MalsysisalTristress Reform Engine

Healthcare Cellular Stress Greed · antidote: Mercy

RAASHPAAPMIA

Cellular Stress Dashboard

RAAS, HPAA and PMIA activation, the Greed index and the Mercy index for each sample entity. Choose an entity to see its profile and the reforms that would move it most.

Stress map

Cellular Stress map: score 0–100 for each sample entity. For the three axes and Greed, lower is better; for Mercy, higher is better.
EntityRAASHPAAPMIAGreedMercy
health system · Mid-Atlantic, US64.262.357.858.838.7
insurer · National, US53.354.649.374.226
regulator · State program, US71.371.265.931.461.2
health system · Great Lakes, US40.854.339.317.578.7

Entity profile

Example Health System A · health system · Mid-Atlantic, US · large · budget 4,200M USD · serves 1,100,000 people Fictional example

Greed index

58.8/100

Profit from downstream sick-care relative to upstream prevention. Lower is better.

Mercy index

38.7/100

Upstream care delivered relative to downstream sick-care. Higher is better.

Axis activation

61.4/100

Mean of RAAS, HPAA and PMIA. Lower is better.

Example Health System A: RAAS 64.2, HPAA 62.3, PMIA 57.850100RAAS64.2HPAA62.3PMIA57.8
Cellular Stress axes for Example Health System A (0–100, lower is better)
View data table
AxisExample Health System A
Renin–Angiotensin–Aldosterone System64.2
Hypothalamic–Pituitary–Adrenal Axis62.3
Purinergic–Mitochondrial–Inflammatory Axis57.8

Inputs

MetricValueStress
Chronic disease prevalence % of adults served5863
Hypertension rate % of adults served4464
Chronic stress load index 0–1006262
Elevated inflammatory markers % of tested adults3856
Generic drug usage % of prescriptions8233
Prevention share of spend % of total spend480
Downstream care margin % operating margin960

Stress is each input placed on a 0–100 scale, where 100 is the most stress.

Recommended reforms

Ranked by impact potential: the total score movement each reform would produce on Example Health System A by itself.

  1. 1. Outcome-based reimbursement

    Impact 32.6

    Core principle: Health systems must be paid to prevent disease, not manage it

    Greed −10.6 · Mercy +8.6 · RAAS −5.1 · HPAA −3.7 · PMIA −4.6

  2. 4. Early generics

    Impact 31.7

    Integrate cheap, effective metabolic drugs early, not late

    Greed −7.1 · Mercy +6.1 · RAAS −9 · HPAA −3.7 · PMIA −5.8

  3. 5. Primary care redesign

    Impact 30.5

    Redesign primary care around cellular health, not symptom triage

    Greed −3.5 · Mercy +8.6 · RAAS −6.4 · HPAA −6.2 · PMIA −5.8

  4. 7. Insurer incentive realignment

    Impact 29.1

    Realign insurer incentives: pay for fewer sick people, not more sick-care

    Greed −11.8 · Mercy +7.4 · RAAS −3.9 · HPAA −2.5 · PMIA −3.5

  5. 3. Upstream CPT codes

    Impact 27.9

    Reimburse upstream interventions as seriously as downstream procedures

    Greed −5.9 · Mercy +8.6 · RAAS −5.1 · HPAA −3.7 · PMIA −4.6

Simulate the top three for Example Health System A