System and method for evidence based differential analysis and incentives based healthcare policy

A system for determining lifetime healthcare expenditures for an illness among a plurality of illnesses based on body mass index, comprising:

• a memory of a computing system configured to store aggregate health profiles for a plurality of individuals, wherein the aggregate health profile of an individual among the plurality of individuals includes at least the body mass index, the age, and the personal health record of the individual, wherein the plurality of individuals includes at least a first subset of individuals associated with an illness, a second subset of individuals not associated with the illness, a third subset of individuals associated with a second illness, and a fourth subset of individuals not associated with the second illness;
• a receiving device of the computing system configured to receive a request to estimate a future lifetime healthcare expenditure, wherein the request includes at least a plurality of body mass indexes for which an estimated future lifetime healthcare expenditure for an individual of interest is requested;
• and
• a processor of the computing system configured to
• calculate an estimated future lifetime healthcare expenditure for one of the plurality of body mass indexes for the individual of interest, wherein calculating the estimated future lifetime healthcare expenditure includes
• identifying one or more interactions including at least an interaction between the illness and body mass index of the individual of interest and an interaction between the illness and age of the individual of interest based on the aggregate health profile for the first subset of individuals associated with the illness,
• predicting a lifetime healthcare expenditure for the individual of interest using a linear regression model based on at least the identified interactions and a total predicted expenditure associated with the illness for the individual of interest,
• predicting a probability of a lifetime healthcare expenditure for the individual of interest using a logistic regression model based on at least the identified interactions,
• predicting the estimated future lifetime healthcare incurred expenditure by multiplying the predicted probability of an expenditure with the predicted expenditure, and
• repeating the calculating of the estimated future lifetime healthcare expenditure for the individual of interest for all illnesses of the plurality of illnesses and for each of the plurality of body mass indexes for the individual of interest,
• wherein the receiving device of the computing system is further configured to receive a cost variance request from an entity external to the computing system, wherein the cost variance request includes at least a first body mass index of the plurality of body mass indexes and a second body mass index of the plurality of body mass indexes for the individual of interest associated with the illness,
• wherein the processor of the computing system is further configured to calculate a cost variance based on the calculated estimated future lifetime healthcare expenditure for the first body mass index for the individual of interest associated with the illness and the calculated estimated future lifetime healthcare expenditure for the second body mass index for the individual of interest associated with the illness, and
• wherein the transmitting device of the computing system is further configured to transmit the calculated cost variance to the entity external to the computing system.

A system for determining lifetime healthcare expenditures for an individual of interest without an illness among a plurality of illnesses based on body mass index, comprising:

• a memory of a computing system configured to store aggregate health profiles for a plurality of individuals, wherein the aggregate health profile of an individual among the plurality of individuals includes at least the body mass index, the age, and the personal health record of the individual, wherein the plurality of individuals includes at least a first subset of individuals associated with an illness, a second subset of individuals not associated with without the illness, a third subset of individuals associated with a second illness, and a fourth subset of individuals not associated with the second illness;
• a receiving device of the computing system configured to receive a request to estimate a future lifetime healthcare expenditure, wherein the request includes at least a plurality of body mass indexes for which an estimated future lifetime healthcare expenditure for the individual of interest is requested;
• and
• a processor of the computing system configured to
• calculate an estimated future lifetime healthcare expenditure for one of the plurality of body mass indexes for the individual of interest, wherein calculating the estimated future lifetime healthcare expenditure includes
• identifying one or more interactions, the one or more interactions including at least an interaction that relates not having the illness to the body mass index of the individual of interest and an interaction that relates not having the illness to the age of the individual of interest based on the aggregate health profile for the second subset of individuals,
• predicting a lifetime healthcare expenditure for the individual of interest using a linear regression model based on at least the identified interactions and a total predicted expenditure without the illness for the individual of interest,
• predicting a probability of an expenditure for the individual of interest using a logistic regression model based on at least the identified interactions,
• predicting the estimated incurred expenditure by multiplying the predicted probability of an expenditure with the predicted expenditure, and
• repeating the predicting of the estimated future lifetime healthcare expenditure for the individual of interest for all illnesses of the plurality of illnesses and for each of the plurality of body mass indexes for the individual of interest;
• wherein the receiving device of the computing system is further configured to receive a cost variance request from an entity external to the computing system, wherein the cost variance request includes at least a first body mass index of the plurality of body mass indexes and a second body mass index of the plurality of body mass indexes for the individual of interest without the illness,
• wherein the processor of the computing system is further configured to calculate a cost variance based on the calculated estimated future lifetime healthcare expenditure for the first body mass index for the individual of interest without the illness and the calculated estimated lifetime healthcare incurred expenditure for the second body mass index for the individual of interest without the illness, and
• wherein the transmitting device of the computing system is further configured to transmit the calculated cost variance to the entity external to the computing system.