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

• Current Assignee: Ascension Health (Ascension Health Alliance)
• Original Assignee: Ascension Health (Ascension Health Alliance)
• Inventors: Palombo, Christopher Felice, Webster, JoAnn A., Brooks, Connie J., Brinkley, Joshua P.
• Primary Examiner(s): Morgan, Robert
• Assistant Examiner(s): HUNTER, SEAN KRISTOPHER
• Application Number:
  US12/721,660
• Time in Patent Office: 1,139 Days
• Field of Search: 705/2, 705/3
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/06 Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
• CPC Class Codes: G06Q 10/10 Office automation; Time management

Abstract

A system includes a healthcare server for determining a return on investment (ROI) for a healthcare program of an organization that provides healthcare services to patients. The healthcare server includes an expense determination module, a benefit determination module and a ROI module. The expense determination module determines operating expenses for the healthcare program. The benefit determination module determines benefits of the healthcare program to beneficiaries of the healthcare program. The beneficiaries include the organization, the patients, employers of the patients and a community that is served by the healthcare program. The ROI module determines the ROI for the healthcare program based on the operating expenses and the benefits.

Claims

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, and

wherein 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, and

wherein 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.

2. The system of claim 1, wherein the healthcare server further comprises a user input module that outputs expense data for the healthcare program to the expense determination module and wherein the operating expenses for the healthcare program are based on the expense data.

3. The system of claim 1, wherein the healthcare server further comprises a beneficiary identification module that identifies the beneficiaries of the healthcare program based on beneficiary data from user inputs to determine beneficiary identification data and that outputs the beneficiary identification data to the benefit determination module, wherein the benefits of the healthcare program are based on the beneficiary identification data.

4. The system of claim 1, wherein the data acquisition module is in communication with the at least one research database through a communication module.

5. The system of claim 1, wherein the healthcare server further comprises a control module that adjusts the research data based on consumer price index data to determine adjusted research data and that outputs the adjusted research data to the data acquisition module, wherein the benefits of the healthcare program are based on the adjusted research data.

6. The system of claim 1, wherein the healthcare server further comprises an output module that outputs the ROI for the healthcare program.

7. The system of claim 6, wherein the output module includes at least one of a display, a speaker and a printer.

8. A computer system configured to determine a return on community investment (ROCI) for a healthcare program of an organization providing healthcare services to patients in a community, the computer system comprising:

a user input module that receives user inputs and that outputs expense data for the healthcare program;

an expense determination module that receives the expense data and that determines operating expenses for the healthcare program based on the expense data;

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 receives the research data from the data acquisition module and that determines benefits of the healthcare program to beneficiaries of the healthcare program based on at least one of past performance of the healthcare program and the research data, wherein the beneficiaries include the organization and the community served by the healthcare program, wherein the community includes the patients and employers of the patients, and 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 indicates a quantum of benefit that the beneficiaries of the healthcare program receive in return for every unit of community investment in 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, and

wherein the ROI 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.

9. The computer system of claim 8, further comprising a beneficiary identification module that identifies the beneficiaries of the healthcare program based on beneficiary data from user inputs to determine beneficiary identification data and outputs the beneficiary identification data to the benefit determination module, wherein the benefits of the healthcare program are based on the beneficiary identification data.

10. The computer system of claim 8, wherein the data acquisition module is in communication with the at least one research database through a communication module.

11. The computer system of claim 8, further comprising a control module that adjusts the research data based on consumer price index data to determine adjusted research data and that outputs the adjusted research data to the data acquisition module, wherein the benefits of the healthcare program are based on the adjusted research data.

12. The computer system of claim 8, further comprising an output module that outputs the ROI for the healthcare program.

13. The computer system of claim 12, wherein the output module includes at least one of a display, a speaker and a printer.

14. The computer system of claim 8, further comprising a special purpose computing device that includes the user input module, the expense determination module, the data acquisition module, the benefit determination module, and the ROI module.