Abstract: A computer-implemented system and method are provided as an organizational risk and readiness assessment tool (ORA) for assessing organizational health-related risks and readiness for wellness and disease management programming. Survey data is collected for an organization, such as environmental survey data, leadership survey data and health culture survey data. The survey data may include binary survey data and scalar survey data. A scoring engine generates one or more readiness scores for the organization by applying at least one scoring algorithm to the survey data to generate one or more risk and/or readiness scores for the organization. The risk and/or readiness scores may relate to the environment, leadership perceptions, and health culture of the organization. Overall risk and readiness scores may also be generated.

Abstract: A computer-implemented system and method utilizes patient claim data, including medical, pharmaceutical, laboratory claims, and self-report survey data to classify patients into one or more health management groups (HMGs) relating to one or more particular diseases, health conditions or health pre-conditions, each having an associated severity level that indicates the severity of the patient's condition. The HMGs assigned to each patient (e.g., health plan member) enable users of the system and method to identify patients having particular diseases, health conditions and pre-conditions based not only upon the patients' claim data but also based upon the patients' self-report survey data obtained from various sources. The HMGs assigned for each patient also enable the user to identify the severity of the patient's disease, condition or pre-condition to facilitate intervention and/or preventative care of the patient.