Patent ID: 7711577

Claim:
A method of optimizing healthcare services consumption, including the steps of: (A) assessing a healthcare situation of an employer who provides healthcare benefits to a population of patients consisting of employees of the employer and family members of the employees, the assessing step including the steps of (i) using a computing device to execute software to access a database containing data relating to the employer, the patients, and providers who service the patients, (ii) identifying a plurality of non-overlapping geographic regions, (iii) associating with the computer an address of each patient with a geographic region, (iv) associating with the computer a location of each provider with a geographic region, and (v) aggregating with the computer the geographic regions associated in steps (iii)-(iv) above into a health economic zone (HEZ), wherein the HEZ encompasses only the aggregated geographic regions; (B) using a computing device to transform past healthcare claims data generated by the patients and stored in the database into data representing a first group of patients likely to generate expensive healthcare claims relative to other patients in the population; (C) using a computing device to transform past practice patterns data generated by the providers in the HEZ who provide services to the patients and stored in the database into data representing a first group of providers who provide high quality, cost efficient healthcare services; and (D) responding to a healthcare request from a patient by determining whether the provider associated with the request is in the first group of providers, and when the provider is not in the first group of providers, using an electronic communication device to contact the patient before the patient consumes the requested services from the provider to urge the patient to obtain the requested services from a provider in the first group of providers.