The proposed $10M+ Healthcare X PRIZE is designed to improve health value by more than 50 percent in a community during a three-year trial. A competition around value measures and compares health outcomes against the total cost of care for a community. Health outcomes would be measured by a "community health index," which combines functional health (e.g., reduced sick days, improved ability to climb stairs) and clinical events (e.g., visit to ER, rehospitalization). Total cost would include direct costs incurred across health benefits, payroll (sick and disability pay), coupled with out-of-pocket health care.
"We have a challenge of how we pay for things. In many ways, we over pay for acute care and we underpay for preventative care and wellness," said Speaker Gingrich. "This approach allows for significant improvements that would lead to better health outcomes, which would lead to longer, more active lives and do so at lower costs."
Under the proposed competition framework, teams would have 18 months to conceive, model, and submit plans to create a new paradigm that can impact the health status of individual participants as well as the overall health status of communities. A later pilot phase will be used to demonstrate that the models can successfully be applied on a small scale. To select finalists, the competitive field will be narrowed to approximately the top five performers as judged by an objective process currently under development. During the competition stage, the five finalists will be matched to a test community of 10,000 individuals and compared against a control group during a three-year real-world trial. WellPoint, together with its affiliated health plans, has committed to collect appropriate data and collaborate with employers and providers to set up the test communities, subject to validation by an independent third party. The competing team's ability to change incentives is expected to drive improved behaviors across consumers and providers.
The X PRIZE Foundation, Wellpoint, Inc. and the Wellpoint Foundation Unveil Initial Design for Revolutionary $10+ Million Healthcare X PRIZE
The proposed $10M+ Healthcare X PRIZE is designed to improve health value by more than 50 percent in a community during a three-year trial. A competition around value measures and compares health outcomes against the total cost of care for a community. Health outcomes would be measured by a "community health index," which combines functional health (e.g., reduced sick days, improved ability to climb stairs) and clinical events (e.g., visit to ER, rehospitalization). Total cost would include direct costs incurred across health benefits, payroll (sick and disability pay), coupled with out-of-pocket health care.
"We have a challenge of how we pay for things. In many ways, we over pay for acute care and we underpay for preventative care and wellness," said Speaker Gingrich. "This approach allows for significant improvements that would lead to better health outcomes, which would lead to longer, more active lives and do so at lower costs."
Under the proposed competition framework, teams would have 18 months to conceive, model, and submit plans to create a new paradigm that can impact the health status of individual participants as well as the overall health status of communities. A later pilot phase will be used to demonstrate that the models can successfully be applied on a small scale. To select finalists, the competitive field will be narrowed to approximately the top five performers as judged by an objective process currently under development. During the competition stage, the five finalists will be matched to a test community of 10,000 individuals and compared against a control group during a three-year real-world trial. WellPoint, together with its affiliated health plans, has committed to collect appropriate data and collaborate with employers and providers to set up the test communities, subject to validation by an independent third party. The competing team's ability to change incentives is expected to drive improved behaviors across consumers and providers.