“Wellness Program Navigation Engine” in Patent Application Approval Process (USPTO 20240006046): Integer Health Technologies LLC

2024 JAN 23 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent application by the inventors Grifno, Ken (The Colony, TX, US); Roloff, Scott (Arlington, TX, US), filed on June 30, 2022, was made available online on January 4, 2024, according to news reporting originating from Washington, D.C., by NewsRx correspondents.

This patent application is assigned to Integer Health Technologies LLC (Arlington, Texas, United States).

The following quote was obtained by the news editors from the background information supplied by the inventors: “Healthcare is a significant expenditure for employers, insurers and individuals.

“In addition, medically-related absences from work are a significant cost to employers and employees.

“Wellness programs are a way to decrease healthcare expenditures and medically-related absences.

“These programs aim to make their participants healthier because healthier individuals consume less healthcare and are sick less often, missing fewer days of work.

“The types of wellness programs include: (1) general wellness programs for everyone, such as walking and weight watchers programs, (2) disease management programs for individuals with specific chronic conditions, such as diabetes and obesity, and (3) Employee Assistance Programs (EAPs) for individuals with behavioral health issues.

“When an employer sponsors a wellness program the participants may include employees, the dependents under the employer’s health plan, and retirees and their dependents when the employer provides retiree health benefits.

“Employers and others sponsoring wellness programs know what they pay vendors for them (or if they create their own programs, what they cost to create and operate them). They have no idea what they get in return.

“Vendors may measure certain qualitative factors to demonstrate that their programs are working, such as the number of steps taken in a walking program or the decrease in participant A1c scores in a diabetes management program.

“These qualitative measures may, or may not, be reasonable proxies for the program’s effect on the only quantitative thing that matters-the participants’ healthcare costs and medically-related absences.

“What is needed is a way to quantify the effect of a wellness program on the participants’ healthcare costs and medically-related absences so that the sponsor can determine if the program is working-or not, and if it isn’t working, what to do about it.

“That is what the navigation engine does; evaluates a wellness program based on its occupational outcome, healthcare outcome and ROI.”

In addition to the background information obtained for this patent application, NewsRx journalists also obtained the inventors’ summary information for this patent application: “A method and/or system consisting of a navigation engine that evaluates wellness programs based on their effect on the participants’ healthcare costs and medically-related absences from work.

“The navigation engine begins with a visual interface that displays all the engine’s analytics and data on the computer monitor at one time, arranging such items in categories and subcategories represented by circles or other images for quick retrieval by hoovering the computer mouse’s cursor over the circle with the desired item and clicking on it.

“The navigation engine intakes employer Human Resources (HR) data and combines it with a wellness program’s enrollment and costs to determine the program’s “occupational outcome,” the program’s impact on employee absences from work.

“For EAPs, the occupational outcome includes an analysis of participating employees whose employment was terminated, either voluntarily or involuntarily.

“The navigation engine can then determine a wellness program’s “healthcare outcome” and ROI by intaking the medical and pharmacy claims under the health plan and combining them with the HR and program data. In addition, the engine may intake the medical and pharmacy claims under the workers’ compensation program too.

“The navigation engine can generate a list of employees and/or other individuals that could benefit from the wellness program but who are not participating, and the impact on the program’s healthcare outcome and ROI if those employees or individuals did participate.

“The navigation engine can also recommend wellness and safety programs that the employer has not implemented, but should, along with the impact such programs could have on the medical and pharmacy claims and medically-related absences.”

The claims supplied by the inventors are:

“1. A method and/or system of navigating through, and searching in, a computing environment (i.e., the navigation engine) to evaluate wellness programs on a quantitative basis based on their impact on the participants’ healthcare costs and absences from work, and which then determines the ROIs (Returns on Investment) on such programs, comprising: presenting a system of visual navigation on a single computer screen for an individual (i.e., the user) using the computer along with a monitor and mouse, that represents categories and subcategories (and sub-subcategories, etc.) of material with functionally labeled circles or other images in a hierarchical organization; organizing that order with a central circle branching off into several smaller circles connected by stems, and from each of those smaller circles several more even smaller circles so connected, with more detailed subsets of the material as the circles descend; displaying thumbnails of the dashboards and reports available under a circle when the user hovers the computer mouse’s cursor over it; accessing those dashboards and reports when the user clicks the mouse’s cursor over the circle, or alternatively opening a particular dashboard or report directly when the user clicks on its thumbnail; linking the color of each circle for a wellness program to the navigation engine’s determination of the program’s ROI, which may include shading such color darker or lighter based on where the ROI falls within the color’s range; organizing employer human resources (HR) data (e.g., time & attendance, payroll, turnover, etc.) and wellness program data (e.g., enrollment and cost) in databases arranged in tables with schemas that permit the engine to extract the data and perform the engine’s algorithms on it; determining the number of sick or PTO (Paid Time Off) days (i.e., absence days) for each employee participating in the program during that employee’s base year (i.e., the year immediately before the employee joined the program); constructing a synthetic base year of the number of absence days for each employee that joined the program in the first year that the employee became an employee based on the average base year absence days of similarly situated employees as determined using the HR data set (e.g., age, gender, job description, location, and other job demographics); comparing the base year absence days to the current year absence days (or other period under evaluation) for each employee participating in the program; valuing the excess of the base year absence days over the current year absence days at the employee’s current year compensation rate or a normalized rate for all employees (which will be a positive number if the base year days exceed the current year days, and a negative number if the current year days exceed the base year days); aggregating these values for all the employees participating in the program to determine the program’s occupational outcome for the current year or other period under evaluation; determining the program’s occupational outcome ROI for the current year (or other period under evaluation) by taking (1) the overall value of the change in absence days (may be positive or negative), less (2) the overall cost of the program (if the overall value of the change in absence days is positive, this will decrease that positive value, while if the overall change is negative it will increase it), and then dividing that difference by (3) the overall cost of the program; determining the program’s occupational outcome ROI since the inception of the program by taking (1) the aggregate of the overall value of the change in absence days for each year of the program, increased for inflation (or decreased for deflation) from such year to the current year, less (2) the aggregate of the overall cost of the program during each year, increased for inflation (or decreased for deflation) from such year to the current year, and then dividing that difference by (3) the aggregate of the overall cost of the program during each year, increased for inflation (or decreased for deflation) from such year to the current year; and filtering the results by various metrics and/or combinations thereof, including programs, periods, business units and/or departments, job descriptions and/or functions, and employer locations and/or geographies.

“2. The method and/or system of claim 1, as well as comprising: assigning a change in absence day value of zero (or a selected negative amount based on the employer’s turnover costs) to an employee participating in a wellness program that is an EAP (Employee Assistance Program) when the employee terminates their employment, voluntarily or involuntarily, during the current year (or other period under evaluation).”

There are additional claims. Please visit full patent to read further.

URL and more information on this patent application, see: Grifno, Ken; Roloff, Scott. Wellness Program Navigation Engine. U.S. Patent Application Number 20240006046, filed June 30, 2022 and posted January 4, 2024. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20240006046)&db=US-PGPUB&type=ids

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