Intelligent Health Benefit Design System

• US 20080147441A1
• Filed: 02/27/2007
• Published: 06/19/2008
• Est. Priority Date: 12/19/2006
• Status: Active Grant

• Current Assignee: Accenture Global Services Limited (Accenture PLC)
• Original Assignee: Accenture Global Services GmbH (Accenture PLC)
• Inventors: Kil, David H.
• Granted Patent: US 7,912,734 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 20/00 ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Apparatuses, computer media, and methods for supporting health needs of a consumer by processing input data. An integrated health management platform supports the management of healthcare by obtaining multi-dimensional input data for a consumer, determining a health-trajectory predictor from the multi-dimensional input data, identifying a target of opportunity for the consumer in accordance with the health-trajectory predictor, and offering the target of opportunity for the consumer. A health benefit plan is offered from a set of health benefit plan configurations. Responses from members of a consumer group are received that are responsive to a questionnaire and preferred health benefit plans chosen by members of the group are predicted. From the responses, an overall enrollment distribution is estimated. A plurality of health benefit plans is offered to the group when a minimum economic objective is obtained from the set of health benefit plan configurations.

Claims

1. A method for providing a health benefit plan, comprising:

(a) determining a set of health benefit plan configurations;

(b) receiving a response from a member of a group of consumers, the response being responsive to a questionnaire;

(c) predicting a preferred health benefit plan chosen by the member from the set of health benefit plan configurations;

(d) repeating (c) for another member of the group;

(e) estimating, responsive to (c)-(d), an overall enrollment distribution for the group;

(f) determining an economic return for each health benefit plan in the set of health benefit plan configurations from the overall distribution and at least one health trajectory predictor;

(g) repeating (a)-(f) until a minimum economic objective is obtained from the set of health benefit plan configurations; and

(h) offering a plurality of health benefit plans to the group of consumers.

2. The method of claim 1, further comprising:

(i) designing the questionnaire from a combination of predictive modeling and adaptive conjoint analysis.

3. The method of claim 1, further comprising:

(i) including an incentive for a consumer based on a selected health benefit plan.

4. The method of claim 3, further comprising:

(j) determining a utility function associated with the incentive for the consumer.

5. The method of claim 3, further comprising:

(j) assessing a target of opportunity based on a probability of transitioning from a first disease state to a second disease state for the consumer.

6. The method of claim 3, further comprising:

(j) modifying the incentive program for the consumer based on a change of health status.

7. The method of claim 3, further comprising:

(j) determining the incentive based on a profile of the consumer.

8. The method of claim 3, further comprising:

(j) receiving an assessment indication from the consumer; and

(k) modifying the incentive based on the assessment indication.

9. The method of claim 1, further comprising:

(i) re-estimating the overall enrollment distribution for the group based on prior enrollment data and predicative modeling.

10. An apparatus for providing a health benefit plan, comprising:

a user interface;

a memory; and

a processor accessing the memory to obtain computer-executable instructions and executing the computer-executable instructions for performing;

(a) determining a set of health benefit plan configurations;

(b) receiving, from the user interface, a response from a member of a group of consumers, the response being responsive to a questionnaire;

(c) predicting a preferred health benefit plan chosen by the member from the set of health benefit plan configurations;

(d) repeating (c) for another member of the group;

(e) estimating, responsive to (c)-(d), an overall enrollment distribution for the group;

(f) determining an economic return for each health benefit plan in the set of health benefit plan configurations from the overall distribution and at least one health trajectory predictor;

(g) repeating (a)-(f) until a minimum economic objective is obtained from the set of health benefit plan configurations; and

(h) offering, through the user interface, a plurality of health benefit plans to the group of consumers.

11. The apparatus of claim 10, the processor further executing the computer-executable instructions for performing:

(i) including an incentive for a consumer based on a selected health benefit plan.

12. The apparatus of claim 11, the processor further executing the computer-executable instructions for performing:

(j) assessing a target of opportunity based on a probability of transitioning from a first disease state to a second disease state for the consumer.

13. The apparatus of claim 11, the processor further executing the computer-executable instructions for performing:

(j) modifying the incentive program for the consumer based on a change of health status.

14. The apparatus of claim 11, the processor further executing the computer-executable instructions for performing:

(j) determining the incentive based on a profile of the consumer.

15. The apparatus of claim 11, the processor further executing the computer-executable instructions for performing:

(j) receiving, through the user interface, an assessment indication from the consumer; and

(k) modifying the incentive based on the assessment indication.

16. The apparatus of claim 10, the processor further executing the computer-executable instructions for performing:

(i) re-estimating the overall enrollment distribution for the group based on prior enrollment data and predicative modeling.

17. A computer-readable medium having computer-executable instructions to perform:

(a) determining a set of health benefit plan configurations;

(b) receiving a response from a member of a group of consumers, the response being responsive to a questionnaire;

(c) predicting a preferred health benefit plan chosen by the member from the set of health benefit plan configurations;

(d) repeating (c) for another member of the group;

(e) estimating, responsive to (c)-(d), an overall enrollment distribution for the group;

(f) determining an economic return for each health benefit plan for the set of health benefit plan configurations from the overall distribution and at least one health trajectory predictor;

(g) repeating (a)-(f) until a minimum economic objective is obtained from the set of health benefit plan configurations; and

(h) offering a plurality of health benefit plans to the group of consumers.

18. The computer-readable medium of claim 17, further configured to perform:

(i) including an incentive for a consumer based on a selected health benefit plan.

19. The computer-readable medium of claim 18, further configured to perform:

(j) assessing a target of opportunity based on a probability of transitioning from a first disease state to a second disease state for the consumer.

20. The computer-readable medium of claim 18, further configured to perform:

(j) modifying the incentive program for the consumer based on a change of health status.

21. The computer-readable medium of claim 18, further configured to perform:

(j) receiving an assessment indication from the consumer; and

(k) modifying the incentive based on the assessment indication.