Monday, April 27, 2009

Health X PRIZE Communities: New Ulm Minnesota as a model for community health

A breakthrough project in New Ulm, MN provides an example of the potential when an entire community gets involved in improving health outcomes.

One of the more intriguing aspects of the Healthcare X PRIZE is not only the potential to see new technologies, methods, and implementation ideas from competing teams, but also to see how the test "communities" themselves organize themselves to support the innovation itself.

Last week I highlighted the "activated" community of Somerville, MA who is on a mission to eradicate childhood obesity. The entire community is rallying behind school nutrition programs, exercise initiatives, and greater education/awareness of the issue. My research of this community led me to learn more about New Ulm, MN and their Heart of New Ulm Project (thanks to Doug Goldstien at Gaming4Health for the tip!).

New Ulm is a small rural town in Minnesota of just over 13,000 people, nestled just 90 miles southwest of the Twin Cities, in the heart of the scenic Minnesota River Valley. New Ulm is becoming known as the "Christmas City" with its many Christmas traditions held each year but perhaps the greatest gift it is giving itself is to focus in on becoming one the healthiest cities in America.

The Heart of New Ulm project is a breakthrough concept designed to reduce the number of heart attacks that occur in the New Ulm area over the next 10 years. This means helping residents improve their health risks, such as physical activity, nutrition, obesity, or tobacco use, among others. The project will involve community education, medical interventions and environmental changes. Anyone who lives in the 56073 zipcode can participate in the Heart of New Ulm. Those living outside that zipcode are welcome to take part in the screenings and can certainly benefit from the community interventions. However, only those within the 56073 zipcode will be tracked for purposes of the study.

What is fascinating is how the town itself - politically, strategically, and personally - is banding together to work together to improve heart disease. They are obviously supported by their essentially single provider in the area, Allina Health, who happens to have a comprehensive electronic health record system by Epic. The Minneapolis Heart Institute Foundation has partnered on the project as well, providing administrative support and research project expertise as well on this 10 year initiative. , as well as community, government, business and other local stakeholders to conduct a long-term initiative focusing on the City of New Ulm.

We believe that many more "communities" like New Ulm may be interested in competing for the Healthcare X PRIZE. When we expand the definition of community, you can see how other municipalities, employer-based groups, or other affiliations may also choose to align with the efforts of the Healthcare X PRIZE both in the competition phase but also a demonstration projects that run concurrent. Given our desire for the broadest impact, we are currently considering ways to include these concepts into the competition.

As always, we welcome your feedback.

Saturday, April 25, 2009

Optimal Health: Kyle Maynard as inspiration

Just came across the story of Kyle Maynard, a congenital amputee entering a Mixed Martial Arts fight in Alabama.

As a congenital amputee, Kyle has arms that end with his elbows and legs that end by his knees...this is something that puts many people in a wheelchair with extended nursing care.

Kyle, already a football player, wrestler, and CardioFit exercise instructor, has now taken on professional fighting as a new pursuit.

As we debate what we should be doing with health in the US, one of my main concerns is that we damn people with the curse of faint expectations. In many cases, physicians have dismissed the power of human willpower and dreams and brought their patients back from illness, but not to functioning health.

Kyle's story serves as an amazing reminder that wherever we are, we can always dream bigger dreams and that human will allows us to accomplish more than most people think is even possible.


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Friday, April 24, 2009

Burrill Report: The Healthcare X PRIZE as a "Carrot for Good Health"

A great article regarding the Healthcare X PRIZE was published in the Burrill Report on April 22 highlighting some of the unique features of an incentivized prize model.

The United States has put off reforming its ailing healthcare system for decades, but now comes a high-stakes prize that may make the thankless task really worth someone’s while. How does $10 million sound? The foundation that made possible the flight of the world’s first private spaceship plans to offer the sum to the team that comes up with a model that would dramatically improve the delivery of health in America. To become one of five finalists, teams will have to demonstrate that they can improve health value—which takes into account both outcomes and cost—by at least 50 percent.
The competition is being organized by the Playa Vista, California-based X PRIZE Foundation, along with Indianapolis-based insurer WellPoint and its WellPoint Foundation. The goal is to create a health system “that engages and empowers individuals and communities in a way that will dramatically improve health value.” America’s annual $2.4 trillion in healthcare expenditures—17 percent of gross domestic product—currently pays for a system that focuses on short-term disease management rather than the long-term improvement of individuals’ health, the organizers lament. “How do you get really healthy people to come out of all the funds we are putting into healthcare?” says Dr. Vijay Goel, director of prize development at the X PRIZE Foundation. “We see this [the competition] as really a complement to [other reform] efforts.”
The organizers plan to finalize competition design in June, with an anticipated launch of the challenge by the end of 2009. The competition itself involves several stages. To enter, teams will have to show an early concept and be able to cover an initial registration fee, expected to be about $10,000. In the concept phase, teams will have to show that their design can improve health value by at least 50 percent in a predictive model involving 10,000 sample records. Ultimately, the competition sponsors will select five finalists to participate in a real life, three-year trial in five different 10,000-person communities or employer-based test groups. The winner will be picked after the health outcomes and financial results are compared to a control group.
Goel says the competitors will likely have access to WellPoint’s extensive network of providers in order to test their health system models that will care for 10,000 people over the three-year period. Potential patients will have to opt in to the program and will know that they are part of a reform effort. “One of the things we’re saying to these teams is ‘you will have to create a system that people will want to participate in,’’” says Goel. “The problem with existing healthcare is that it isn’t all that engaging.”
The X PRIZE Foundation, which arranged, among others, the $10-million Ansari X PRIZE for suborbital spaceflight, and WellPoint say they expect the competition to result in innovation in a variety of areas. Those include care experience, healthcare financing and payment, comparative effectiveness, coordination of care, electronic health tools and technology, to name a few. An optimal system would eliminate acute care through proactive approaches, include clear information that highlights best performers regardless of their approach, and provide comprehensive solutions where best practices are delivered every time, the organizers say.
The project involves creating a community health index, which would track many components, such as reductions in ER visits and morbidity, as well as total cost—and would do so in a way that could be applied to different approaches and communities. But it will also look at broader metrics that aren’t always included in traditional evaluations, such as whether systems are able to reduce disability and sick days. “It’s really about making the bad clinical events we don’t like go away and making the good, positive events happen more frequently,” Goel says.
The Healthcare X PRIZE comes as the Obama Administration ramps up efforts to reform the U.S. healthcare system, having created the first-ever White House Office of Health Reform. Goel says that he sees the competition’s efforts as being complementary. But he also says that regardless of what happens on a national scale, the most innovative model that emerges from the competition will not just be rewarded with the prize. WellPoint has made a commitment to take the winning concept and expand it across its 35 million members, he says. “There’s a real attraction there,” he says.
Of course, Goel and his colleagues realize that driving vast improvement in healthcare is a highly complex task, perhaps even more challenging than building a suborbital spaceship. For starters, healthcare reform involves many players as well as buy-in from the public, who will need to adopt new approaches to healthcare delivery. “One of the things we are asking in early feedback is ‘are we asking the possible?’” says Goel. “I think one of the great things about being involved with the X PRIZE is that people think it’s crazy until they prove it to be true.” Only one team will win the prize, but the winners could ultimately end up being the American public if the reform that emerges is truly innovative—and actually doable.

Tuesday, April 21, 2009

Health X PRIZE Communities: Somerville Massachussets as a prototype

Somerville's experiment began in 2002, when researchers from Tufts University decided to find out whether efforts to promote exercise and healthful eating could help prevent obesity among schoolchildren

One of the interesting features of the Healthcare X PRIZE is that the competition is aimed at creating an "optimal health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value." This refocusing our disease care system on actual health improvements, and measuring those improvements at both an individual and community level, is what the Healthcare X PRIZE is trying to achieve.

It seems that the town of Sumerville in Massachussets has definitely figured this out. In a great piece in todays's edition of USA Today, the little town that could is featured for their efforts to dramatically "shape" up their community by tackling the childood obesity epidemic head on. They are in the midst of a seven year investment into a comprehensive community program to fight childhood obesity while encouraging a healthier lifestyle for the community. The community altered the school lunch program, installed new bike lanes, restuarant menus included more healthy choices, and residents planted community gardens. Within one year, the results revealed that children gained 15% less weight than other kids their age and they noted a doubling of the bike lanes

You can imagine how teams and communities competing for the Health X PRIZE might adopt similar programs, with greater transparency and complementary programs that can dramatically impact the "community health index". Decreased admissions to hospital (due to greater health awareness, earlier intervention, more activity, etc), reduced re-admissions (better coordination, transition followups, etc), decreased ED visits (due to better compliance, better access to providers, etc), and better health status as well as better overall health experience could begin to yield the level of health value increases we believe are possible as we begin to think about health and vitality as our objective.

If these programs were associated with aligned incentives from the providers and the employers, you can begin to see the potential impact. We believe Somerville represents what is possibility when a community gets together to improve health status - we look forward to innovations like this as we prepare for the competition this fall.

Friday, April 17, 2009

HXP Applications? Requesting Comments on Initial Prize Design First!

The proposed $10MM Healthcare X PRIZE has been released for a 45 day public comment period - Your comments will help shape the prize design.

Just getting back from a 3 day tour of Washington, DC as part of the Healthcare X PRIZE and World Health Care Congress. Susan Dentzer, Bill Bradley, Newt Gingrich, and Angela Braly were all terrific! We had a great time, had a great event, and now look forward to some great interaction throughout the country as we seek to refine the Initial Prize Design (some early news from Reuters, NPR, and Fast Company.

Most of the questions that have been streaming in have related to how to apply for the prize. As mentioned in the Press Release, on our Website, and in all of our materials (here, here, and here) we are actively seeking public comment on the Initial Prize Design itself. The comments we recieve will actually determine what the Prize is ultimately about. We are interested in feedback about the grand challenge, what type of impact we should be seeking, how we should select the populations, what the teams should try to do to impact health, the focus on vitality, and the measurement instruments we should be using to declare the winner.

We are hoping that the public comment period can excite interest in the Prize but also engage people in helping us refine the actually competition. These refinements may impact which teams try to compete, which solutions are developed, and how these are implemented, measured, and a winner is declared. As a result, teams cannot yet "apply" as prize as the competition is as yet not fully defined. All interest at this stage is being directed to the Initial Prize Guidelines to solicit comments, feedback, and suggestions.

So keep those comments coming . . . we will have more information about actually registering to become a team as we get closer to the official launch of the prize (estimated to be late 2009).
In the meantime, we are looking at different ways to begin creating the team ecosystem process with some of the available tools. This should be very useful in connecting people together.

Stay tuned!

Putting together an ecosystem for great ideas on health reform

Had a great comment on sharing thoughts from Bill Edstrom. What elements of an ecosystem would be important to helping teams?

If you don't already have such planned, may I suggest your website include a page where suggestions can be posted, suggestions that contestants might find useful in designing optimally healthy communities, or, if unused, should be considered for such. Regardless of what team may ultimately win the prize, it's highly likely that each team will have unique approaches that should be considered for inclusion in a transformed American healthcare system. So will non-participants. Regardless of who may enter this contest, a limited number of minds, no matter how brilliant, can only provide for a limited number of solutions. Plus, simple ideas, regardless of their source, can often be aggregated to form great ones, or they can be transformational on their own. Please don't limit the possibilities. Thanks.


Originally posted as a comment by Bill Edstrom, MPH on Healthcare X PRIZE Blog using Disqus.
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Tuesday, April 14, 2009

10. Sponsors

About the X PRIZE Foundation

The X PRIZE Foundation is an educational nonprofit prize institute whose mission is to create radical breakthroughs for the benefit of humanity. In 2004, the Foundation captured the world’s attention when the Burt Rutan-led team, backed by Microsoft co-founder Paul Allen, built and flew the world’s first private spaceship to win the $10 million Ansari X PRIZE for suborbital spaceflight. The Foundation has since launched the $10 million Archon X PRIZE for Genomics, the $30 million Google Lunar X PRIZE, and the $10 million Progressive Insurance Automotive X PRIZE. The Foundation, with the support of its partner BT Global Services, is creating prizes in Space and Ocean Exploration, Life Sciences, Energy & Environment, Education and Global Development. The Foundation is widely recognized as the leader in fostering innovation through competition. For more information, please visit www.xprize.org.

About WellPoint, Inc.

WellPoint is committed to improving the lives of the people we serve and the health of our communities by simplifying the connection between health, care and value. Our goal is to help shape the impact each health care decision has on individuals, the health care system at-large, and our communities. WellPoint’s more than 42,000 associates work every day to help create the best health care value for our customers. Through collaborations with providers and with innovative programs, WellPoint’s affiliated health plans reward healthy lifestyles and quality, safe and effective care. As the nation’s largest health benefits company, with approximately 35 million members in its affiliated health plans, WellPoint is at the center of the health care system. This position provides us with the relationships and insights needed to help create affordable and actionable solutions that improve health care. As an independent licensee of the Blue Cross and Blue Shield Association, WellPoint serves members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at www.wellpoint.com.

About WellPoint Foundation

The WellPoint Foundation, Inc. is a private, non-profit organization wholly funded by WellPoint, Inc. Through charitable contributions and programs, the Foundation promotes WellPoint’s inherent commitment to enhance the health and well-being of individuals and families in communities that WellPoint’s affiliate health plans serve. With combined assets of $95 million, the Foundation focuses its funding on strategic initiatives that, among other health related programs, address and provide innovative solutions to promoting the Healthy Generations Program, a multi-generational initiative that targets specific disease states and medical conditions. These disease states and medical conditions include: prenatal care in the first trimester, low birth weight babies, cardiac morbidity rates, long term activities that decrease obesity and increase physical activity, diabetes prevalence in adult populations, adult pneumococcal and influenza vaccinations and smoking cessation. The Foundation also coordinates the company’s annual associate giving campaign and provides a 50 percent match of associates’ campaign pledges. To learn more about the WellPoint Foundation please visit www.wellpointfoundation.org.

9. Contact / Comment

We are excited by the potential of Healthcare X PRIZE and appreciate your interest. It is our hope that the public release of these initial prize guidelines will be of interest to the broader national discussion about the future of health care. Please join the conversation and share your comments regarding this Initial Prize Design with us at healthblog.xprize.org.

For more information, including additional details the competition, X PRIZE Foundation, WellPoint, or WellPoint Foundation, please visit: www.xprize.org/wellpoint.

8. Teams

Based on initial interest, we’re likely to see a large number of entrants to the Healthcare X PRIZE, but most will not be comprehensive enough to be a legitimate competitor on their own. Given the large number of point solutions and a dearth of comprehensive approaches in the health innovation space, we plan to create an ecosystem where teams/partners/sponsors/ financiers can come together and form teams offering more comprehensive solutions. The initial prize timeline of 18 months from competition launch to finalist selection may need to be adjusted should early entries require significant time to build relationships and organize themselves into teams that can deliver a comprehensive solution.

Upon Entry, a team will need to show an early concept and have sufficient resources to pay an initial registration fee. The Concept stage has a more rigorous hurdle; teams will need to be able to demonstrate the effectiveness of their solution in a predictive model with 10,000 sample records. Only those who can successfully model a 50% improvement in health value will move to the next round. As mentioned above, we believe that many of the teams in the Entry and Concept stages will find their solution insufficient to win the prize…we need to help them determine their limitations quickly and help them find partners that will allow them to move forward in the competition. The Pilot phase will show real world proof points for several key assumptions in the model demonstrated at Concept. The Pilot phase will also require an alpha version of the products and services of the teams to be developed. Five Finalists will be selected from those who have successfully completed the Pilot requirements and they will then be matched into a test group for the real world competition during a 3 year trial.

Teams are likely to bring a number of capabilities together into their solution. Areas of innovation we expect to see include:
  • Financing/ Payment
  • Behavior modification
  • Comparative effectiveness
  • Personalized decision support
  • Tracking/ feedback
  • Coordination of care
  • eHealth tools and technology
  • Convenience
  • Care Experience
We expect teams to demonstrate the impact of their solutions in their test populations during the 3 year trial. Test populations are intended to include many different types of individuals to reflect the general population. All efforts will be made to create actuarially equivalent and representative populations in our test groups. In creating equivalent test populations, we will need to balance inclusiveness of a general population with the need to cost-effectively capture sufficient data to show the required changes during the 3 year trial window. We will need to balance the number of people in the trial populations, the mix across health status, and rules/boundaries in dealing with health conditions that may have significant ethical considerations.

7. Philosophy of Prize Design Guidelines

The prize design guidelines were developed from a philosophy focusing on transparency, recruitment of the best ideas globally, and impact. The Healthcare X PRIZE would be a systemic prize for the benefit of all humanity. Creating an objective, open process would create a significant precedent in health care, an industry where data is often guarded zealously. The teams would report progress in regular intervals. WellPoint would share its methods of implementing finalist approaches, where applicable. Auditors, judges, and trusted third parties would both audit results as well as oversee the process of selecting finalists.

The competition is a global one, with an America as the testing ground. The likely location of the test communities will be from the states where WellPoint has markets. To maximize the number of teams that can enter and bring existing assets yet compete fairly, we will allow any funding source and any amount of spend on building solutions outside the test populations. Operating and recruiting expenses in the test populations will be charged against “total cost” and may be constrained by a cap to ensure an equal playing field. As well, use of controlled facilities within the test populations may be limited to allow for a more equal playing field.

The competition is focused on creating a demonstrable impact within a 3 year window. The estimated population of 10,000 individuals should be large enough for real-world value demonstration while still being manageable with a small team. We picked the high target of 50% improvement due to the need for a comprehensive solution capable of generating radical change. An opt-in model was selected to highlight potential for rapid scalability and broad adoption

6. Measurement

If you can’t measure it, you can’t effect change

The choice of the underlying measurements to determine the winner of the Healthcare X PRIZE will have long-lasting implications. The choice of measures will shape the solutions teams will use to compete; the approach to weighting of the index will determine the potential for returns on any health investment. Therefore, given the complexity of the choices, we decided to begin by laying out a philosophic approach to the measurements to be used.

The winner of the Healthcare X PRIZE will need to focus on creating value through improvements in community-level outcomes and costs. Therefore, metrics will need to be at the community/ population level and objective and easy to track using validated tools, where possible. The number of metrics used should be at a manageable level, so we are utilizing broad outcome-based measures, rather than any process metrics or intermediate markers. Given the goal of health optimization, we’re choosing metrics that are either markers of health status improvement or a clinical event we would like to remove from the human experience. We will weight the measures to place functional improvement at equal stature with sick care. All measures will be actionable with existing case examples that indicate significant changes can be achieved. On the cost side, we look to include as many direct costs as possible across multiple types of payment methods and reflect the actual bill at time of service. Test communities will be actuarially equivalent, potentially through the use of oversampling for certain characteristics, allowing us to use real data from the trial groups without the need to further adjust or project it.

Measuring “health value” requires the creation of new measures reflecting improvements in community health and total costs. The initial definition of the “community health index” focuses on tracking the reduction in clinical events, improvements in productivity, and improvements in functional health. Measures under consideration include:

  • Elimination of acute exacerbation: Hospitalization/ rehospitalization; ER visits; Communicable
  • Reductions in long-term impairment: Major morbidity, long term disability, long term care, Mortality
  • Reductions in short-term impairment: Unplanned absence (work, school), short term disability
  • Optimization of individual vitality: Functional fitness, self-reported health status

Initial definition of “total cost” is oriented around direct, actual costs incurred for health. This includes funds processed through the claims system, medical spend incurred via charge card, reimbursed out of pocket spend, and selected non-qualified health spend out of pocket. Direct costs also include communication and incentive program costs to activate, engage, and inform consumers. Sick and disability pay are also costs that can be added. We will not include projected or estimated costs such as presenteeism, as they cannot be objectively captured using current instruments. We will include team costs for operating in the test market (this does not include the creation of any scalable back-end) and does not count an outreach/ testing budget for the 6 month “dry run”/implementation period prior to the competition beginning.

The “individual vitality score” does not directly factor into the health value equation, as it is an individual metric designed by each team used to inform and engage individual consumers. However, we project that an “individual vitality score” will be critical in engaging consumers in health decisions across a wide variety of choices and settings.

5. Impact Potential

  • A new model and system of health that demonstrates a >50% improvement in healthcare value (HCV).
  • A measurable and globally accepted population health metric, tentatively called the “community health index” (CHI), which becomes a benchmark for measuring future improvements in health at a population level
  • An individual health metric, tentatively called the “individual vitality score”, which can helps individuals (and providers helping them) understand and benchmark their current health status and potential for improvement
  • A personalized “vitality dashboard” where consumers will be able to understand current health status, “portfolio” of improvement options, projected return from health improvement efforts
  • A new “optimal health” paradigm that helps consumers optimize their health and rewards providers that can demonstrably create improved health value

4. Initial Prize Design

The proposed Healthcare X PRIZE anticipates a competition to generate a 50% improvement in health value in a community of 10,000 people over 3 years.

Health value is defined as the combination of a “community health index” measuring a range of population health outcomes and “total cost”. Teams would compete to show improvements in the health of their assigned community while also highlighting improvements generated in the total cost of care. The rules require improvements in both outcomes and costs for an entry to qualify. The focus on community-level results encourages teams to continually find new ways to improve the health of a significant number of people Outcomes should lead to innovations improving individual engagement in programs as well as a sharper focus on achieving outcomes for participants. Teams must make a difference by engaging individuals, including the creation of an “individual vitality score” that helps an individual understand their health status and the impact of specific health choices/ programs on their health.

Five finalists will be selected to compete in five separate 10,000 person community or employer-based test group during the three year trial. Each finalist would implement their comprehensive system with mechanisms to engage, coordinate, advise, evaluate, and influence individuals and care providers in their test group. Their outcomes and financial results would be compared to a control group in a similar or adjacent community, allowing for the real-world demonstration of the impact of their system. The competition and all results would be audited by an independent panel of judges and trusted third parties.

The initial prize design for the Healthcare X PRIZE differs significantly from other health reform efforts in the following ways:
  • Focus on health outcomes and value at a community level: The Community Health Index creates a comprehensive picture of health across a community and the combination of Total Cost enables apples to apples comparisons of different approaches over a wide range of health conditions
  • Consumer engagement: Consumers must opt-in to any programs the teams offer. The assignment of people to a team makes high rates of participation a requirement for success.
  • Payment incentives: Teams may create payment innovations to improve incentives for consumer, providers, or vendors who demonstrate desirable outcomes. This allows for a team the flexibility to appropriately reward providers that create value.
  • Comprehensive and proactive outlook: Teams are responsible for an individual’s health across all care settings for a multi-year period of time. This creates an increased focus and investment opportunity in proactive, longer-horizon health improvement programs. This also allows for the development of a relationship across multiple types of care and coordination across multiple care programs and treatments.
  • Local partnerships: Teams must develop relationships with local health care providers/employers/community organizations in order to deploy local solutions. The ability to work outside of established facilities should enhance the scalability of solutions.

3. Prize Design Approach

In developing a Healthcare X PRIZE, sustainable improvement in health value requires a transformative approach. Our starting objectives include:
  • Rewarding entities that optimize health value
  • Investment in activation and engagement of individuals to achieve increases in vitality and to create a foundation for consumers to take responsibility for their health
  • Improvements in the vitality of individuals will advance the health of the community overall
These objectives will link empowered individuals to the improved health of a community and to the savings generated from the improvements in health. This action creates a virtuous cycle where a proactive investment in improving health generates healthier communities which in turn reduce the resources required for treatment of illness. Care coordination during episodes of sickness would appear to have similar potential to create virtuous cycles of improved outcomes after an initial investment into rewarding better outcomes.

2. The Grand Challenge

The Grand Challenge

The proposed Healthcare X PRIZE goal is to create an Optimal Health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value.

Health care is a complex system that touches each of us and consumes 17% of America’s GDP ($2.4 Trillion in 2007). In identifying the Grand Challenge, we interviewed over 50 experts in the health sector about the various challenges a prize might solve. A number of common themes emerged:
  • We have a sick care system rather than a health system
  • Financial incentives are based on volume/ procedures instead of outcomes
  • Our system is fragmented with a lack of coordination or agreement on best practices
  • The focus is on short-term disease management vs. long-term focus on improving the health of individuals and communities
  • The consumer does not have the tools to engage in health even if they have the desire.
As we explored the ways a team might address these issues in the existing system, it became clear that our health system doesn’t function like a system at all. In fact, there are no central goals that orient the different providers across the system into a cohesive unit, nor are there incentives that focus them on working together to achieve these desired outcomes. We are setting that goal. We believe the health system should help all of us attain optimal health.

As we asked our experts what an Optimal Health system should look like, we heard:
  • Eliminate acute/ rescue care through proactive approaches
  • Provide comprehensive solutions where best practices are delivered every time
  • Include clear information that highlights best performers regardless of their approach
  • Recommend effective solutions that work for consumers and drives impact
  • Include tracking systems that allow for high-quality feedback and learning

1. Introduction

Introduction

The X PRIZE Foundation, a nonprofit organization that drives innovation through large incentive competitions, has partnered with the WellPoint Foundation and WellPoint, Inc. to develop a $10M+ Healthcare X PRIZE to revolutionize the US healthcare system. This document contains an initial design for a prize to improve the health of Americans. We are sharing our initial thinking to solicit public feedback and engage you in the conversation to help us create the best prize possible.

This initial prize design was released to the public on April 14, 2009 for a 45 day period of public comment. Your comments and input will be used to test and refine our objectives and design. We will continue to engage the public and experts throughout the world to help us further explore in depth areas critical to the prize development effort. By June, we should have a final prize design that will move into a planning phase in anticipation of a launch by the end of 2009.

Overview of Initial Design and Prize Guidelines, v1.0

As part of a national media event at the World Health Care Congress on April 14, 2009, the X PRIZE Foundation, WellPoint, Inc, and the WellPoint Foundation announced the release for public comment of the Initial Design and Prize Guidelines for a proposed $10M+ Healthcare X PRIZE. The overview slides are attached below.
Healthcare X Prize Initial Design And Prize Guidelines, V1.0
View more presentations from XPRIZE.

X PRIZE Foundation, WellPoint Inc. Unveil Initial Design for Revolutionary $10+ Million Healthcare X PRIZE

Initial Prize Design Released for Public Comment at World Health Care Congress in Washington, D.C.

WASHINGTON (April 14, 2009) -- The X PRIZE Foundation, a nonprofit organization that drives innovation through large incentive competitions, in collaboration with the WellPoint Foundation, one of the nation’s largest private foundations, and WellPoint, Inc. (NYSE: WLP), the nation’s largest health benefits company in terms of medical membership, announced today the initial competition design for a $10M+ Healthcare X PRIZE.

The Grand Challenge for this Healthcare X PRIZE will be to create an optimal health paradigm that empowers and engages individuals and communities in a way that dramatically improves health value. Following today’s announcement, the public is invited to comment on the approach and provide feedback to ensure that the competition results in affordable, high-quality health care for all communities. An overview of the initial prize design and guidelines are available for public comment at www.xprize.org/wellpoint.

The initial X PRIZE design was announced jointly by Dr. Peter H. Diamandis, chairman and CEO, The X PRIZE Foundation and Angela Braly, president and CEO, WellPoint, Inc. They were joined by the Hon. Bill Bradley, former U.S. Senator, and managing director, Allen & Company LLC, and the Hon. Newt Gingrich, former Speaker of the House and Founder, Center for Health Transformation, for a health care discussion moderated by Susan Dentzer, editor in chief, Health Affairs.

“President Obama has called for bold new ideas to revitalize our health care system. We are answering that call by developing an innovative incentive prize that optimizes the health of all Americans and significantly increases the value from every health dollar,” said Dr. Diamandis. “This is not the situation today and we need to change it. Ultimately, you get what you incentivize. If we can refocus our health care system on helping individuals optimize health, and reward providers who improve outcomes, the implications over the next decade will be profound.”

“I’m very pleased to be part of this developing X PRIZE competition,” said Sen. Bradley, “This prize will bring together people from different elements of the health care system and get them collaborating to devise a new system that will produce the highest quality health care for the greatest number of people at the lowest possible cost. The greatest key is tapping into the American people; if you’ve got a great idea, put it forward.”

The collaboration between The X PRIZE Foundation, WellPoint, Inc. and the WellPoint Foundation to design a $10M+ Healthcare X PRIZE was announced in October 2008. Since then, hundreds of comments from the public and leaders across the health care industry have been collected from The X PRIZE Foundation Web site to create the initial design announced today.

“From across the health spectrum physicians, consumers, entrepreneurs, technology experts, government officials and others have already contributed their time and expertise to developing a meaningful prize design,” said Angela Braly. “Now we ask the public and interested stakeholders to take a look at our initial design and share ideas on how we can use a Healthcare X PRIZE to create a dramatic improvement in the health of our families and communities while simultaneously improving affordability.”

The X PRIZE Foundation’s health care prize development team and WellPoint collaborated with prominent health care providers, thought-leaders, academic and political advisors from across the nation to identify key components for a health care focused incentivized competition. Key advisors include: Dr. Glenn Steele, CEO, Geisinger Health System; Dr. Jim Weinstein, director, Dartmouth Institute for Health Policy and Clinical Practice; Dr. Carol Diamond, managing director, Markle Foundation; Mark Litow, principal and consulting actuary, Milliman; Dr. Dean Ornish, president, Preventive Medicine Research Institute; Michael E. Porter, professor, Harvard Business School; Hon. Bill Bradley, former U.S. Senator; and Hon. Newt Gingrich, former Speaker of the House and Founder, Center for Health Transformation.

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.

“We appreciate the tremendous support and advice we've received from the health community as we've shaped this effort,” said Dr. Vijay Goel, director of Prize Development, The X PRIZE Foundation. “By engaging individuals through the creation of a personal vitality score to help them understand their health options, and then measuring the impact of their choices at the community health level, we can create new approaches to achieve optimal health in a convenient, proactive, and effective way. We see the Healthcare X PRIZE effort as a public-private collaboration that makes affordable health care for working families a sustainable reality.”



ABOUT THE X PRIZE FOUNDATION
The X PRIZE Foundation is an educational nonprofit prize institute whose mission is to create radical breakthroughs for the benefit of humanity. In 2004, the Foundation captured the world’s attention when the Burt Rutan-led team, backed by Microsoft co-founder Paul Allen, built and flew the world’s first private spaceship to win the $10 million Ansari X PRIZE for suborbital spaceflight. The Foundation has since launched the $10 million Archon X PRIZE for Genomics, the $30 million Google Lunar X PRIZE, and the $10 million Progressive Insurance Automotive X PRIZE. The Foundation, with the support of its partner BT Global Services, is creating prizes in Space and Ocean Exploration, Life Sciences, Energy & Environment, Education and Global Development. The Foundation is widely recognized as the leader in fostering innovation through competition. For more information, please visit www.xprize.org.

ABOUT WELLPOINT, INC.
WellPoint is committed to improving the lives of the people we serve and the health of our communities by simplifying the connection between health, care and value. Our goal is to help shape the impact each health care decision has on individuals, the health care system at-large, and our communities. WellPoint’s more than 42,000 associates work every day to help create the best health care value for our customers. Through collaborations with providers and with innovative programs, WellPoint’s affiliated health plans reward healthy lifestyles and quality, safe and effective care. As the nation’s largest health benefits company, with approximately 35 million members in its affiliated health plans, WellPoint is at the center of the health care system. This position provides us with the relationships and insights needed to help create affordable and actionable solutions that improve health care. As an independent licensee of the Blue Cross and Blue Shield Association, WellPoint serves members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at www.wellpoint.com.

ABOUT THE WELLPOINT FOUNDATION, INC.
The WellPoint Foundation, Inc. is a private, non-profit organization wholly funded by WellPoint, Inc. Through charitable contributions and programs, the Foundation promotes WellPoint’s inherent commitment to enhance the health and well-being of individuals and families in communities that WellPoint’s affiliate health plans serve. With combined assets of $95 million, the Foundation focuses its funding on strategic initiatives that, among other health related programs, address and provide innovative solutions to promoting the Healthy Generations Program, a multi-generational initiative that targets specific disease states and medical conditions. These disease states and medical conditions include: prenatal care in the first trimester, low birth weight babies, cardiac morbidity rates, long term activities that decrease obesity and increase physical activity, diabetes prevalence in adult populations, adult pneumococcal and influenza vaccinations and smoking cessation. The Foundation also coordinates the company’s annual associate giving campaign and provides a 50 percent match of associates’ campaign pledges. To learn more about the WellPoint Foundation please visit www.wellpointfoundation.org.

Friday, April 10, 2009

Media Advisory: Announcement of Initial Prize Design for Potential $10 Million Healthcare X PRIZE to Revolutionize U.S. Health System

Initial prize design with call for public comment to be shared at 6th Annual World Health Care Congress on April 14 in Washington, D.C.

  • WHO/WHAT: Health care, wellness, academic and innovation thought-leaders will join Dr. Peter Diamandis, Chairman and CEO, The X PRIZE Foundation, and Angela F. Braly, President and CEO, WellPoint Inc. to announce - for public comment - an initial PRIZE design for a proposed $10+ Million Healthcare X PRIZE. This first-of-its kind competition will focus on reinventing the health care system in a bold, measurable and scientific fashion to enable dramatic improvement in health care value in the United States.
  • WHEN: April 14, 2009 from 12:15pm - 1:00pm (EST)
    WHERE: Press Conference during the 6th Annual World Health Care Congress in the Washington 5, Exhibit Level Marriott Wardman Park Hotel - 2660 Woodley Road, NW, Washington, D.C. 20008
The Prize is focused on improving health care value through optimal health. The proposed design will align and improve care within communities and proactively assist individuals in optimizing their health in a way that reduces overall costs. By setting a higher bar for good health based on better outcomes and an individual’s active participation, The X PRIZE Foundation, the WellPoint Foundation, and WellPoint, Inc. are striving to make health care dramatically more proactive, personalized and focused on engagement in health and vitality.
The initial competition design is the result of extensive research into health care market challenges and the identification of opportunities for improvement that could result from an incentivized competition.

The PRIZE design work was supported by a team of prominent health care providers, health care thought-leaders, academic and political advisors, including: Dr. Glenn Steele, CEO, Geisinger Health System; Dr. Jim Weinstein, director, Dartmouth Institute for Health Policy and Clinical Practice; Dr. Carol Diamond, managing director, Markle Foundation; Mark Litow, principal and consulting actuary, Milliman; Dr. Dean Ornish, president, Preventive Medicine Research Institute; Michael E. Porter, Harvard Business School professor; Hon. Bill Bradley, former U.S. Senator; and Hon. Newt Gingrich, founder, Center for Health Transformation.

A panel discussion with Dr. Diamandis, Angela Braly, Hon. Bill Bradley and Hon Newt Gingrich will follow the announcement. The panel will be moderated by Susan Dentzer, editor in chief, Health Affairs. One-on-one interview opportunities can be scheduled upon request.

To listen in by conference call, please contact prcontact@xprize.org or 310-741-4884. Questions may also be submitted via Twitter @healthxprize or you can follow the event at #HXP

CREDENTIALS & INTERVIEW REQUESTS:
To request credentials and/or to schedule interviews with Dr. Peter Diamandis, CEO and Chairman, The X PRIZE Foundation, Angela Braly, President and CEO, WellPoint Inc., or one of the Healthcare X PRIZE advisors, please contact Arron Robinson at prcontact@xprize.org or (310) 741-4899.

For more information about the initial prize design or to comment on the draft guidelines, visit www.xprize.org/wellpoint