2023 10 19 Haris Kamal of Chronicled

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Details

Date: Thursday, October 19, 2023

Time: 10:30pm IST / 6:00pm CET / 5:00pm GMT / 12:00pm EST / 9:00am PST

Meeting link: https://zoom.us/my/hyperledger.community.backup?pwd=dkJKdHRlc3dNZEdKR1JYdW40R2pDUT09

Zoom Meeting ID: 622 333 6701 Passcode: 475869

Meeting Recording on YouTube

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Presentation

Haris Kamal of Chronicled: Financial transactions in life sciences: How blockchain revolutionizes the chargebacks and claims ecosystem

Chronicled started by looking for

Haris joined MediLedger because he saw the business case, he saw they were using blockchain in a way that made sense
In the US, more than $1 trillion annually spent on healthcare administration
There is a misalignment of data in supply chains
- Data has to align for transactions to take place.
- Data misalignment creates errors
Chargebacks managed by EDI (electronic data interchange)
- Used since 1970s
- Not real time
- Can take days-weeks for manual reconciliation
- MediLedger moves this to real time
MediLedger uses automation, standardized data, for a shared 'source of truth' - for pricing, drugs, etc.
- Developed through collaboration
- Built by-the-industry, for-the-industry
  - Wholesalers: McKessen, Cardinal Health, Amerisource Bergen - collectively control 90% of supply
  - Group purchasing organization, which facilitates lower prices for healthcare purchases
  - Manufacturers: Pfizer, Genentech, Zydus, Lily, Horizon, Gilead, Bayer, Novartis, Merck, AstraZenica, Amgen, others
  - Integrations: SAP, Model N, Restful APIs
  - Supported Data Sources: Premier, Vizient, Intalere
  - Industry participants raised the issue of chargebacks as being one of their biggest challenge (pain-point)
  - Effort for growing the network is focused on manufacturers
Chargebacks- similar to consumer rebates that required mailing in a receipt and coupon
- $90B in annual chargeback transactions
  - Involved Wholesalers, Group Buying Organizations (GPOs) & Buying Groups, Manufacturers
- 4% processing errors, due to manual processing
- >10 days processing time
- $4-10B in annual revenue leakage
Expectations:
- Eliminate manual effort to manage data - estimated $500M cost annually
- Eliminate disputes - est. 4% chargeback claims, 100k disputes daily
- Reduce revenue loss - $10B annual revenue leakage
  - No more aged write-offs
  - No more threshold write-offs
  - No more unapproved distributor deductions
  - No more ineligible customers for 340b programs
Blockchain
- Permission-based
- Uses Substrate, they expect info to be exchanged across different blockchains
- Looking for:
  - security,
  - rule-enforcement - no need for a person to validate claims,
  - trust - data and business rules can't be changed unilaterally by anyone
Current state:
- Manufacturers use a roster of who can buy off which contract, at which price
- GPO is source of truth of who is on membership list
- Everyone has identifier numbers, must be reviewed (price-of-trade determination)
- All info exchanges via EDI and emails
- Pricing changes, membership changes, other data changes - cause disputes
- Chargebacks also submitted by EDI message
  - If all data matches
Mediledger modules:
- Roster Management
- Contract communication
  - Moves info transfer from EDI to peer-to-peer info
  - Info immediately made available to wholesaler
- Claim adjudication
Network nodes exist for HIN, DEA, 340B orgs (different types of organizations)
- Network does data validation
  - Issues approval if data is correct.
  - Does not allow submission if data is missing or incorrect, sends message to customers/party entering data
Contract info communication is done through peer-to-peer network
MediLedger supports Contracting and Finance teams coming together
- Alignment w/trading partners
  - Share accurate info in real-time
    - Anchored around distributors
  - Verify eligibility w/external data points
  - Map identities between trading partners
- Automate transactions
  - Automatically executes inter-company busines rules
  - Ensures reception of valid data
  - Automate resubmissions
- Increase profitability
- Reduce float
- Increase rate of return
- Customers save $150M on average after deploying Mediledger
"Right application of blockchain to the right business case"
Working group still meets quarterly
- Took years to create a unified protocol
Network operates on a SAAS model
- Participants pay an annual fee
Chronicled recognizes that multiple other industries have challenges/pain-points around chargebacks and this platform could be adapted
- The industry they are considering moving into next is semiconductors.