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Computer system and method for generating healthcare risk indices using medication compliance information

  • US 8,489,416 B2
  • Filed: 05/25/2010
  • Issued: 07/16/2013
  • Est. Priority Date: 10/22/2003
  • Status: Active Grant
First Claim
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1. A method comprising:

  • accessing, on a processor, a plurality of pharmacy claims associated with an individual,processing, on the processor, the plurality of pharmacy claims to identify any chronic conditions possessed by the individual;

    processing, on the processor, the plurality of pharmacy claims to identify any compliance medications prescribed to the individual;

    generating, on the processor, a plurality of chronic condition scores, a chronic condition score of the plurality of chronic condition scores being associated with a particular chronic condition that is possessable by the individual;

    generating, on the processor, a plurality of compliance medication scores, a compliance medication score of the plurality of compliance medication scores being associated with a compliance medication prescribed to the individual;

    generating, on the processor, a plurality of modified chronic condition scores, a modified chronic condition score of the plurality of modified chronic condition scores being generated by multiplying a chronic condition score associated with a chronic condition by an overall chronic condition regression coefficient and, when the individual has no pharmacy claims associated with the chronic condition, subtracting a no-claims weight from the chronic condition score; and

    generating, on the processor, a chronic condition risk index by summing for a plurality of chronic conditions the modified chronic condition score or the chronic condition score and the compliance medication score.

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