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System and method for administering health care cost reduction

  • US 20050222867A1
  • Filed: 03/31/2004
  • Published: 10/06/2005
  • Est. Priority Date: 03/31/2004
  • Status: Active Grant
First Claim
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1. A method for administering reductions in health care costs for those participants in a health insurance plan for whom future health care costs may be reduced through intervention (“

  • intervention candidates”

    ) comprising;

    determining a first score for an intervention candidate, which first score reflects the predicted utilization of future health care services;

    determining a second score for the intervention candidate, which second score depends on the intervention candidate'"'"'s prior consumption of a plurality of predetermined health care services;

    comparing the first score against a first threshold value and the second score against a second threshold value and generating a result of such comparison;

    providing to select individuals access to the health care history of the intervention candidate and the result of the comparison; and

    intervening in the health care regimen of the intervention candidate depending on the result of the comparison.

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