as a Service (IaaS) - Cloud Computing
  • Networks & Connectivity - Network Management & Analysis Software
Applicable Industries
  • Healthcare & Hospitals
Applicable Functions
  • Business Operation
  • Procurement
Use Cases
  • Cybersecurity
  • Process Control & Optimization
  • Track & Trace of Assets
Services
  • Software Design & Engineering Services
  • System Integration
The Challenge
Change Healthcare, one of the largest independent healthcare technology companies in the United States, operates one of the largest healthcare networks in the country, linking 900,000 doctors and 5,500 hospitals to 2,200 payers. In 2017/18, the network handled nearly 14 billion healthcare transactions and claims worth $1 trillion. However, the American healthcare system, which Change Healthcare is a part of, is plagued by inefficiency, fraud, and waste. Patients, providers, and payers seldom see complete, up-to-date healthcare records. Incompatible file formats, data silos, and privacy concerns all hamper the free flow of information. Consulting firm McKinsey estimates that U.S. healthcare could save up to $450 billion a year by using updated processes and technology. Change Healthcare wanted to play a leading role in this transformation, by extending its Intelligent Healthcare Network with blockchain technology to provide a faster, better experience for all.
About The Customer
Change Healthcare is one of the largest independent healthcare technology companies in the United States. The company provides software and analytics, network solutions, and technology-enabled services that help customers obtain actionable insights, exchange mission-critical information, control costs, optimize revenue opportunities, increase cash flow, and effectively navigate the shift to value-based healthcare. The company operates one the largest healthcare networks in the country, linking 900,000 doctors and 5,500 hospitals to 2,200 payers. In 2017/18, the network handled nearly 14 billion healthcare transactions and claims worth $1 trillion. Change Healthcare is a key catalyst of a value-based healthcare system – working alongside our customers and partners to accelerate the journey toward improved lives and healthier communities.
The Solution
Change Healthcare decided to test a blockchain, Hyperledger Fabric, to see if it could help improve the efficiency of the healthcare system. The company started with an existing network linking providers to payers and wanted to model their existing system with a blockchain and then see if it could stand up to real-world traffic. The new system makes all claims transparent to authorized users via APIs. This enables a hospital administrator, for example, to view the real-time status and remittance of all the hospital’s claims as they move through the system. Every transaction of the claim’s lifecycle, including any changes to a claim, are all securely recorded on the blockchain along with who made them when. The blockchain network is designed to underpin revenue cycle management software and is currently integrated with the Assurance Reimbursement Management™1 claims submission solution for healthcare providers.
Operational Impact
  • The blockchain-enabled network has been running in parallel with the company’s traditional system in an extensive field test since January 2018.
  • The blockchain initially ran on six nodes in the company’s data center in King of Prussia, PA and the team is exploring moving it to run in the cloud.
  • The new system makes all claims transparent to authorized users via APIs, enabling a hospital administrator, for example, to view the real-time status and remittance of all the hospital’s claims as they move through the system.
Quantitative Benefit
  • The test network demonstrated the ability to process up to 50 million transactions a day—with throughput up to 550 transactions a second.
  • That’s enough capacity to handle all claims activity that occurs on the Change Healthcare Intelligent Healthcare Network.

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