Abstract: A system and method generates customized health-related messages for one or more health plan members. The customized messages may include customized information relevant to each recipient member based on available member data, and provide the members with education, resources, knowledge and/or guidance on a member's accounts, benefits, health-related conditions and wellness potentially needed to make better-informed healthcare decisions. Messages may be provided to members and/or healthcare personnel involved in the care of plan members. To provide customized messages relating to one or more health plan members, member data is compiled to identify one or more outcomes related to the member data for each member. The outcomes are risk-stratified, and message data is generated based on the risk-stratified outcomes. The message data is configured based on the member's plan benefits, and customized messages including the configured message data are provided to the respective members and/or healthcare personnel.

Abstract: A system and method for providing a consumer healthcare guide receive a set of search criteria and retrieve one or more health-related listings based on the set of search criteria. The health-related listings may include healthcare quality data and/or consumer cost data, which may include provider listings and/or facility listings. The provider listings may include a consumer cost rating based upon provider costs associated with a selected healthcare product or service. The facility listings may include a consumer cost rating based upon facility charges associated with a selected healthcare product or service. The consumer guide may also provide quality data, such as a healthcare quality rating corresponding to a quality score based on predetermined criteria. The consumer guide further may provide cost and/or quality information on a variety of aspects of healthcare including, for example, hospitals and other facilities, doctors and other providers, pharmaceuticals, and health insurance plans.