Method and computer program product for measuring and...

Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management

Reexamination Certificate

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Details

C705S003000

Reexamination Certificate

active

07831443

ABSTRACT:
A method and computer program product is provided that, in various embodiments, may provide a measure of efficiency of resources used in medical treatment plan options. A normalized Relative Resource Value (RRV) may be obtained that measures the level of resources required to satisfy a “normal” case for a particular aspect of medical care. Applying this value against actual costs allows ranking and/or comparison of health care providers relative to one another on the basis of the price or resources applied or utilized. Moreover, applying the RRV against the quality of outcome allows comparison and ranking of providers on overall value. The invention may be applied to the components of medical care comprising, inter alia, acute inpatient, non-acute inpatient, outpatient, professional office-based care including scheduled outpatient, and pharmacy/prescriptions. The normalized RRV obtained under various embodiments of the invention may measure resource use for medical treatment plan options/resources independent of price. The RRV may be relative across, as well as within, each of the components of medical care. Thus, provider profiling generally as well as profiling across treatment plan options based on efficiency generally is within the scope of various embodiments of the invention. Moreover, providers may be compared based on efficiency for specific conditions, as well as across conditions, across treatment plan options and across components of care using various embodiments of the invention.

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patent: 2006/0190295 (2006-08-01), Merkin
Bridges to Excellence, “Measuring Provider Efficiency Version 1.0”, Dec. 31, 2004 (51 pages).
Symmetry, “Episode Treatment Groups™, An Illness Classification and Episode Building System”, May 20, 2005 (16 pages).
Edward Bassin, ProSoft, Inc., Cambridge, Massachusetts, “Episodes of Care, A Tool for Measuring the Impact of Healthcare Services on Cost and Quality”, May 20, 2005 (7 pages).

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