Systems, methods, and program products for calculating shared savings for a self-insured health care plan

摘要

A computer implemented method and system is provided for managing one or more self-insured plans, where healthcare provider's discount rate may be dynamically or retroactively adjusted during each plan period based at least in part on, for example, the rate of utilization of in-network or in-system providers by a plurality of respective plan participants. In exchange for the discounts on its services, shared savings may be calculated and paid to the provider after the end of each plan period based at least in part on lower than expected claims.