Patent Application

App. No. 13/943,600

Abstract

Claims (34)

1 . A computer implemented system for sustaining healthcare consumerism comprising:

a database, wherein the database contains pricing information for a medical service;

a reference price for the medical service;

an application configured to determine the reference price for the medical service; and

an incentive engine configured to incentivize a policy holder to obtain the medical service at a price lower than the reference price for the medical service.

2 . The computer implemented system of claim 1 , further comprising:

an algorithm, performed by the application, configured to establish the reference price for the medical service based at least in part on a range of prices charged for the medical service by a plurality of medical service providers.

3 . The computer implemented system of claim 1 , wherein the database further contains the reference price for the medical service.

4 . The computer implemented system of claim 1 , wherein the pricing information contained in the database is information about a range of prices charged for the medical service by a plurality of medical service providers.

5 . The computer implemented system of claim 1 , wherein the incentive engine is a reward program, wherein the policy holder accumulates credit toward a reward given at the end of a cycle when the policy holder obtains the medical service at a price lower than the reference price for the medical service.

6 . The computer implemented system of claim 5 , wherein the reward is one of a rebate, receiving a percentage of the price differential between the reference price for the medical service and the price paid for the medical service, cash back, a rate reduction, or a discount.

7 . A computer implemented method for sustaining healthcare consumerism comprising:

compiling pricing information about a range of prices charged for a medical service by a plurality of medical service providers;

establishing a reference price for the medical service based at least in part on the pricing information for the medical service;

analyzing a price differential between the reference price for the medical service and a price a policy holder paid for the medical service; and

providing a rebate to the policy holder when the analysis indicates that the policy holder obtained the medical service at a price lower than the reference price for the medical service, wherein the rebate is determined at least in part by the price differential between the reference price for the medical service and the price the policy holder paid for the medical service.

8 . The method of claim 7 , wherein the reference price is established by an algorithm.

9 . The method of claim 7 , wherein the rebate is provided to the policy holder at the end of a cycle.

10 . The method of claim 9 , wherein the end of the cycle occurs at the end of the year, at the end of the plan year, semi-annually, quarterly, monthly, weekly, or at the time of the analysis.

11 . The method of claim 7 , wherein the reference price is established based at least in part on pricing information limited to a plurality of local medical service providers.

12 . The method of claim 11 , wherein local medical service providers are medical service providers located within 35 miles of the policy holder's place of residence.

13 . The method of claim 11 , wherein local medical service providers are medical service providers located within 35 miles of a reference point which may be the policy holder's employment location, a specified city, a specified building, a specified address, a specified medical service provider, or another specified area.

14 . A computer implemented system for managing healthcare costs comprising:

a database, wherein the database contains pricing information for a medical service;

a reference price for the medical service;

an algorithm configured to establish the reference price for the medical service;

an application configured to perform the algorithm; and

an incentive configured to incentivize a policy holder to obtain the medical service at a price lower than the reference price for the medical service.

15 . The computer implemented system of claim 14 , wherein the incentive is a reward that is one of a rebate, receiving a percentage of the price differential between the reference price for the medical service and the price paid for the medical service, cash back, a rate reduction, a discount, or some other reward given to the policy holder for obtaining the medical service at the price lower than the reference price for the medical service.

16 . The computer implemented system of claim 15 , wherein the policy holder accumulates credit toward the reward by obtaining the medical service at the price lower than the reference price for the medical service, wherein the policy holder's total credit at the end of a cycle is used to determine the reward given to the policy holder.

17 . The computer implemented system of claim 16 , wherein the end of the cycle occurs at the end of the year, at the end of the plan year, semi-annually, quarterly, monthly, weekly, or at the time of the analysis.

18 . The computer implemented system of claim 14 , wherein the algorithm establishes the reference price for the medical service based at least in part on the pricing information for the medical service stored in the database.

19 . The computer implemented system of claim 14 , wherein the application is further configured to calculate a rebate payable to the policy holder.

20 . The computer implemented system of claim 14 , wherein the algorithm establishes the reference price for the medical service based at least in part on an evaluation of a plurality of medical service providers, wherein the evaluation considers the quality and price of the medical service provided by each of the medical service providers.

Assignments (15)