Health News

New blockchain health consortium with Express Script, Blue Cross Blue Shield

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Yesterday another substantial healthcare blockchain consortium was unveiled in the U.S. called Coalesce Health Alliance. Express Scripts is joining several companies under the Blue Cross Blue Shield umbrella. The alliance plans to evaluate blockchain for exchanging healthcare data within the Blues’ ecosystem.

The Blue Cross Blue Shield Association (BCBS) is a federation of 36 separate U.S. health insurance organizations serving 106 million people. Coalesce includes the operators of three of the plans in Massachusetts, Michigan (BCBSM) and New Jersey (Horizon Healthcare Services) which will work with Express Scripts and NASCO, the health technology company owned by BCBS health plans.

Express Scripts is number 25 on the Fortune 500 list with a $100 billion turnover in 2016. It’s one of the largest pharmacies in the U.S., and one of the largest pharmacy benefit (insurance) claims managers. It was acquired by Cigna just over a year ago.

NASCO has been exploring blockchain with BCBS since 2018. It has already executed a successful pilot that aimed to address several issues. For example, there are problems identifying patients across BCBS entities, stale or incomplete data, and inconsistent data formats. The ultimate goal is to make the process more efficient and improve member experiences.

“As both a co-owner and customer of NASCO, we recognize the value of interoperability as a key pillar of our strategy,” said Bill Fandrich, Senior Vice President and CIO for BCBSM. “Our recent success leveraging blockchain, in partnership with several other Blue plans in the Coalesce Health Alliance, is one step in that journey.”

As a result of the pilot, other Blues plans are considering joining. HealthNow New York has joined the Coalesce Advisory Group.

There’s some membership overlap with the other big health consortia. Cigna, the owner of Express Scripts, joined an IBM blockchain consortium that includes three of the top five U.S. insurers. The other participants are PNC Bank, Aetna, Anthem and Health Care Service Corporation (HCSC). HCSC runs Blue Cross Blue Shield programs in five states serving 15 million people.

Aetna is also a member of the Synaptic Health Alliance which includes Humana and UnitedHealth Group.

And Change Healthcare, one of the largest clearinghouses for health insurance, is also running multiple blockchain projects.