Patent ID: 8744878
Filing Date: 2014-06-03
Classification: G06Q

Abstract:
1. A computerized method for tracking financial incentives to reduce health care claims costs comprising: (a) entering in a server at least one administrative fee charged by a health care plan administrator to a sponsor of a health care plan for a plurality of members of a member population; (b) entering in said server data for at least one plan activity requiring participation from said plurality of members; (c) entering in said server a target level of participation by said plurality of members in said plan activity; (d) determining at said server a number of members in a said health care plan; (e) determining at said server a number of members in said health care plan participating in said plan activity; (f) comparing at said server said number of members in said health care plan to said number of members participating in said plan activity to calculate a level of participation for said member population; (g) calculating by said server a difference between said level of participation and said target level of participation; (h) calculating by said server a claims cost target for said sponsor according to said difference between said level of participation and said target level of participation wherein said claims cost target is a cap on claims cost growth during an applicable health care plan period; (i) measuring at said server actual claims cost performance against said claims cost target for said applicable health care plan period to determine a claims cost difference for said member population; and (j) calculating at said server an administrative fee refunded to said sponsor or paid to said health plan administrator based on said claims cost difference for said member population.