97 or Better™—Before 2029
A shared ambition. A practical mission. An invitation to help.
Medicaid eligibility accuracy matters to the people who depend on coverage, the states administering the program, and the public funding it.
Getting a decision right requires more than a policy or a system change. The supporting evidence must be available. Errors must be corrected early enough to protect subsequent payments. Improvements must hold through the next renewal, the next worker action, and the next independent review.
97 or Better™—Before 2029 asks our industry to make that standard a shared ambition—and help build the conditions to achieve it.
What does “97 or Better” mean?
It is our shorthand for an aspiration: at least 97 percent of Medicaid payment dollars supported by accurate, adequately documented eligibility determinations.
The focus is payment dollars and the eligibility evidence behind them. A count of correctly processed applications alone cannot demonstrate that result.
This is a goal to work toward, not a claim that any state or organization has already achieved it. Progress requires transparent measures and independent verification.
What are we asking the field to do?
Preserve the evidence.
Retain what supports the eligibility decision, including the applicable policy and the timing of verification.
Correct errors earlier.
Find vulnerable processes and address defects while there is still an opportunity to protect later payments and prevent avoidable disruption.
Prove the improvements last.
Test whether corrections work in practice and remain effective over time.
Protect eligible people.
Accuracy includes preventing improper denials and avoidable coverage losses. Strong controls should support access for people who qualify.
Help make this an industry expectation
No single state, researcher, or technology company can do this alone.
We invite Medicaid agencies, frontline eligibility professionals, researchers, auditors, health plans, technology partners, providers, and people with experience navigating Medicaid to contribute.
Bring a practical lesson. Identify an evidence gap. Share a control that worked—or a correction that did not hold. Help define measures that make progress visible and credible.
Our aim is to build shared understanding, publish useful lessons, and encourage collaboration across organizational boundaries.
Participation is open and does not require a purchase or commercial relationship.
Follow the mission
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Subscribe freeJoin the conversation
I would welcome a conversation about what your organization is seeing, what you have learned, and where we might contribute together.
When you reach out, tell me the challenge you are working on and how you would like to participate—through research, operational experience, discussion, or collaboration.
Ralph Choate
Editor, PERM Insights & Perspectives
Contact Ralph about the missionPlease share general observations or deidentified examples. Do not submit member records or confidential information.
97 or Better™—Before 2029
Preserve the evidence. Correct earlier. Prove it holds.