SYSTEM AND METHOD FOR MODELING HEALTH CARE COSTS

摘要

Systems and methods for generating models of potential medical treatment pathways are provided. In some embodiments, the systems and methods determine estimated costs of medical treatment responsive to user input of medical conditions. Some embodiments generate candidate treatment pathways from historic medical claim information. The candidate treatment pathways can be based on a channel of care and a medical condition. Further embodiments determine a probability associated with a treatment pathway and determine potential costs for the treatment pathway within a respective channel of care for a medical condition. In some examples, the system provides cost estimates within each channel and/or for each treatment pathway. In other examples, the system can also identify a likelihood associated with each treatment pathway, assign weights based on occurrence, and calculate the costs for treatment paths using the calculated weights and, for example, location of service.

主权项

1. A system for estimating health care costs, the system comprising:
at least one processor operatively connected to a memory; an analysis component, executed by the at least one processor, configured to determine weight values associated with one or more treatment options from historical medical information, and to generate one or more treatment paths, each treatment path including one or more treatment options; and a calculation component, executed by the at least one processor, configured to calculate an estimated cost associated with the one or more treatment options, based on, at least in part, the weight values and the one or more treatment paths.