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Systems and methods for determining return on community investment in healthcare access programs

  • US 8,428,962 B1
  • Filed: 03/11/2010
  • Issued: 04/23/2013
  • Est. Priority Date: 03/12/2009
  • Status: Expired due to Fees
First Claim
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1. A system, comprising:

  • a healthcare server that determines a return on community investment (ROCI) for a healthcare program of an organization providing healthcare services to patients in a community,wherein the ROCI indicates a quantum of benefit that beneficiaries of the healthcare program receive in return for every unit of community investment in the healthcare program,wherein the beneficiaries include the organization and the community served by the healthcare program, andwherein the community includes the patients and employers of the patients,the healthcare server including;

    an expense determination module that determines operating expenses for the healthcare program;

    a data acquisition module that obtains research data from at least one research database, wherein the research data includes tax-related research data, employer-related research data, employee-related research data, hospital-related research data, and patient-related research data, and wherein the data acquisition module obtains the research data from (i) a local-level agency if the research data is unavailable within the organization, (ii) a state-level agency if the research data is unavailable from the local-level agency, and (iii) a national-level agency if the research data is unavailable from the state-level agency;

    a benefit determination module that determines benefits of the healthcare program to the beneficiaries of the healthcare program based on at least one of past performance data of the healthcare program and the research data, wherein the benefits include decreased visits by the patients to the organization, reduced healthcare expense for the patients, increased earnings for the patients, increased employee productivity for the employers of the patients, and increased tax revenues for the community served by the healthcare program; and

    a ROI module that determines the ROCI for the healthcare program based on the operating expenses for the healthcare program and the benefits to the beneficiaries of the healthcare program,wherein the ROCI is a percentage of a ratio of the benefits to the beneficiaries of the healthcare program and the operating expenses for the healthcare program, andwherein the ROCI allows the organization to benchmark and evaluate a plurality of healthcare programs and, based on the benchmarking and evaluation, to determine (i) projected financial and clinical performance of the healthcare program, (ii) whether to start the healthcare program, (iii) past financial and clinical performance of the healthcare program, and (iv) whether to alter or end the healthcare program.

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