Invention Grant
US08744878B1 Method for using financial incentives with member engagement metrics to reduce health care claim costs
有权
使用财务奖励与成员互动指标的方法来减少医疗保健索赔成本
- Patent Title: Method for using financial incentives with member engagement metrics to reduce health care claim costs
- Patent Title (中): 使用财务奖励与成员互动指标的方法来减少医疗保健索赔成本
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Application No.: US12101344Application Date: 2008-04-11
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Publication No.: US08744878B1Publication Date: 2014-06-03
- Inventor: Beth Bierbower , Traci Elliot , Beth Grice , Khalid Nazir , Rick Remmers , Benjamin Slen , Melissa L. Weaver , Patrick Bryan
- Applicant: Beth Bierbower , Traci Elliot , Beth Grice , Khalid Nazir , Rick Remmers , Benjamin Slen , Melissa L. Weaver , Patrick Bryan
- Applicant Address: US KY Louisville
- Assignee: Humana Inc.
- Current Assignee: Humana Inc.
- Current Assignee Address: US KY Louisville
- Agency: Standley Law Group LLP
- Main IPC: G06Q40/00
- IPC: G06Q40/00

Abstract:
A health care plan system and method designed to reduce future claims costs through financial incentives with member engagement metrics. Targets are pre-set for member engagement metrics. Claims cost targets for the sponsor are set based on the sponsor meeting member engagement targets. A percentage of health care plan base administrative fees are at risk based on the sponsor's claims cost performance in relation to the claims cost target. If the claims cost target is missed, the health plan administrator repays or reduces administrative fees charged to the sponsor. If the claims cost target is met, the sponsor pays additional fees to the health plan administrator. Base administrative fees are also repaid or reduced if the health care plan administrator fails to meet service performance targets. The sponsor is appraised on progress of member engagement and service performance metrics through scorecards that are sent during the plan year.
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