Patent ID: 7640177

Claim:
A computer-implemented method for determining an optimal sharing mix in a shared savings prescription plan, comprising: (a) storing in a computer storage of a computer a first drug group and a second drug group, wherein the drugs of the first drug group and the drugs of the second drug group are at least one of the following: formulary, chemical, physical, or therapeutic equivalents of each other, and the first and second drug groups each include one or more prescriptions; (b) a processor of the computer determining a total estimated cost to an insuring entity for the first drug group and a total estimated cost to the insuring entity for the second drug group; (c) the processor of the computer determining a first estimated savings rate associated with utilizing the second drug group versus the first drug group; (d) the processor of the computer determining a first estimated distribution amount as a function of the first estimated savings rate and the total estimated cost to the insuring entity for the first drug group; (e) the processor of the computer allocating the first estimated distribution amount to at least one of the following: the insuring entity, at least one member entity insured by the insuring entity, a plan facilitating entity, and a physician entity based upon one or more predetermined percentages; and (f) the processor of the computer determining an estimated physician entity amount and distributing the estimated physician entity amount to a designee of the physician entity wherein the physician entity is participating in the shared savings prescription plan, and wherein the estimated physician entity amount is determined as a function of the first estimated distribution amount and a physician entity share rate.