Intelligent health benefit design system

• US 7,912,734 B2
• Filed: 02/27/2007
• Issued: 03/22/2011
• Est. Priority Date: 12/19/2006
• Status: Expired due to Fees

• Current Assignee: Accenture Global Services Limited (Accenture PLC)
• Original Assignee: Accenture Global Services Limited (Accenture PLC)
• Inventors: Kil, David H.
• Primary Examiner(s): O'Connor; Gerald J.
• Assistant Examiner(s): PHONGSVIRAJATI, POONSIN
• Application Number:
  US11/679,267
• Publication Number:
  US 20080147441A1
• Time in Patent Office: 1,484 Days
• Field of Search: 705 2- 4
• 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 computer-implemented method comprising:

selecting a set of health benefit products including a new health benefit product for which no prior enrollment data is available, each health benefit product in the set having different product attributes;

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

predicting, from the member'"'"'s response to the questionnaire, a preferred health benefit product chosen by the member from the set of health benefit products;

predicting, from another member of the group'"'"'s response to the questionnaire, a preferred health benefit product chosen by the other member from the set of health benefit products;

estimating from the preferred health benefit plans, an overall predicted enrollment distribution for the group, from among the health benefit products of the set;

determining, by one or more computers, an economic return for each health benefit product in the set of health benefit products, based on the overall predicted enrollment distribution and information referencing a predicted, future health trajectory of the member, wherein the economic return is reflected in a ratio of a projected profitability to a level of subsidization for each health benefit product;

adjusting the product attributes of the health benefit products in the set until a minimum economic objective is obtained; and

when the minimum economic objective is obtained, offering the set of health benefit products to the group of consumers.

2. The method of claim 1, wherein the questionnaire comprises an Adaptive Conjoint Questionnaire (ACQ).

3. The method of claim 1, wherein estimating the overall predicted enrollment distribution for the group further comprises estimating, for each individual member of the group, a consumer preference function.

4. The method of claim 1, further comprising:

determining that a difference between the ratio of the projected profitability to the level of subsidization of the set of health benefit products, and the ratio of a projected profitability to a level of subsidization of a different set of health benefits products, is below the acceptability threshold.

5. The method of claim 1, wherein at least one health benefit product in the set includes a lifestyle change incentive.

6. The method of claim 5, wherein the lifestyle change incentive comprises an incentive for altering nutrition or exercise habits.

7. A system comprising:

one or more computers; and

a computer-readable medium coupled to the one or more computers having instructions stored thereon which, when executed by the one or more computers, cause the one or more computers to perform operations comprising;

selecting a set of health benefit products including a new health benefit product for which no prior enrollment data is available, each health benefit product in the set having different product attributes;

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

predicting, from the member'"'"'s response to the questionnaire, a preferred health benefit product chosen by the member from the set of health benefit products;

predicting, from another member of the group'"'"'s response to the questionnaire, a preferred health benefit product chosen by the other member from the set of health benefit products;

estimating from the preferred health benefit plans, an overall predicted enrollment distribution for the group, from among the health benefit products of the set;

determining an economic return for each health benefit product in the set of health benefit products, based on the overall predicted enrollment distribution and information referencing a predicted, future health trajectory of the member, wherein the economic return is reflected in a ratio of a projected profitability to a level of subsidization for each health benefit product;

adjusting the product attributes of the health benefit products in the set until a minimum economic objective is obtained; and

when the minimum economic objective is obtained, offering the set of health benefit products to the group of consumers.

8. The system of claim 7, wherein the questionnaire comprises an Adaptive Conjoint Questionnaire (ACQ).

9. The system of claim 7, wherein estimating the overall predicted enrollment distribution for the group further comprises estimating, for each individual member of the group, a consumer preference function.

10. The system of claim 7, wherein the operations further comprise:

determining that a difference between the ratio of the projected profitability to the level of subsidization of the set of health benefit products, and the ratio of a projected profitability to a level of subsidization of a different set of health benefits products, is below the acceptability threshold.

11. The system of claim 7, wherein at least one health benefit product in the set includes a lifestyle change incentive.

12. The system of claim 11, wherein the lifestyle change incentive comprises an incentive for altering nutrition or exercise habits.

13. A non-transitory computer readable storage medium encoded with a computer program, the program comprising instructions that when executed by one or more computers cause the one or more computers to perform operations comprising:

selecting a set of health benefit products including a new health benefit product for which no prior enrollment data is available, each health benefit product in the set having different product attributes;

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

predicting, from the member'"'"'s response to the questionnaire, a preferred health benefit product chosen by the member from the set of health benefit products;

predicting, from another member of the group'"'"'s response to the questionnaire, a preferred health benefit product chosen by the other member from the set of health benefit products;

estimating from the preferred health benefit plans, an overall predicted enrollment distribution for the group, from among the health benefit products of the set;

determining an economic return for each health benefit product in the set of health benefit products, based on the overall predicted enrollment distribution and information referencing a predicted, future health trajectory of the member, wherein the economic return is reflected in a ratio of a projected profitability to a level of subsidization for each health benefit product;

adjusting the product attributes of the health benefit products in the set until a minimum economic objective is obtained; and

when the minimum economic objective is obtained, offering the set of health benefit products to the group of consumers.

14. The non-transitory computer readable storage medium of claim 13, wherein the questionnaire comprises an Adaptive Conjoint Questionnaire (ACQ).

15. The non-transitory computer readable storage medium of claim 13, wherein estimating the overall predicted enrollment distribution for the group further comprises estimating, for each individual member of the group, a consumer preference function.

16. The non-transitory computer readable storage medium of claim 13, further comprising:

determining that a difference between the ratio of the projected profitability to the level of subsidization of the set of health benefit products, and the ratio of a projected profitability to a level of subsidization of a different set of health benefits products, is below the acceptability threshold.

17. The non-transitory computer readable storage medium of claim 13, wherein at least one health benefit product in the set includes a lifestyle change incentive.

18. The non-transitory computer readable storage medium of claim 17, wherein the lifestyle change incentive comprises an incentive for altering nutrition or exercise habits.

19. A computer-implemented method comprising:

selecting a set of health benefit products including a new health benefit product for which no prior enrollment data is available, each health benefit product in the set having different product attributes;

submitting a questionnaire to at least a portion of a group of consumers;

estimating, from the consumers'"'"' responses to the questionnaire, an overall predicted enrollment distribution for the group, from among the health benefit products of the set;

calculating a projected profitability and a level of subsidization associated with the set of health benefit products based on the overall predicted enrollment distribution and information referencing predicted, future health trajectories of the group of consumers;

calculating a ratio of the projected profitability to the level of subsidization for the set of health benefit products;

determining, by one or more computers, whether the difference between the ratio of the projected profitability to the level of subsidization of the set of health benefit products, and the ratio of projected profitability to a level of subsidization of a different set of health benefits products, is below an acceptability threshold; and

when determining that the difference between the ratio of the projected profitability to the level of subsidization of the set of health benefit products, and the ratio of the projected profitability to the level of subsidization of the different set of health benefits products, is below the acceptability threshold, offering the set of health benefit products to the group of consumers.