THE MOVELA INDEX · METHODOLOGY
COMING SOON · WORK IN PROGRESS

The Movela Index isn't shipped yet. This page is the methodology we're building toward as we add clients and services. We'll roll it out once enough longitudinal data flows through the platform to make a score meaningful — likely after the second PT and OT are in place.

One number.
Four domains.
Twenty-eight validated inputs.

The Movela Index is a longitudinal functional risk score that predicts hospitalization, functional decline, and mortality — and changes when you do. It's anchored in Life's Essential 8, PROMIS, and USPSTF evidence — wrapped in one number a human can act on.

COMPOSITE · 0 — 100
Movela Index =
0.40 × Physical
+ 0.25 × Mental
+ 0.20 × Social
+ 0.15 × Spiritual
NORMALIZED · AGE & SEX ADJUSTED
01 · DOMAINS

Four domains.
Weighted by evidence.

Weights derive from the relative strength of each domain as a predictor of all-cause hospitalization and mortality in the published literature.

DOMAIN · PH
40%

Physical

Cardiometabolic health, functional performance, recovery, preventive adherence. Anchored in Life's Essential 8.

WEIGHT40 / 100
LE8VO2 maxGripA1cBPUSPSTF
DOMAIN · ME
25%

Mental

Mood, anxiety, sleep, cognition. Validated, longitudinal, sensitive to early drift.

WEIGHT25 / 100
PHQ-9GAD-7ISIMoCA
DOMAIN · SO
20%

Social

Isolation, support, caregiver load, social determinants. Strongest underweighted predictor of hospitalization.

WEIGHT20 / 100
UCLA-3LubbenZaritSDOH
DOMAIN · SP
15%

Spiritual

Meaning, resilience, existential distress. Optional, non-denominational, resilience-focused.

WEIGHT15 / 100
PROMIS-MPFACIT-SpBRS
02 · PHYSICAL INDEX · 40% WEIGHT

Function > diagnosis.
Anchored in Life's Essential 8.

A sedentary "healthy" person scores lower than an active 75-year-old with diabetes who walks 2 miles a day. We measure what predicts hospitalization — function, fitness, and recovery — not just disease labels.

CODE
SUBDOMAIN
WEIGHT
INPUTS
LE8-A
Health Behaviors (LE8)
30%
Nutrition · Mediterranean / DASH
Activity · ≥150 min/wk + 2× resistance
Nicotine · pack-years, vape, secondhand
Sleep · 7–9 hr, regularity, efficiency
LE8-B
Health Factors (LE8)
30%
Body composition · BMI + waist + lean mass
Lipids · LDL · HDL · TG · ApoB
Glucose · A1c · fasting · TIR if CGM
Blood pressure · <120/80 target
FUN
Functional Performance
15%
VO2 max · age- & sex-percentile
Grip strength · dynamometer
Gait speed · ≥1.0 m/s target
5× sit-to-stand · TUG
PRO
Patient-Reported (PROMIS)
10%
PROMIS Physical Function
PROMIS Fatigue
PROMIS Pain Interference
EQ-5D quality of life
PRV
Preventive Adherence (USPSTF)
10%
Cancer screening — age/risk adjusted
Vaccinations — flu, COVID, Tdap, shingles, pneumo
Cardiometabolic screening
Bone & fall-risk assessment
REC
Recovery & Resilience
5%
HRV trend
Resting heart rate
Sleep recovery consistency
Training-load balance
FOUNDATION
Life's Essential 8
The AHA's Life's Essential 8 is the most validated modern framework for predicting cardiovascular disease and all-cause mortality. It accounts for 60% of the Physical Index — the rest captures function, fitness, lived experience, and prevention.
60%
03 · MENTAL INDEX · 25% WEIGHT

Mood. Anxiety. Sleep. Cognition.
The signals that drift first.

Mental health drift precedes most chronic-disease decompensation. We screen every quarter using validated instruments — and escalate to our LCSW/LPC clinicians at threshold.

PHQ-935%
Depression

Gold-standard 9-item self-report. Triggers escalation at ≥10.

GAD-725%
Anxiety

Generalized anxiety screen. Tracks severity longitudinally.

ISI20%
Sleep

Insomnia Severity Index. More sensitive than simple sleep questions.

MoCA20%
Cognition

Montreal Cognitive Assessment. Mini-Cog for fast triage.

04 · SOCIAL INDEX · 20% WEIGHT

Loneliness
is a vital sign.

Social isolation predicts hospitalization, dementia, depression, and all-cause mortality at strengths comparable to smoking and obesity. Most healthcare systems don't track it. We do.

EVIDENCE
26%

Increased mortality risk associated with social isolation (Holt-Lunstad et al., meta-analysis).

05 · SPIRITUAL INDEX · 15% WEIGHT

Meaning is medicine.
Optional. Non-denominational. Resilience-focused.

We measure what predicts coping and recovery: sense of purpose, resilience, alignment with values, and existential distress. Clients can opt out — the score re-weights automatically.

PROMIS-MP40%
Meaning & Purpose

PROMIS Meaning & Purpose Short Form.

BRS30%
Resilience

Brief Resilience Scale (6 items).

VAL20%
Values Alignment

Daily-life congruence with values.

FACIT-Sp10%
Existential

Existential well-being subscale.

06 · TRAJECTORY

Change matters
more than level.

A static 82 is interesting. A 90 falling to 82 over six months is an emergency. Every visit produces a delta — and we surface declining trajectories before the absolute score crosses a threshold.

SAMPLE · 12 MONTHS
Two clients, both currently scoring 65–86.
CLIMBING
DECLINING
CLIENT A · 86 (+8)
Climbing trajectory. Wellness plan continued, no escalation.
CLIENT B · 65 (−25)
Steep decline triggered NP review at month 6, before threshold.
07 · HOSPITALIZATION RISK FORECAST

The number that
actually matters.

Beyond the Index, every client has a 12-month hospitalization risk forecast. It's the line connecting prevention work to outcomes — and the metric we report to insurers and employer partners.

SARAH K · 12-MO FORECAST
4.2%
LOW · −2.1 90D
LOW <6%
MED 6–15%
HIGH >15%
POPULATION CONTEXT
Movela members average 5.8% 12-mo hospitalization risk vs. 10.0% in the unmanaged Atlanta cohort.
9 PREDICTORS · ALL TRACKED LONGITUDINALLY
Frailty indexHIGH
Gait speedHIGH
Prior hospitalizationHIGH
Polypharmacy ≥5 RxHIGH
PHQ-9 ≥10MED
UCLA loneliness ≥6MED
Falls (12 mo)MED
Caregiver burdenMED
Sleep impairmentLOW
08 · INPUTS BY SOURCE

Five data streams.
One record.

Wearables
CONTINUOUS
Apple WatchOuraWHOOPGarminFitbit
Labs
BIANNUAL
Lipid panelA1cCMPApoBhsCRP
Surveys
QUARTERLY
PHQ-9GAD-7PROMISUCLA-3BRS
In-home
PER VISIT
BPGripTUGGait speedWaist
Manual
AS NEEDED
Diet logSmokingMedicationsSymptoms
09 · RISK BANDS · WHAT EACH SCORE TRIGGERS
SCORE → ACTION
85 — 100
Strong

Continue wellness plan. Quarterly check-in. Annual deep panel.

70 — 84
Stable

Coach-led plan. Targeted programming on the lowest sub-score.

55 — 69
Watch

Increased coaching cadence. Clinical visit within 30 days. Re-panel.

< 55
Escalate

NP/PA review within 7 days. Coordinated care plan with PCP.

10 · EVIDENCE BASE

Built on what's already proven.

We don't invent instruments. We assemble the best validated ones into a single longitudinal record.

Life's Essential 8
American Heart Association
CVD & mortality prediction scaffolding
USPSTF Recommendations
U.S. Preventive Services Task Force
Preventive screening adherence baseline
PROMIS
NIH
Patient-reported outcome measurement system
EQ-5D
EuroQol Group
Quality-of-life cross-disease index
PHQ-9 / GAD-7
Spitzer et al.
Validated depression & anxiety screens
UCLA Loneliness Scale
Hughes et al.
3-item validated loneliness measure
Brief Resilience Scale
Smith et al.
Bounce-back capacity measurement
Grip & VO2 max literature
Multiple meta-analyses
All-cause mortality prediction

Book your first visit.
The Index starts the day you do.