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Healthcare X PRIZE
Initial Prize Design
Version 1.0 Released April 14, 2009 for Public comment
Share your thoughts on the initial prize design for the proposed Healthcare X PRIZE at
www.xprize.com/wellpoint
Revolution through Competition
Introduction
The X PRIZE Foundation, a nonprofit organization that drives innovation through large incentivecompetitions, has partnered with theWellPoint FoundationandWellPoint, Inc.to develop a $10M+
Healthcare X PRIZE to revolutionize the US healthcare system. This document contains an initialdesign for a prize to improve the health of Americans; we are sharing our initial thinking to solicitpublic feedback andengage you in the conversationto 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 publiccomment. 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 explorein depth areas critical to the prize development effort. By June, we should have a final prize designthat will move into a planning phase in anticipation of a launch by the end of 2009.
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 thehealth sector about the various challenges a prize might solve. A number of common themesemerged:
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We have a sick care system rather than a health system
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Financial incentives are based on volume/ procedures instead of outcomes
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Our system is fragmented with a lack of coordination or agreement on best practices
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The focus is on short-term disease management vs. long-term focus on improving thehealth 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 mightaddress these issues in the existing system, it becameclear that our health system doesn’t function like a system at all. In fact, there are no central goalsthat orient the different providers across the system into a cohesive unit, nor are there incentivesthat focus them on working together to achieve these desired outcomes. We are setting thatgoal. 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:
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Eliminate acute/ rescue care through proactive approaches
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Include clear information that highlights best performers regardless of their approach
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Recommend effective solutions that work for consumers and drives impact
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Include tracking systems thatallow for high-qualityfeedback and learning
Share your thoughts on the initial prize design for the proposed Healthcare X PRIZE at
www.xprize.com/wellpoint
Prize Design Approach
In developing a Healthcare X PRIZE,sustainable improvement in health value requires atransformative approach. Our starting objectives include:
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Rewarding entities that optimize health value
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Investment in activation and engagement of individuals to achieve increases in vitality andto create a foundation for consumers to take responsibility for their health
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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 thesavings generated from the improvements in health. This action creates a virtuous cycle where aproactive investment in improving health generates healthier communities which in turn reduce theresources required for treatment of illness. Care coordination during episodes of sickness wouldappear to have similar potential to create virtuous cycles of improved outcomes after an initialinvestment into rewarding better outcomes.
Initial Prize Design
The proposed Healthcare X PRIZE anticipates a competition to generate a50% 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 thehealth of their assigned community while also highlighting improvements generated in the total costof care. The rules require improvements in both outcomesand costs for an entry to qualify. Thefocus on community-level results encourages teams to continually find new ways to improve thehealth of a significant number of people Outcomes should lead to innovations improving individualengagement in programs as well as a sharper focus on achieving outcomes for participants. Teamsmust make a difference by engaging individuals, including the creation of an “individual vitalityscore” that helps an individual understand their health status and the impact of specific healthchoices/ 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 comprehensivesystem with mechanisms to engage, coordinate, advise, evaluate, and influence individuals andcare providers in their test group. Their outcomes and financial results would be compared to acontrol group in a similar or adjacent community, allowing for the real-world demonstration of theimpact of their system. The competition and all results would be audited by an independent panelof judges and trusted third parties.
Share your thoughts on the initial prize design for the proposed Healthcare X PRIZE at
www.xprize.com/wellpoint
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