Medical Shared Savings System for International Care Cost Reduction
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Solution Overview
Problem
Rising healthcare costs in the United States are unsustainable for businesses and individuals, leading to increased premiums, reduced health insurance coverage, and financial instability, with the U.S. spending more on healthcare than other countries yet achieving lower life expectancy, indicating inefficiencies and waste in the healthcare system.
Innovation Solution
A medical shared savings system that allows patients to select medical providers outside the U.S., calculating savings based on procedure costs and dividing them between insurers and employers, using a Health Reimbursement Account to provide tax-free funds for employees, thereby reducing healthcare expenses and promoting affordable, high-quality care through medical tourism.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of manufacture
If medical procedures are performed within the U.S. medical plan network, then quality of care and accessibility are maintained, but healthcare costs continue to rise at unsustainable rates
Solution Approach 1:
The patent introduces international medical providers as a new dimension in the healthcare delivery system, allowing patients to access quality care abroad while generating savings. This expands the traditional domestic provider network into a global network, enabling cost-effective care without compromising quality through the use of Health Reimbursement Accounts and shared savings models.
2Reliability
If employers absorb higher medical costs to maintain coverage, then employee health insurance coverage is preserved, but business operating margins and competitiveness are reduced
Solution Approach 1:
The system implements a feedback mechanism where savings from international procedures are captured and redistributed through Health Reimbursement Accounts. This creates a positive feedback loop that maintains coverage reliability while generating financial benefits for employers, allowing them to sustain coverage without eroding operating margins or competitiveness.
3Device complexity
If employees contribute more to health premiums to offset cost increases, then employer subsidy burden is reduced, but employee financial stability and affordability are compromised
Solution Approach 1:
The patent empowers employees to actively participate in cost savings by selecting international providers and managing their own Health Reimbursement Accounts. This self-service approach allows employees to reduce their own healthcare costs while maintaining coverage, improving financial stability without requiring increased employer subsidies.
4Adaptability or versatility
If the U.S. healthcare system maintains high spending levels, then domestic provider networks and service availability are sustained, but life expectancy outcomes remain lower compared to spending levels in other countries
Solution Approach 1:
The system creates a universal healthcare delivery model that functions effectively both domestically and internationally. By establishing partnerships with international providers that meet quality standards and integrating them into the U.S. medical plan network, the system achieves comparable or superior health outcomes at lower costs, making the provider network more versatile and effective.
Data Source
AI summary
A medical shared savings unit receives a selection from one or more computing devices to select a medical provider in a region outside the United States for a patient as part of a medical savings plan, and accesses the medical plan information from the data store, and calculates a savings based on a difference between a cost of the medical procedure performed in the region outside the United States and a cost of the medical procedure performed within the United States. The medical shared savings unit further divides the savings between the insurer and the employer based on a medical savings plan model when the patient undergoes the medical procedure in the region outside the United States.