State Healthcare Exchanges Winning with the BRE Horse

A business rules engine is a targeted fix that has helped state healthcare exchanges achieve dramatic results. 

Don’t get me wrong, I think humans are great. I’m one too, and recognize that we have the capacity to do awesome things. That said, we do have limits to our processing capacity that software doesn’t. I mention this because this human limitation directly translates to manual coding. This is no knock on humans; it’s just not a fair contest. Comparing automated decision processes to manual ones is like matching our newly garlanded Triple Crown winner against a snail in a race. The result is a foregone conclusion.

That’s why it’s so rewarding to see the fantastic results customers get when deploying our automated Business Rules Engine (BRE) in a host of complex decision making scenarios. Like the horse and the snail, the results are dramatic: rules in a fraction of a second vs. weeks or months when hard coding manually. Plus, BREs offer both accuracy and speed, something missing from the manual equivalent.

Healthcare Exchanges Find Success Using Business Rules Engine

This strong package of benefits led many state healthcare exchanges to implement our BRE—to great success. With last week’s Supreme Court ruling on the Affordable Care Act, struggling states are now evaluating their options. Before taking the extreme step of abandoning home-grown exchanges, many are looking to fellow states to potentially adopt successful models. Deploying a BRE like Progress® Corticon® is a targeted fix that has proven results in state government applications. For example, the State of Pennsylvania was able to adopt 60%-70% of the decision logic from the State of New Mexico, even though New Mexico used JavaScript and Pennsylvania is .NET-based. That’s the flexibility a BRE like Corticon provides. Pennsylvania has since reduced defects and finds them earlier in the testing cycle because Corticon rule modeling more closely mirrors their business processes.

And its not just New Mexico and Pennsylvania. A total of 26 states have chosen Corticon for a variety of complex uses ranging from HIX to pensions and more.

As a new era dawns for state healthcare exchanges, here’s hoping more decision makers invest on a winning horse.