NASCO : Demystifying the Management of Healthcare Finances

David Weeks, SVP and Chief Digital and Technology Officer
Today, the infrastructure leveraged by the U.S. healthcare sector is a very complex, integrated network ecosystem where all the relevant parties, including physicians, patients, and insurance companies, manage and share critical health and financial information amongst each other. However, due to the siloed and batch-oriented approach opted by the healthcare organizations, the end-user experience offered by this network becomes opaque and highly cumbersome. Particularly in healthcare finances, this inefficient user experience and lack of real-time information updates are pressurizing the healthcare space to seek out a more seamless experience that offers significant mobility and efficiency boosts.

As an antidote to this problem, Georgia-based NASCO is leading a multiorganizational consortium of health plans and their partners, Coalesce Health Alliance, that has developed a blockchain ledger-based solution with secure open APIs to track and manage all healthcare deductibles, thereby helping patients gain the benefits of a real-time information system. "We recognized the value of having a real-time ledger-based solution, and with Coalesce’s AccumXChain solution, we offer a single source of truth for all the financial accumulators of a health payer," says David Weeks, senior vice president and chief digital and technology officer at NASCO.

Founded in 1987, NASCO is a community of leading health plans, visionary technology providers, and experts in the healthcare arena that builds digital health solutions for Blue Cross and Blue Shield organizations. And with its consortium of several blue-centric companies, the company's Coalesce Health Alliance connects four of the largest Blue-centric payers, two pharmacy benefit managers (PBMs), and other healthcare organizations. NASCO spent 18 months testing the alpha and beta iterations of Coalesce's ‘AccumXChain’ blockchain ledger and secure open-source API capabilities and went into final production earlier this year. "We developed Coalesce in conjunction with our partner Blue-centric firms to assess the prevalent challenges faced by physicians, payers, and patients alike, and break down the walls of healthcare information inefficiency," explains Weeks.
Coalesce’s AccumXChain solution helps health payers (including PBMs, dental and vision claims, and others) by offering them a standard set of eight to 10 APIs that they can use to reading and updating information on the ledger. As soon as the payers connect their systems to AccumXChain’s APIs, they gain the ability to operate in real-time, which eliminates instances of out-of-sync balances that are prevalent in the existing manual and batch-oriented reconciliation processes. Simultaneously, AccumXChain’s real-time information updates also boost the efficiency of audit processes and minimize the need for re-entering information, saving a significant amount of time and resources. Alternatively, AccumXChain helps patients seamlessly gain information on the best prices for their desired medication and update their out-of-pocket prescription expenditures onto the ledger. "AccumXChain can help improve patient satisfaction by bypassing the need to contact insurance plan service centers and enhancing the overall transparency of their interactions with health insurance companies and medical practitioners," adds Weeks.

Currently, Coalesce is performing end-to-end testing on AccumXChain with its partners and aiming for a fully-tested solution to be ready in the upcoming months. The consortium plans to have some of its insurance partners use AccumXChain’s capabilities in 2021 with a goal to have larger healthcare insurers utilize the solution by early 2022. From a feature's standpoint, the Coalesce Health Alliance is continually developing additional features to incorporate into AccumXChain and exponentially expand its clients' value. Additionally, the consortium is also adding consulting capabilities to support its users in gaining the most benefits from AccumXChain’s implementation. "With Coalesce, our goal is to provide a single place for our clients to connect to many of their health insurance transactions, and help them gain the ability to adapt, integrate, and scale their operations, offering more benefits to their patients," concludes Weeks

Company
NASCO

Headquarters
Atlanta, GA

Management
David Weeks, SVP and Chief Digital and Technology Officer

Description
Provides a blockchain ledger-based solution with secure open APIs to track and manage all healthcare deductibles, and aid patients gain the benefits of a real-time healthcare information system