Arizona Care Network in Phoenix is a physician-led and physician-governed accountable care organization that aims to improve care and reduce costs by actively managing care for its patients. Arizona Care Network is a partnership between Dignity Health Arizona and Abrazo Community Health Network and includes hundreds of independent providers. ACN also is affiliated with Phoenix Children’s Care Network.
The ACO and vendor Solve.Care are pilot testing blockchain technology.
“We deployed version 1.0 of the Arizona Care Network (ACN) Care Wallet to a representative selection of practices and providers that participate in our Medicare ACOs,” said Jamie Berger, executive director of operations at the Arizona Care Network and lead on the Care Wallet initiative. “They had been hearing about the tool for some time because our approach was to co-design, test, rollout, update.”
And when they were able to download the final blockchain app and they could view their own performance data and that of their practice members and compare to the network overall, Arizona Care Network demonstrated the technology’s value. They could see that this is an innovative, user-friendly way to help them deliver quality care at a lower total cost, Berger said.
“The rollout has been a success,” she said. “On their personal mobile devices, our providers can now see their own performance on ACN’s Provider Rewards Program – this is the way we focus providers on the metrics that we have found to drive quality and reduce cost to ensure our success in value-based arrangements.”
“On their personal mobile devices, our providers can now see their own performance on ACN’s Provider Rewards Program – this is the way we focus providers on the metrics that we have found to drive quality and reduce cost to ensure our success in value-based arrangements.”
Jamie Berger, Arizona Care Network and the Care Wallet initiative
Just five weeks after launch, the blockchain app is in use by nearly three-quarters of eligible practices. On October 15th, ACN distributed the first-ever deposit of Care.Coins digital currency during the pilot as part of the quarterly rewards it makes available for excellent clinical care and high patient satisfaction, direct to the wallet holder, which they can redeem for US dollars.
WHY IT MATTERS
The ACN Care Wallet was designed specifically for physicians so their input in its creation and involvement in refining the tool was an essential strategy to ensure they will use it. As they used the prototype and suggested improvements, ACN was able to respond with changes to meet their needs.
This involvement helped drive adoption, which is important for several reasons.
“First, the ACN Care Wallet displays actionable insights that allow providers to proactively deliver better care,” Berger explained. “Via blockchain technology, they can view their count of members that have clinical care gaps, plus results for in-network care coordination and patient satisfaction.”
Data may drive population health, but care is delivered one patient at a time, she said. For example, if a provider sees on their ACN Care Wallet performance card that 200 of their 1,000 Medicare patients have not had their annual wellness visit, they can go to ACN’s secure portal for a list of those patients and reach out to them to schedule the appointment.
“As they close those care gaps, blockchain technology allows us to update the information and credit the provider’s performance toward the Provider Rewards Program,” Berger said. “They can view how all metrics were calculated, current status and a trend-line of expected success in ACN’s Provider Rewards Program.”
Second, the Care Wallet for Physician is just the first step. ACN already is in production on a Care Wallet for use by patients, and for it to be successful, the providers and practices need to be acclimated to the tool first.
“So, getting it into the hands of our providers and having them understand its value to them as a way to see their clinical metrics with full transparency into their incentives was an essential first step,” Berger stated. “Then when we dropped financial rewards into the Care Wallet with instant access, it truly became real to them.”
In 2019, ACN will introduce the Care Wallet for patients. Payers that partner with ACN will give members access to a secure digital wallet on their personal devices, very similar to their phone’s digital wallet. Like an airline boarding pass, the data behind it has been verified through complex, back-end technology with rule sets that, for example, can confirm eligibility for the clinic, allow for coordination of scheduling, facilitation of travel needs, etc. – information that is verified in real time without having to make a call to the payer and wait for a response.
WHAT IS THE TREND?
Blockchain already is in use in agriculture and supply chain management as a way to share information through a secure, decentralized ledger. One can immediately see the benefit to an industry that also deals with private information that needs to be verifiable at multiple points in a customer’s journey.
“Our focus is to reduce the significant administrative burden on providers and improve the healthcare experience for patients,” Berger said. “There are some statistics that show physicians spend up to 70 percent of their daily time on administrative functions. When you’re spending that much time on administrative work you’re not spending your time communicating with and touching the patient.”
The current industry focus on patient experience, customer satisfaction and increasing efficiency in healthcare as a way to reduce costs have all opened doors to the application of blockchain technology, she added.
ON THE RECORD
“With healthcare quickly approaching 20 percent of GDP, we must make innovative changes quickly to bend the healthcare cost curve,” Berger said. “When you think about the claims payments systems that are in place today, it’s an incredibly expensive, resource-intensive, archaic system that’s been in place for 75 years.”
Blockchain has the ability to automate some of these activities, Berger contended. It doesn’t mean those legacy systems will go away overnight, but it does mean that there are some things that can be done on the blockchain at a much lower cost, and in a more secure and more timely manner, and still preserve confidentiality and security, she said.
“Let’s put our focus and energy toward technologies that add value to providers and patients alike, so clinicians can spend more time doing what they have been called to do – care for patients,” she concluded.