97 results about "Health program" patented technology

Methods and systems for health and wellness management, including computer programs for implementing such methods and systems, are disclosed. An illustrative system for managing the health and wellness of plan members within a health plan can include a plan sponsor, a behavior modification program targeted to one or more plan members within the health plan, and a plan administrator adapted to monitor the progress of each plan member participating in the behavior modification program. A customizable computer exercise program can be provided as a part of the behavior modification program to promote weight loss, increase activity level, as well as other health related objectives. The computer exercise program can include a compliance module adapted to monitor the plan member's usage of the program, and a communications module for transferring data back and forth between the exercise program and administrator.

In an effort to reduce employer health insurance related costs, at least one benefit under a health benefit plan is conditional on the employee voluntarily participating in a wellness program. The wellness program could include wellness categories such as a tobacco free category, normal blood pressure category, regular exercise category, a non-overweight category, a healthy cholesterol level category, a healthy blood glucose level category, and possibly even a category for participation in a health risk assessment. The invention may be implemented by an employer adopting a health plan with a higher deductible over a previous year, and providing credits against that deductible for employees who satisfy requirements regarding each of a variety of wellness categories. This should enable the employer to realize an immediate savings in the year that the invention is implemented, and future savings in years thereafter from healthier employees having lesser numbers of claims and smaller dollar claims.

Methods, systems and devices for electronically prescribing medication to a patient include providing to a prescriber prescription medications in response to a request to prescribe medication to a patient, allowing selection of one of the prescription medications, in response to the selection of one of the prescription medications, determining in a processor whether alternative prescription medications having equal or more preferred status than the selected prescription medication exist based upon the patient's health plan, and if any such alternative medication exists, alerting the prescriber of the preference status of the selected prescription medication and alternative prescription medication.

A system and method are provided that include a health and wellness system that includes a network configured to provide one or more members of an organization access to the health and wellness system, a web server configured to provide a plurality of web pages over the network, and a plurality of wellness programs. A survey that has a plurality of health and wellness categories is delivered to the one or more members via the plurality of web pages. The one or more members provide a response to the survey that has a plurality of numerical scores for each of the plurality of health and wellness categories. Each of the plurality of wellness programs are configured to improve the health and wellness in at least one of the plurality of health and wellness categories for at least one of the one or more members. Each of the plurality of wellness programs have a predefined numerical equation for each of the plurality of health and wellness categories. One or more of the plurality of wellness programs are identified in a readable format via the plurality of web pages by comparing results from the predefined mathematical equations using the numerical scores as input.

A method and system of providing comparative cost information for health insurance plans. Claims files are generated for the reference population of real historical patients for each the plans. Information is presented to users on the distribution of out-of-pocket costs for health care that users are likely to incur in the coming year, based on the parameters of health plans, information on the user and his/her household, and the actual health care use and costs for a reference population comparable to the users. Information is presented to users on optimal contributions to their flexible spending account for health care in the coming year and solving a dynamic numerical model based on users' objective function; solutions are based on the parameters of health plans, information on the user and his/her household, and the actual health care use and costs for a reference population comparable to the user.

A system and method for generating and sending reward messages to users accomplishing goals related to a personalized health behavior plan. Rewards may be issued for reasons such as achieving an ultimate goal, reaching an intermediate goal, or completing a suggested activity such as eating a suggested meal or performing a suggested physical activity. A reward may be a coupon for use at an establishment such as a restaurant, a clothing store, or a fitness center. Rewards may also be checks sent through postal mail or coupons for printing on a personal printer. Reward messages are generated by an expert system based on a user's personalized diet, exercise, or other health plan, goals associated with the plan, and specified preferences. Reward messages are sent to user's portable devices. Current location information may be used to send a user a reward for use at a nearby establishment.

Provided are embodiments of systems, computer medium and computer-implemented methods to monitor the health of an employee. A method for monitoring the health of an employee while the employee is located in an employee workstation including collecting, from a plurality of biometric and biomechanical sensors disposed throughout an employee workstation, health data indicative of biometric and biomechanical characteristics of the employee. The plurality of biometric and biomechanical sensors adapted to sense biometric and biomechanical characteristics of the employee and output corresponding health data indicative of the biometric and biomechanical characteristics of the employee. The method including determining an employee health profile based at least in part on the collected health data, generating a health plan for the employee based at least in part on the health profile, and displaying health content including the employee health profile and the health plan for the employee.

In a system and method for estimating medical costs under at least one health plan, one or more user devices provide user health data entered by one or more users to a processor, and the processor provides estimated health plan cost data to the user device(s) to enable the user(s) to compare the costs and benefits of various health plan options available to the user(s). The processor includes an administrative module for receiving user account data and health plan data entered by an administrator; a calculation module for providing estimated cost data based upon the user health data; a user module for generating the estimated health plan cost data based upon the user health data, user account data, health plan data and estimated cost data and providing the estimated health plan cost data to the user device; and a database for storing the estimated health plan cost data, user health data, user account data, health plan data and estimated cost data. The user health data may include medical condition data, prescription data, prescription cost saving option data, healthcare provider selection data, historical user data, expected medical procedure data and/or expected durable medical equipment data. The user module calculates the estimated health plan cost data by adding all estimated cost data corresponding to the user health data and applying the health plan data and user account data to determine expected costs to the user under each health plan option available to the user. The user module may further calculate a recommended contribution to a flexible spending account or health savings account based upon the estimated health plan cost data and a tax savings amount associated with the recommended contribution to the flexible spending account or health savings account using income and tax status data provided by the user.

Provided are embodiments of systems, computer medium and computer-implemented methods for monitoring the health of an employee while the employee is located in an employee workstation. A method including collecting, from a plurality of biomechanical sensors disposed throughout the employee workstation, biomechanical health data indicative of biomechanical characteristics of the employee, determining an employee biomechanical health profile based at least in part on the collected biomechanical health data. The employee biomechanical health profile including biomechanical health characteristics, biomechanical health conditions and/or biomechanical health risks for the employee. The method including generating a health plan for the employee based at least in part on the biomechanical health profile, and displaying the employee biomechanical health profile and the health plan to the employee.

A system and method for providing dietary guidance is provided. The method includes receiving a selection of a health program for an individual, the health program including a dietary regimen, measuring the individual's caloric expenditure and change in body composition or body mass during the individual's participation in the health program, determining adherence to the health program based on the measured caloric expenditure or the measured change in body composition or body mass, identifying a modification to the health program, and informing the individual of the modification. The modification can include nutritional supplements, meals or recipes having a nutritional and/or caloric content tailored to assist the individual in meeting his or her health goals. The method can further include predicting an expected change in body composition or body mass based on the health program and based on the individual's gender, age, height, weight, and other factors.

An information management and communications system for communication between patients and healthcare providers, including an automated interactive patient response system, and apparatus and software to create, configure, and manage the content and structure of the patient response system to provide secure standards-based outpatient health assessment monitoring, to include disease management, medication compliance, wellness program compliance, and general health screening.

The present invention provides a system and method for measuring the relative economic benefits from services offered by health care plans. The present invention quantifies value of health care quality by indicating an economic return on the investment in health care quality, enabling organizations and businesses to view health care quality in a familiar paradigm that extends health plan differentiation beyond premium and benefits. Businesses may employ the present invention to compare different health care plans or classes of plans, such as accredited versus non-accredited plans. Specifically, a particular plan or class of plans may provide improved monitoring, treatment and control of various medical conditions, and the present invention quantifies the economic benefits to employers from the improved health care for employees. In one embodiment, the present invention looks to a set of specific medical conditions and is based on three key steps. First, the present invention identifies the overall level of employees at the organization affected by these conditions. Second, the present invention uses the reduction in absenteeism and low productivity days made possible by improved monitoring and control of the medical conditions. Third, the present invention calculates a monetary valuation to the firm of the reduction in absenteeism and low productivity days based on the firm's average revenue per employee, average daily wage, and other parameters.

A computer implemented method is disclosed for receiving employee usage information associated with at least one employee's usage of a wellness program. A status level associated with the at least one employee for the wellness program is determined based on the employee usage information. A status level indicates a degree of participation in the wellness program. A data set is created comprising at least the status level associated with the at least one employee. The data set is in a format acceptable by a payroll vendor without conversion of the data set. The data set is then sent to an employer of the at least one employee.

To take into account the various specifics of health care information available to the health plan members and health care providers in the context of estimating the members' out-of-pocket payments, embodiments of the invention are used to provide an electronic health care information system with custom interfaces and underlying processing optimized for the health plan member and health care provider contexts. Embodiments of the health care information system construct a pseudo-claim based on the information gathered via the member or provider interfaces and provide an accurate real-time estimate of the member's out-of-pocket responsibility based on adjudicating the pseudo-claim by taking into account the details of the member's health plan and current benefit levels.

The current system can include user-initiated, system-prompted and sometimes human-assisted consumer access to specific filters within the automated system. These filters can direct the consumers/patient to a rank ordered list of various health and wellness providers that are relatively available. This list can be segmented by various criteria that are ranked however the consumer chooses. These can include providers that are within the specific health plan or under the insurance coverage or previous pay arrangement of the consumer, or by geographical or zip code locations, and various other optional criteria, including, but not limited to, ethnicity, language, proficiency, gender, experience level, specialization, and the like. The consumer can schedule a consultation/appointment/visit on the appointment schedule of the provider of the consumer's choice after reviewing the options available.

A method, a system and a computer program product that includes an interactive interface for healthcare financial planning. Healthcare financial planning is performed for a plurality of health plan options. The invention enables a user to compare various health plan options. The user may be required to input data, which is used to project health plan liabilities for a pre-determined time period. The projections are based on a known health claim probability distribution. Health plan liabilities are transformed into health plan costs. The projection and transformation of health plan liabilities are based on age, gender, family dependent status, industry classification and zip code data.

A method and system for managing a wellness programme includes obtaining personal information pertaining to an individual, the personal information including at least the individual's age and gender. In addition, health information pertaining to the individual is obtained. The health information typically includes at least one of exercise, diet, smoking, blood pressure, cholesterol and weight. The personal information and the health information are then used to determine a wellness programme for the individual, the wellness programme including a plurality of programme areas with which the individual must comply. Information is then received regarding the individual's compliance or non-compliance with the individual's wellness programme and points are awarded to the individual for compliance with the wellness programme. At predetermined intervals the total number of points awarded to the individual are calculated and a reward is awarded to the individual based on the total number of points accumulated.

A method of health care financing, comprising: calculating an economic burden on an entity caused by a health situation; providing, by a third party, application and monitoring of a health plan for at least 10,000 individuals in least part of the entity; and paying to the third party in response to a proof that said burden is reduced.

A system and method is provided for determining a probability that a member of a health plan has a disease or condition within one or more disease categories, by using data from the member's pharmacy claims. Logistic regression models are generated for each condition category using therapeutic drug categories, provider information, and/or other variables including member demographic information.

In an effort to reduce employer health insurance related costs, a state-governed fully-insured health insurance policy is provided for a group of employees. At least one benefit under the health insurance policy is conditional on the employee voluntarily participating in a wellness program. The wellness program could include wellness categories such as a tobacco free category, normal blood pressure category, regular exercise category and even a non-overweight category. In addition, the wellness program could condition coverage, or subsidize deductibles for, certain illnesses on employee submission to screening tests on a prescribed basis for the identified illness, such as cancer screening for early detection of cancer. The voluntary wellness program can also include a variety of other aspects including wellness education, disease inoculation, and injury prevention. The invention provides an incentive for employees to make healthier lifestyle choices.

The invention provides an employee medical care management method including (i) a wellness program management method including storing a purchased subset of the wellness programs; (ii) an employee health analysis method including storing a plurality of employee records, and for each employee record, storing at least one medical variable so that the medical variable is associated with the employee record; (iii) an employee health directive method including associating at least a selected one of the medical wellness programs with the employee record based on the medical variable associated with the employee record, and providing an output with the selected medical wellness program being associated with the employee record.

A method for providing insurance protection against the inability to pay for, and consequential loss of, group health insurance benefits if an individual employee who is an active participant in the employer's group health plan becomes disabled. The invention provides for a disability insurance policy, or alternatively a combination of a plurality of disability insurance policies, that will pay both the employer and participant's portions of health insurance premiums during the period of COBRA coverage, with the monthly benefit amount determined by determining the total premium due under COBRA guidelines for the participant's group health insurance.

A method and system for assessing user engagement during wellness program interaction are disclosed.

Systems and methods are disclosed for monitoring, recording, verifying, auditing, and executing healthcare communications, decisions, and transactions using centralized storage and blockchain technology. The healthcare communications relate to communications between a patient, doctor, specialist, healthcare provider, a private or government entity that processes and reimburses healthcare providers, insurance provider, and a healthcare facility.

Systems and methods are disclosed for processing, monitoring, recording, verifying, auditing, and executing healthcare communications, decisions, and transactions using centralized storage and blockchain technology. The healthcare communications relate to communications between a patient, doctor, specialist, healthcare provider, a private or government entity that processes and reimburses healthcare providers, insurance provider, and a healthcare facility.

In one embodiment, the system processes a healthcare transaction that relates to medical care provided for a patient that has a medical health plan. The method involves providing a centralized control manager for obtaining, storing, and analyzing healthcare transaction data.

The centralized control manager is connected to a central database and utilizes the central database for storing healthcare data. The centralized control manager operates through a processor. The processor executes instructions stored in the database leading to the centralized control manager performing its functions.

The centralized control manager is electronically and communicatively connected to at least two entities that are part of the authorized entities within the computer network. These entities may include a patient, doctor, primary physician, specialist, payer system, health plan provider, and government entity such as Medicare. The centralized control manager allows bidirectional communication with the centralized control manager and other authorized entities that are allowed to communicate with the centralized control manager and use an electronic device over a computerized network. Communications directly between the entities is also contemplated.

The entities electronically execute a healthcare transaction. The centralized control manager records each executed healthcare transaction into the centralized database as well as posts the transaction to the blockchain. Each entity performing the transaction also posts the details of the transaction to the blockchain. Details include the time and date of transaction, the parties involved, and other details of medical care provided to the patient relating to the transaction.

A prediction engine, utilizing machine learning technology, uses the data of all the transactions obtained to continuously enhance and predict the outcome of future transactions and make suggestions as needed. If any transaction deviates above a certain limit, e.g. a medical claim is filed or a medical code is entered that does not fall within a set limit, the prediction engine flags the transaction for review and optionally alerts the entities involved in the transaction.

All of the transactions are replicated to the blockchain by multiple entities in the computer network. These include the transacting entity, the receiving entity, and the centralized control manager. Posting to the blockchain allows for verification and authentication of the transactions.

System and methods also allow automated claim adjudication and dispute resolution between two parties in the healthcare environment. The claim adjudication and dispute resolution relate to medical care provided for patients who have a medical health plan.

The system includes a server computer and a computing device. The server computer is comprised of a central database and a processor as well as a server application that is stored in the central database. The computing device includes an electronic device having a client processor and client database. Both the server and client are communicatively connected.

In this embodiment, a Healthcare Provider executes a transaction that is recorded in the centralized database as well as in the blockchain. The server computer electronically stores the data of the healthcare transaction in the central database and provides access of the transaction to the Healthcare Provider, Payer, and other relevant parties.

Thereafter, the Healthcare Provider files a dispute with the Payer System. The server computer electronically sends an alert to the relevant and authorized parties informing them that a dispute has been filed. The server processor then obtains data from the central database, blockchain, and any other relevant data provided by other parties in the computer network that relate to the disputed healthcare transaction. The processor then parses the data, resolves the dispute, and posts the results to the centralized server and blockchain.