Patent ID: 8355926

Claim:
A computer-implemented method for high-performance capability assessment of a Medicaid program, comprising: providing a processor operatively coupled to a communication network; providing one or more databases operatively coupled to the processor and accessible through the communication network; coupling an interface to the processor for receiving input; the processor establishing a machine-readable memory in said one or more databases, including a multidimensional Medicaid program performance reference set comprising multiple key assessment performance reference tables, at least one key assessment performance reference table defining a member management platform, including: a ‘Basic’ performance level specifying ‘Basic’ performance assessment criteria; a ‘Competitive’ performance level specifying ‘Competitive’ performance assessment criteria; a ‘Market Leading’ performance level specifying ‘Market Leading’ performance assessment criteria; the processor establishing eligibility determination assessment criteria, wherein the ‘Basic’ performance assessment criteria includes a first criteria: where information is manually validated; wherein the ‘Competitive’ performance assessment criteria includes a first criteria: where application data are standardized; wherein the ‘Market Leading’ performance assessment criteria includes a first criteria: where external and internal validation sources automatically send notice of change in member status; receiving, by the processor, an input specifying a Medicaid program area and a Medicaid program key assessment area with the Medicaid program area for analysis; searching, by the processor, the multidimensional Medicaid program performance reference set for a matching key assessment performance reference table that matches the Medicaid program area and the Medicaid program key assessment area; retrieving, by the processor, the matching key assessment performance reference table; analyzing, by the processor, the matching key assessment performance reference table; and obtaining, by the processor, a resultant performance level for the Medicaid program key assessment area.