PDI · v1.0 · April 2026
Working in collaboration with Mayo Clinic
Patent pending · USPTO Track One

You pay for 100% of your members.
You measure 7%.

93%

of behavioral health risk is
unmeasured, unmanaged, and unpriced.

— Three compounding gaps —
GAP 1
Penetration
75%+
of members never reach validated behavioral measurement.
GAP 2
Sensitivity
~25%
of those measured are misclassified by single-test screening.
GAP 3
Routing
~67%
of positive screens never convert to care.
These gaps compound into the 93% of risk.
from the Net Structural Exposure Model · patent-derived

This is not a utilization problem. It's a measurement failure.

That gap has a measurable cost.

— The Pre-Diagnostic Index
$515 per member, annually
$43 PMPM · per member per month
Now quantify it

Two independent models.
One number.

Both models recalculate live as you enter your population. Drawn from entirely different published source sets — they share zero inputs.

Population
Members
Both models recalculate on change
1 100 1K 10K 100K 1M 10M 160M
Penetration
Population Penetration Model
Prevalence × Productivity-Medical Cost
Percent of population structurally affected
default 8.5%
%
Affected members 85,000
Annual cost per structurally affected life
default $6,480
$
Subtotal $550,800,000
Workflow friction overhead (per member)
default $3
$
Applied to pop. $3
Annual Structural Exposure
$553,800,000
Per member: $554 · PMPM: $46
Gap
Screening Gap Model
(1 − Screening Rate) × MDD × Incremental Cost
Documented depression screening rate
default 4.2%
%
Unmeasured 95.8%
MDD prevalence (adult population)
default 8.4%
%
Exposed members 80,472
Direct incremental annual healthcare cost
default $6,404
$
Cost basis 38.1% of $16,854
Annual Structural Exposure
$515,342,000
Per member: $515 · PMPM: $43
— THE STANDARD —

The Pre-Diagnostic Index

the number behind the 93%
$515
per member · annually
$43 PMPM · per member per month

Where two independent models converge — taken at the conservative bound.

— Validation · per member —
Population Penetration
$554
Screening Gap
$515
Structural · patent-derived
$593
Convergence band: $515 – $554 per member

The structural model explains why the exposure must exist. The two external models independently validate where it lands. The PDI is the conservative number you take home.

— How the gap gets closed —

Here's why that number exists.

Three gaps. Three fixes. One architecture.

The Pre-Diagnostic Index™ measures the exposure. O2OS™ is the infrastructure that closes it — one layer at a time.

GAP 1
Penetration Gap
75%+ never reached

Most members never reach validated behavioral measurement at all.

O2OS
Fix
Stress Number
across 100% of members

A standardized measurement layer deployed across the entire member population — not just the subset that reaches a clinical visit.

GAP 2
Sensitivity Gap
~25% misclassified

Single-test screening tools misclassify roughly one in four measured individuals.

O2OS
Fix
Stress Number
continuous · multi-domain

A continuous, multi-domain measurement signal that replaces point-in-time screening error with an architecturally stable index.

GAP 3
Routing Gap
~67% never convert

Most positive signals never translate into care. Identification without connection does nothing.

O2OS
Fix
Smart Referral Engine
inside O2OS infrastructure

Routing infrastructure that converts every positive Stress Number™ into a committed intervention pathway.

All three layers operate within O2OS
— One architecture. Three gaps closed. —

This is O2OS

The Pre-Diagnostic Index™ quantifies the exposure.
O2OS is the infrastructure that eliminates it.

Working in collaboration with Mayo Clinic · Utility patent application pending
— The proof beneath the standard —

Why the convergence is not a coincidence.

The patent-derived causal architecture that explains why the two external models must agree.

The Net Structural Exposure Model
Patent-derived · explains why the exposure must exist
NSR-2026-001 · Net Structural Exposure · Medical-Only Model · Per 1,000,000 Members
GAP 1
Penetration · 75%+
750,000
1,000,000 × 75%
Never reached by validated behavioral screening.
GAP 2
Sensitivity · ~25%
62,500
250,000 × 25%
Single-test screening misclassifies ~25% of measured.
GAP 3
Routing · ~67%
125,000
187,500 × ~67%
70–80% of positive screens never convert to care.
93%
of behavioral health risk outside structured infrastructure
937,500 of 1,000,000 members
Net Structural Exposure · Base Case
$593M
Sensitivity range (λ): $494M – $692M
Assumptions: C=$6,200 · πp=17.5% · λ=30%

Methodology: Exposure model derived from CMS utilization data, peer-reviewed sensitivity benchmarks, and published referral conversion studies. Published by The Oxygen Plan Corporation for institutional discussion and methodological transparency. Utility patent application pending.

— Source Citations —
CDC NCHS Data Brief No. 527 (2024) · Population prevalence of depression (NHANES 13.1%)
Greenberg et al. (PharmacoEconomics 2021) · Evans-Lacko & Knapp (2016) · AAFP Cost of Care · Direct healthcare expenditure + productivity loss
USPSTF Evidence Synthesis 223 · Akincigil & Matthews (2017) · Documented depression screening rates
NIMH · 2021 NSDUH · National MDD prevalence
Greenberg et al. (Advances in Therapy 2023) · Direct incremental annual healthcare cost · $16,854/adult MDD
— See how this applies —

Explore the PDI across 60 institutional use cases.

From commercial payers to Medicaid MCOs, from reinsurance to self-insured employers — the PDI behaves identically. Same math. Different member bases.

60 Institutional Use Cases →
2008
— Patent-Pending Architecture —

Four primitives.
One closed system.

The measurement standard cannot function without the routing layer. Routing cannot function without reimbursement. Reimbursement cannot function without governance. The architecture is the product.

Each primitive is patent-pending.
Each primitive fails without the others.
The standard closes on itself.

Utility Patent Application Pending
USPTO Track One · April 2026
2008 Prior Art · 2018 Peer Review · Mayo Clinic Collaboration
— Access —

The Standard is not published as a specification.

It is governed.

Implementation requires licensed access to the measurement layer, scoring logic, and routing architecture.

A limited number of institutional integrations are currently being evaluated.

License the Standard →
How to Cite
The Oxygen Plan Corporation. (2026). The Pre-Diagnostic Index™ (PDI), v1.0. Retrieved from theoxygenplan.com
Inline reference: "Per the Pre-Diagnostic Index™ (The Oxygen Plan Corporation, v1.0, April 2026) — the standardized exposure band defined by the independent convergence of two external models and explained by the patent-derived Net Structural Exposure Model — structural behavioral exposure is $515M–$554M per one million covered lives."