System, method and computer program product for providing a healthcare user interface and incentives

摘要

Actively engaging members in managing their own healthcare, improving their health, and reducing healthcare costs to the payer involves providing a unified interface for member engagement. The interface may be communicatively coupled with a healthcare system, may be personalized to the member, and may offer multiple possible rewards to the member to encourage member behavior to effectively reduce healthcare costs and improve the quality of healthcare plans. The interface may provide the member with a pathway guiding the member to engage in activities to achieve short-term, intermediate and long-term goals for which actions are presented. Goals or actions may be predefined and may additionally be selected by the member. When member-engagement in the actions is verified, rewards may be granted to the member's account. In connection with such member engagement, the healthcare system collects member information, applies rules to that information, and generates alerts from those rules.

主权项

1. A computer-implemented method of encouraging healthy behavior, the method comprising the steps of:
receiving, at a server, health-related member information with respect to a member of a health plan; applying evidence-based medicine rules to the received member information to identify actions to improve the member's health or health risk, wherein the actions may be pending or completed; comparing the received member information with the identified actions to determine whether the actions are completed; and for completed actions, granting rewards under a rewards program, the rewards program comprising a sequence of steps including at least one action that is verifiable and at least one action that is non-verifiable, each step in the sequence being associated with a reward; wherein granting rewards for the at least one verifiable action comprises verifying completion of the at least one verifiable action by obtaining biometric data from an authenticated biometric device that confirms or denies completion of the at least one verifiable action, wherein the biometric data comprises biometric data selected from the group consisting of blood pressure data, glucose level data, cholesterol data, and weight data, and wherein the authenticated biometric device reports one or more of blood pressure, glucose level, cholesterol, or weight; wherein granting rewards for the at least one non-verifiable action comprises receiving non-verifiable medical information or self-reported member data and the granted rewards for the at least one non-verifiable action are based thereon; and wherein the completed verified action is granted a first level of reward and the completed non-verifiable action is granted a second level of reward having a lesser value relative to the first.