SOURCE: Corticon


August 10, 2011 09:00 ET

Corticon's "No-Coding" Rules Engine Drives State Government Health & Human Services Applications

25 Percent of States Rely on Corticon to Streamline Determinations of Citizen Eligibility, Increase Productivity and Reduce Costs

REDWOOD CITY, CA--(Marketwire - Aug 10, 2011) - Corticon, a leading provider of business rules management systems (BRMS), announced today that over 25 percent of state governments now use Corticon as the rules engine in their next-generation Health and Human Services (HHS) applications. Automating business rules with Corticon lets government agencies streamline determinations of citizen eligibility, insure program integrity, increase productivity, and reduce costs.

State Government HHS Departments face many challenges: lower revenues, more citizens in need, and the requirement to do more with less. Critical applications such as Health Insurance Exchange (HIX), Eligibility & Web Self-Service, Women, Infants & Children (WIC), and Medicaid Management Information Systems (MMIS) demand a different approach. Many states, including Idaho, Iowa, Louisiana, North Carolina, Pennsylvania, Wisconsin and others, have chosen Corticon to automate business rules. Corticon's patented "no-coding" approach, which enables states to make better, faster decisions, is employed in dozens of HHS solutions, driving productivity and enabling citizen self-service.

Specific examples of HHS applications that benefit from automating business rules with Corticon include:

Health Insurance Exchange (HIX)
On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA). Although national healthcare reform is a matter of dispute, state governments have begun to organize toward receiving the billions of dollars that the federal government will allocate. Funding is provided to states to expand healthcare coverage, using systems such as Health Insurance Exchange (HIX). HIX creates a marketplace for potential buyers of health insurance to meet sellers and to be guided through the eligibility process with maximum efficiency and minimal interaction with case workers. The PPACA fosters efficiency by recommending business rules engines as a key component of HIX systems.

The State of Wisconsin, considered exemplary for state governments nationwide as a pioneer in providing the best service for its citizens, has a strong reputation for selecting best-of-breed technology. Wisconsin received an early innovator grant as part of healthcare reform and, as one of the seven early adopters of HIX, chose Corticon through a rigorous selection process. Corticon best represented the type of agility that an HIX system requires, due to its patented "no-coding" technology and impact analysis features.

Eligibility & Web Self-Service
Historically, citizen eligibility for various HHS services was a complex web of systems and processes, often extremely people and time-intensive, and handled manually. In the current economic climate, traditional approaches are stretched to the breaking point. Many states are choosing Corticon to create a common customer view across systems and apply centralized business rules to merged data. This approach achieves a 90-percent decrease in development time when compared with traditional methods.

The Commonwealth of Pennsylvania uses the COMPASS system to provide intelligent web self-service for citizen eligibility. With COMPASS, citizens interact online for screening, application routing, and verification across multiple HHS case management systems. Corticon's rules engine automates the complex rules for determining eligibility, benefits, payments and fraud, while accelerating development and change cycles and reducing project risk.

Women, Infants and Children (WIC)
WIC refers to the Special Supplemental Nutrition Program for Women, Infants and Children, a Federal assistance program of the Food and Nutrition Service (FNS) of the United States Department of Agriculture (USDA). WIC provides nutrition assistance for low-income pregnant women, breastfeeding women, and infants and children under the age of five. WIC programs have expanded dramatically in recent years, and social workers are increasingly overwhelmed.

Idaho is an example of a state that chose Corticon as the rules engine to power its legacy replacement system. The new solution improves social workers' productivity by helping to automate the process of certification (i.e., eligibility), needs assessment, and food package selection. Citizens receive faster service, and overall service quality is improved via better adherence to federal regulations and best practices. Idaho recognized Corticon as providing a true breakthrough in ease-of-use. "Most products require learning multiple tools and languages to do what Corticon can do with a single, business-friendly tool," said Vickie Flatt, Project Manager at the Idaho Department of Health and Welfare (DHW).

Medicaid Management Information Systems (MMIS)
Medicaid was established in 1965 under authority of the Social Security Act and has grown over the years to the point where today it provides benefits to millions of individuals and families with low incomes and resources. Medicaid has also become one of the largest single budget items for state governments and thus is the focus of intense scrutiny. While the federal government contributes 90-percent federal financial participation (FFP) for design, development, or installation, and 75-percent FFP for operation of state-mechanized claims processing and information retrieval systems, states can no longer receive federal funding if they operate IT systems that do not comply with federal regulations. States are under tremendous pressure to increase efficiency, reduce costs and improve flexibility in programs and administration, and are aggressively looking at new systems and technologies to modernize architectures and increase the efficiency of their Medicaid programs.

"Corticon's rules engine automates the rules, regulations, and best practices that govern state government HHS applications," said Dr. Mark Allen, CEO of Corticon. "With Corticon, next-generation systems can be quickly developed and modified, with transparent, easy-to-understand rules that enable State business users, not just IT, to drive better, faster decisions."

About Corticon
Corticon enables organizations to make better, faster decisions by automating business rules. Corticon's patented "no-coding" rules engine is used by over 450 customers worldwide to automate their most sophisticated decision processes, reducing development and change cycles by 90 percent. Automated decision management with Corticon empowers organizations to improve productivity and customer service, and adapt quickly to changing market conditions. For more information, visit

Corticon is a trademark of Corticon Technologies, Inc. All other brands, products or service names are or may be trademarks or service marks of their respective owners.

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