Computer system and method for generating healthcare risk indices using medication compliance information

A method for generating a risk index for an individual using said individual's pharmacy claims, said method comprising the steps of:

• (1) generating a raw risk index indicative of at least one of said individual's medical costs, acute medical conditions, and variation in medical costs, by using said pharmacy claims;
• and
• (2) modifying said raw risk index in accordance with a compliance medication score indicative of said individual's compliance with prescribed pharmaceuticals, to thereby generate said risk index.

A method for generating a risk index for an individual using said individual's pharmacy claims, said method comprising the steps of:

• (1) generating a raw risk index indicative of at least one of said individual's medical costs, acute medical conditions, and variation in medical costs, by using said pharmacy claims;
• and
• (2) modifying said raw risk index in accordance with a no-claims weight indicative of an absence of claims in said individual's pharmacy claims, to thereby generate said risk index.

A system for generating a risk index for an individual using said individual's pharmacy claims, said system comprising:

• means for generating a raw risk index indicative of at least one of said individual's medical costs, acute medical conditions, and variation in medical costs, by using said pharmacy claims;
• and
• means for modifying said raw risk index in accordance with a compliance medication score indicative of said individual's compliance with prescribed pharmaceuticals, to thereby generate said risk index.

A system for generating a risk index for an individual using said individual's pharmacy claims, said system comprising:

• means for generating a raw risk index indicative of at least one of said individual's medical costs, acute medical conditions, and variation in medical costs, by using said pharmacy claims;
• and
• means for modifying said raw risk index in accordance with a no-claims weight indicative of an absence of claims in said individual's pharmacy claims, to thereby generate said risk index.

A computer readable medium for use in generating a risk index for an individual using said individual's pharmacy claims, said computer readable medium comprising:

• computer readable instructions for generating a raw risk index indicative of at least one of said individual's medical costs, acute medical conditions, and variation in medical costs, by using said pharmacy claims;
• and
• computer readable instructions for modifying said raw risk index in accordance with a compliance medication score indicative of said individual's compliance with prescribed pharmaceuticals, to thereby generate said risk index.

A computer readable medium for use in generating a risk index for an individual using said individual's pharmacy claims, said computer readable medium comprising:

• computer readable instructions for generating a raw risk index indicative of at least one of said individual's medical costs, acute medical conditions, and variation in medical costs, by using said pharmacy claims;
• and
• computer readable instructions for modifying said raw risk index in accordance with a no-claims weight indicative of an absence of claims in said individual's pharmacy claims, to thereby generate said risk index.

A method for generating a risk index for an individual using said individual's medical information, said method comprising the steps of:

• (1) generating a raw risk index indicative of at least one of said individual's medical costs, acute medical conditions, and variation in medical costs, by using said medical information;
• and
• (2) modifying said raw risk index in accordance with a compliance medication score indicative of said individual's compliance with prescribed pharmaceuticals, to thereby generate said risk index.

A method for generating a risk index for an individual using said individual's medical information, said method comprising the steps of:

• (1) generating a raw risk index indicative of at least one of said individual's medical costs, acute medical conditions, and variation in medical costs, by using said medical information;
• and
• (2) modifying said raw risk index in accordance with a no-claims weight indicative of an absence of claims in said individual's medical claims information, to thereby generate said risk index.