Economic model for measuring the cost and value of a particular health insurance plan
AssigneeNcqa
InventorJames Bost
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AssigneeNcqa
InventorJames Bost
Estimating the term…
The present invention provides a system and method for measuring the relative economic benefits from services offered by health care plans. The present invention quantifies value of health care quality by indicating an economic return on the investment in health care quality, enabling organizations and businesses to view health care quality in a familiar paradigm that extends health plan differentiation beyond premium and benefits. Businesses may employ the present invention to compare different health care plans or classes of plans, such as accredited versus non-accredited plans. Specifically, a particular plan or class of plans may provide improved monitoring, treatment and control of various medical conditions, and the present invention quantifies the economic benefits to employers from the improved health care for employees. In one embodiment, the present invention looks to a set of specific medical conditions and is based on three key steps. First, the present invention identifies the overall level of employees at the organization affected by these conditions. Second, the present invention uses the reduction in absenteeism and low productivity days made possible by improved monitoring and control of the medical conditions. Third, the present invention calculates a monetary valuation to the firm of the reduction in absenteeism and low productivity days based on the firm's average revenue per employee, average daily wage, and other parameters.
Software for use by an organization having a number of members of differing ages, said software stored on a computer readable storage device containing instructions for causing a microprocessor to determine the amount of money an organization could expect to pay by selecting a particular health plan from a set of health plans (H0-Hj), and a total annual reduction in sick days and low productivity days for a medical condition, said instructions causing the microprocessor to perform the steps of:
Dependencies are inferred from the claim text.