As a psychiatric health maintenance organization, Merit personnel were responsible for approval of hospital admissions for its members. Routine audits revealed elevated expenses being charged to the company due to an unduly high level of unnecessary hospital admissions. No process was in place, however, to allow adequate checks to control or re-route the unnecessary admissions to appropriate treatment options.

Stonegate analysts and programmers worked together with Merit personnel to craft an admissions screening system. The system, largely automatic, channeled member patients through a new business flow, a triple-tiered series of checks by increasingly qualified therapists and psychiatrists so that patients were only admitted for hospitalization when deemed necessary.