Health care payment system utilizing an intensity adjustment factor applied to provider episodes of care
US5819228A · kind A · utility
Assignee
Inventor
Key dates
| Filing date | Oct 31, 1995 |
| Grant date | Oct 6, 1998 |
| Priority date | — |
| Expiry date | Oct 31, 2015 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG06Q40/08
- WIPO fieldIT methods for management
- WIPO sectorElectrical engineering
Abstract
A method for providing a payment mechanism for out-patient diagnostic imaging services based upon an episode of care payment methodology. An episode of care is selected as a given time period during which all imaging studies performed for a given patient for one clinical indication. An episode of care may include multiple diagnostic imaging procedures. All tests performed by a provider within the given time period comprise one episode of care. An intensity adjustment factor based upon the types of imaging studies performed is multiplied against the total episodes of care. This results in a total intensity adjusted episode of care. Each provider's percentage of the total intensity adjusted episode of care is calculated, and each provider is paid from the funds collected from the members. Provisions are also made for giving credit to providers based upon the complexity of the imaging studies. Furthermore, providers can be given credit for consulting with the referring physician to provide the best imaging studies based upon the identified clinical conditions.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.