Tuesday, June 23, 2009

Magical Medium: Update on the Healthcare X PRIZE

An interim update on the progress of the Healthcare X PRIZEas it moves through the Prize Design Process in anticipation of several key milestones in July.

The X PRIZE Foundation is the world wide leader in developing and operating incentivized competitions designed to transform entire industries. This model has been highly successful in technological break through's (like the Ansari X PRIZE and the Progressive Automotive X PRIZE) and in helping the unimaginable become commonplace (like the Google Lunar X PRIZE). As X PRIZE has surveyed the world-wide market for innovation, it is becoming clear that the many world wide systemic failures (education, health, poverty, etc) can and should be addressed with incentivized competitions.

The first attempt at this is with the development of the Healthcare X PRIZE. WellPoint has stepped forward to sponsor both the Prize Development process as well as the winners purse. However, a systems prize is a challenge for a variety of reasons. Its bigger, its more complicated, it has far more moving parts, and given its complext interactions it is alot harder to describe in a single sentence statement. However, Healthcare is big, complicated, has lots of moving parts, and multiple interactions from lots of different players. What the Healthcare X PRIZE Design Team is trying to do is to simplify the madness and refocus on those things that can truly make a difference within the constraints and challenges of our competition framework.

As you already know from reading our Initial Prize Design, we are contemplated three general phases to the project:

The phases and timelines are all approximations subject to revision as part of the normal Prize Development process.

First, we have the Design phase which we are currently in. During this phase we are attempting to develop the infrastructure for Prize operations, the rules and measurement set, and to define the competition in such a way that teams will want to compete, that our sponsor will want to fund the prize, and that we can make the impact that we aspire to (nothing short of transforming the health care system of course!).

The next step, which is anticipated to begin following the Prize Launch event this fall, is the Selection phase. During this phase we plan to actively recruit communities and potential teams interested in participating in the competition. The EcoSystem is also anticipated to launch during this time, and will be a large collaboratory of teams, communities, individuals, point solutions, and other vendors who are interested in the HXP. We are hopeful that it serves as a useful match making service, an online marketplace for health care innovators to share ideas, meet each other, and engage in collaborative projects that advance the ball for everyone. We have begun to explore potential partnerships in this area, and several innovative technologies exist that can create this type of environment which we hope will live on well beyond the lifetime of the competition (more later).

It is important to understand that we are planning for three simultaneous selection processes to occur during this phase - team, community, and measurement set:
  1. Teams will be registering, putting forward their concept, modeling that concept against a standardized database made available by WellPoint, and then having to validate their assumptions based on feedback from the independent judging panel who will have strict evaluation criteria but allow for the freedom for the widest range of solutions. Once teams pass the "threshold of validity", they will be available for the "match" with the five test communities.
  2. "Communities" (most likely geographically based employer communities for reasons to be discussed) will also be selected from across the 14 states in which WellPoint operates. Community criteria are being finalized but will fall along the line of history of innovation, willingness to share information, geographic concentration of employees, data management capabilities, culture, leadership, and a variety of other factors. The five communities will rigorously studied, evaluated, and every attempt will be made to select "actuarially equivalent" populations. Communities will ultimately be "matched" to five Teams in an analogous process to the residency match (details forthcoming).
  3. The measurement set, which we will begin to share publicly over the coming months, will also be finalized and validated during this selection period. We anticipate what we will put forward represents one thoughtful approach (among many alternatives) to help orient the teams to continue to move along the health value chain from disease -> health -> vitality. These will be subject to further refinement and validation during this phase by our team of measurement advisors and experts.
Given the amount of activities you can see why we are currently allowing for 18 months for this phase to complete. After the team and community match, we have allocated a 6 month window for team / solution implementation. Finally, after implementation is complete, the Competition phase can begin as planned in January 2012. During the competition phase Teams and Communities will be workign together to introduce health finance, care delivery, and personal incentive innovations that improve the Community Health Index while lowering the Total Cost required to obtain those results. Teams will be required to file quarterly reports which will be made publicly available to all interested parties and biannual educational conference events will be held with most sessions being made available to the public. A publicly available leader board will document who is leading the competition at all times and a public site will make available preliminary results from the competition. Independent third party judges, who audit the quarterly reports, will pronounce a winner at the end of the three year competition cycle.

While none of the above is set in stone, it should provide a summary of current thinking and is shared in this raw form to maintain our commitment to a transparent development process. We realize, occasionally to our own frustration, that we raise just as many questions as answer in moving through our Prize Development process. What I can say, without reservation, is that we are really trying to remain true to our aspirations of tranforming the health care system through the magically medium of the X PRIZE.
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