Patent ID: 8036916

Claim:
A method of optimizing healthcare services consumption, including the steps of: assessing a healthcare situation of an employer who provides healthcare benefits to a population of patients that reside and consume healthcare services in a health economic zone, the health economic zone consisting of a plurality of non-overlapping geographic regions, each of which includes at least one of a residential address of a patient in the population and a location of a provider who services patients in the population; using a computing device to transform past healthcare claims generated by the population into data representing a first group of patients from the population likely to generate expensive healthcare claims relative to other patients in the population; periodically determining whether patients in the first group have obtained healthcare services that satisfy predetermined requirements; using a computing device to transform data representing past practice patterns of providers in the health economic zone into identification of a first group of providers in the health economic zone who provide high quality, cost efficient healthcare services relative to other providers in the health economic zone; prompting patients who have not obtained healthcare services that satisfy the predetermined requirements to obtain additional healthcare services to satisfy the predetermined requirements from providers in the first group of providers; and responding to healthcare requests from the population by determining whether patients submitting requests are seeking to obtain healthcare services from providers in the first group of providers, and for a patient requesting services from one of the other providers, communicating with the patient before the patient consumes the services from the provider to urge the submitting patient to obtain the requested healthcare services from a provider in the first group of providers.