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; 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 action by:
obtaining, from a medical provider, medical information for the member that confirms or denies completion of the action;obtaining, from a third party, at least some medical provider information that confirms or denies completion of the action; orobtaining biometric data from an authenticated device that confirms or denies completion of the action; andgranting rewards based on verification of the completed verifiable action; wherein granting rewards for the at least one non-verifiable action comprises receiving non-verifiable medical information or self-reported member data and granting rewards 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.