Working in collaboration with Mayo Clinic
Patent pending · USPTO Track One
Healthcare governs what it can measure.
Behavioral load has no governed reference number.
We built the candidate — and the category it anchors.
Clinically validated, deployment-agnostic behavioral health technology designed to reach 100% of a population — not only the share that shows up. Stress Number™ quantifies behavioral load across Home, Work and Social. Validated in research conducted at Mayo Clinic, peer-reviewed and published in 2018.
Peer-reviewed clinical validation · Mayo Clinic study CLS-20308379 · N = 292 · Patent Pending · USPTO Track One
A 20-minute institutional overview · executive and actuarial scoping available · all materials under NDA
An upstream measurement and routing layer that sits ahead of existing behavioral-health, coaching, navigation and care-management assets. Population measurement without an encounter, and the repeat administration a quality measure requires. The benefit: more members measured means more members identified and routed before the cost appears in claims.
How it deploys →HRV, sleep and recovery provide physiological signals associated with stress. Stress Number™ adds a direct self-reported measure of behavioral load across three settings, with peer-reviewed clinical validation behind the instrument.
How it deploys →Two points of entry, both running on the same standard. The Signal is where a member takes the Stress Number™ — a 30-question assessment producing a personal score across Home, Work and Social, with routing through the Smart Referral Engine™. The Visibility is Population Scale, the licensee dashboard.
Population Scale is where the measure becomes infrastructure. Individual responses aggregate — de-identified — into a leading-indicator view that rolls up and filters across an entire book of business: by company, by geography, by department, by site. An administrator sees where behavioral load is concentrated in a covered population without seeing any individual in it. That aggregation is what makes the measure usable for quality reporting, actuarial modeling and capacity planning rather than for one person at a time.
Domain distribution and movement show where behavioral load is concentrated — Home, Work or Social — creating a routing signal that a single undifferentiated score cannot provide.
Filter and visualize as heat maps. Configure Smart Referral Engine™ routing rules at the item, domain and score level. Trends and benchmarks convert repeat administration into a pre/post measurement record.
Population figures use the 0–100 normalized display convention — not the Stress Number™ composite scale, and not a clinical decision threshold.
This is the difference between a questionnaire and infrastructure. Measurement that ends at a number moves the burden to a care team. Measurement that routes moves the person.
Thirty questions, any channel a population already uses. No appointment, no clinician time.
A composite and three domain scores — Home, Work, Social — returned immediately.
Domain resolution shows where the load sits. Social isolation is a different problem than work strain, and routes differently.
Smart Referral Engine™. Rules configured at item, domain and score level match the person to support that is actually available to them locally.
The administrator sees population distribution, heat maps and routing utilization — without seeing individuals.
Repeat administration on the same population produces the before and after a quality measure requires.
Stress Number™ measures behavioral load across three settings — Home, Work and Social — through thirty questions completed in minutes. Not a symptom checklist. A measure of behavioral load across the environments where it accumulates.
Existing instruments ask what a person is experiencing now, and they score symptoms once those symptoms have appeared. Stress Number™ measures behavioral load across the settings where it accumulates — upstream of the symptom, not alongside it.
It does not require an appointment, a clinician, or a diagnosis to be administered. It runs wherever an organization already reaches its members, which is what makes measuring an entire covered population possible rather than only the share already in care.
Thirty questions, three named domains, a documented scoring specification and a version record. A person sees where their load sits. An administrator sees where a population's load sits. The methodology is citable.
On scales and thresholds. The 0–100 values shown are a normalized display convention for domain reporting. They are not the Stress Number™ composite scale, and the colored bands are a presentation convention rather than clinical decision thresholds. A candidate composite threshold has been derived internally from the retained research dataset; it is not what the 2018 publication established, it has not been independently reproduced, and it is not presented here as a validated or clinically adopted cutoff. The 2018 publication established correlational clinical validity against two established comparators — not a decision threshold.
Every system already pays for it — in claims, in absence, in turnover, in treaty losses, in quality scores. What none of them has is a number for it before it becomes a diagnosis.
Behavioral risk is identified once symptoms cross a diagnostic threshold. By then the load has usually accumulated for years, and the intervention is treatment rather than prevention.
Screening is encounter-bound and episodic. It reaches people already in care, when screening is indicated. Most covered populations are never reached by validated behavioral measurement at population scale.
The instruments in routine use ask what a person is experiencing now. They do not resolve behavioral load across Home, Work and Social — the environments in which that load accumulates and may remain addressable before diagnosis.
Demonstrating improvement requires measuring the same population twice — which favors measurement that can reach people beyond the clinical encounter. Penetration methodology and estimates: Pre-Diagnostic Index™ → · Read the category →
We measure behavioral load upstream.
We translate it into actuarial exposure.
We route people to the right support.
One measure resolved across three domains — Home, Work and Social. Thirty items, minutes to complete, portal-agnostic.
The instrument →The layer that converts the coordinate into actuarial exposure. Derived from federal and peer-reviewed published sources.
The economics →Domain scores indicate what kind of support may fit; the referral layer surfaces what is actually available locally.
The routing →The operating system that holds them — the scoring architecture, the governance, and the record of who measured what, when, and under which version.
The standard →O2OS™ is portal-agnostic. It runs wherever an organization already meets its members — a member portal, a benefits platform, an EHR patient gateway, a secure link, or SMS. It does not replace an EHR, compete with one, or require a clinical encounter to function.
A secure link. Thirty items, completed in minutes on any device. No app download, no clinician time, no appointment. Rural smartphone ownership is 87%; cellphone ownership 97%.
Sits alongside existing systems rather than inside them. Results can be delivered by API, FHIR-aligned integration, SFTP or flat file — matched to the counterparty’s existing environment. EHR-ready deployment is available where integration is desired, not required.
Three domain outputs per person, with the governed composite scoring architecture available under protocol. Routing recommendations from the Smart Referral Engine™. An administrator dashboard with population composite, domain distribution and trend. Pre/post on repeat administration.
No clinician time required for administration. No replacement clinical workflow. No credentialing requirement for assessment administration. The measurement architecture is licensed and can be deployed within existing enterprise infrastructure rather than requiring a replacement platform.
A structured briefing under NDA. The full evidence state, the scoring architecture, and the deployment model. Typically one session.
A defined population, a defined window. Completion rates, domain distribution, routing utilization and workflow burden — measured in your environment, not asserted in ours.
Co-designed deployment where the use case needs it. Integration, workflow and reporting built to your environment rather than around a fixed product.
Population-scale deployment under license. Covered-life economics, defined term, and a sector position where one is available.
A pilot does not require a settled decision threshold. It answers whether the instrument reaches your population, what it finds, and what it costs to run — questions the published validation cannot answer for your environment. Start a conversation →
A buyer should know precisely which claims are established and which are still in development. The distinction is stated here rather than discovered in diligence. See the standard →
Independent institutional reproduction represents the next scientific layer. The published validation, retained participant-level dataset and current operating architecture stand independently of that workstream.
The federal payment system is converging on a single structural need at the same moment. Behavioral health screening remains largely encounter-bound and episodic, so most covered populations are never reached by validated behavioral measurement at population scale. Demonstrating improvement requires measuring the same population twice.
CMS-0057-F · payer API requirements phasing in from 2026
CMS ACCESS Model · outcome-aligned reimbursement for behavioral health
Star Ratings · Improving or Maintaining Mental Health moves weight 1 → weight 3
Consolidated Appropriations Act · plan sponsors must demonstrate vetted behavioral spend
Eight Star measures carry a weight of 3. Behavioral load may sit upstream of all of them — one directly, three supported by published literature, four hypothesized and untested. See the exposure map →
The peer set — FICO, Bloomberg, MSCI, S&P Global, HL7 — achieved position through progressive satisfaction of these criteria, not through a single designation event. Stress Number™ is the reference instrument at the core of the O2OS™ architecture. Each criterion below is stated with its status and the documentary basis behind it.
Nine of eleven criteria supported by documentary record. Two actively in motion. Chain of custody: Mayo Clinic research → Stress Number™ → O2OS™ reference-standard architecture. Read the standard →
Six federal mechanisms. Each a real designation, publicly documented, and independently defensible — not dependence on a single program that could be modified.
The closed circuit. CMS-0057-F creates the pipe. The 2027 Star Ratings provide the check. O2OS™ is architected to sit between the two — using the pipe to deliver the leading indicators that secure the check. Also aligned: CPT 96127 / 96138, Medicaid 1115 waivers, and the CMS ACCESS Model.
Every system already pays for behavioral exposure. They simply pay at different points in the chain, in different currencies.
Access is governed by a structured tier system, published rather than pitched — the way standards bodies publish membership and licensing criteria. The measurement architecture is licensed and can be deployed within existing enterprise infrastructure rather than requiring a replacement platform.
Access and licensing are structured to preserve the independence required for multi-institutional adoption and future reference-standard recognition. Read the standard →
An instrument, a filing, a clinical study, and a retained dataset that still reproduces its own published statistics. Precision held over time is the asset.
About
the corporation →
Products require adoption. Standards require recognition.
O2OS™ contains the foundational assets required to pursue clinical measurement reference-standard recognition — formal recognition remains ahead.
A peer-reviewed clinical-validation asset, a working deployment architecture, retained research data, and a patent-pending position. The asset is available for licensing, paid pilots, design partnerships and enterprise deployment today. Independent reproduction and reference-standard recognition constitute the next institutional layer.
Institutional and enterprise inquiries: enterprise@theoxygenplan.com · Eric G. Lucas, Founder & Chief Executive Officer · Direct peer-to-peer contact welcomed.