LexiPoint on Salesforce adds policy intelligence to the platform your team already uses. Every eligibility decision explained, audited, and defensible — without leaving your org.
Typical program ROI — Year 1
Net first-year value
$657K
6.5:1 return on a $10K/month investment
The Problem
Salesforce is phenomenal at workflow, case management, and data. But the regulatory logic that determines eligibility outcomes? That lives in caseworkers' heads, 200-page policy manuals, and hard-coded validation rules nobody can audit.
$289M
Across 18 audits since 2016, OIG identified $289M ($202M federal share) in unallowable Medicaid capitation payments to managed care organizations on behalf of deceased enrollees. In FY2022 alone, $207.5M was paid for deceased enrollees — 99 of 100 sampled payments were errors.
25 min
Caseworkers earn a median of $29/hr ($60,863/yr). Cross-referencing policy manuals and validation rules takes 20–30 min per application. At 200 cases/week, that's $630/week per worker in review time alone.
Source: Glassdoor Caseworker Salary, 2026 · PayScale Eligibility Worker, 2025
0%
Salesforce validation rules enforce field-level logic. They cannot trace a denial to a specific statute, explain a decision to an applicant, or model what happens when a rule changes.
The Gap
Salesforce is the system of record. LexiPoint makes it the system of reasoning.
| Capability | Salesforce Alone | + LexiPoint on Salesforce |
|---|---|---|
| Case routing & workflow | Excellent — this is what it's built for | Preserved. LexiPoint doesn't touch workflow. |
| Field validation | Validation rules check format, not policy | Full regulatory rule evaluation with thresholds, weights, and dependencies |
| Decision explainability | No built-in capability | Human-readable explanation of every decision, rule by rule |
| Statute traceability | No way to link decisions to legal citations | Every rule tied to specific statutory authority |
| Immutable audit trail | Field history tracking (limited fields) | Complete rule-by-rule decision trace, immutable, regulator-ready |
| Impact analysis | Not available | "What-if" modeling before any policy change goes live |
| Policy change velocity | Requires dev work: Apex, flows, validation rules | Admin UI update — no code, no deploy, immediate effect |
| AI-powered reasoning | Einstein does prediction, not policy reasoning | AI-native: scenario generation, reasoning, explainability |
The Math
Conservative estimates based on published federal audit data, verified caseworker compensation data, and standard eligibility processing benchmarks. Every number is sourced below.
Net monthly savings from time alone
$20,875
Before audit savings, before improper payment reduction
A caseworker earning $29/hr (Glassdoor, 2026) with a standard 30% benefits load = ~$38/hr fully loaded. Each spends an average of 25 minutes per application cross-referencing policy manuals, checking thresholds, and documenting reasoning. That's $15.83 in labor per application.
LexiPoint automates the policy reasoning and generates the explanation — reducing that 25-minute review to under 9 minutes. The caseworker still makes the final call on complex cases. Routine determinations? Instant, documented, defensible.
At 3,000 applications per month (a modest mid-size program), the time savings alone cover the cost of LexiPoint more than 3x over. And that's before you account for:
Improper payments: HHS OIG found $289M in unallowable Medicaid payments across 18 audits since 2016. In a single year (FY2022), $207.5M was paid for deceased enrollees alone. (HHS OIG, Dec 2025)
Audit readiness: When OIG or a state auditor asks "why was this person approved?" — you have an immutable, statute-backed answer. No scrambling, no reconstructing logic after the fact.
Regulatory compliance: OMB M-24-10 (White House, Mar 2024) requires federal agencies to implement risk management for rights-impacting AI by Dec 2024. Colorado SB24-205 (Colorado Legislature) mandates explainability for consequential automated decisions, effective June 2026. More states will follow.
One prevented audit finding pays for a full year of LexiPoint. The time savings pay for it every single month.
Why Native
LexiPoint on Salesforce is a managed package that installs directly into your existing org. Your team never leaves the platform they already know.
One-click AppExchange install. Custom objects, Lightning components, and Platform Events deploy directly into your org. No external servers.
Runs on your Salesforce instance — including Government Cloud. No data leaves your org. Your profiles, permission sets, and sharing rules apply automatically.
LexiPoint publishes decision events via Salesforce Platform Events. Your existing flows, triggers, and automations react in real time. Zero custom integration.
Decision data lives in standard Salesforce objects. Build reports, dashboards, and Einstein analytics on top of LexiPoint data using the tools you already have.
LexiPoint surfaces as Lightning components inside your existing case record pages. Caseworkers see decision explanations right where they work — no tab switching, no new login.
Policy staff manage rules through a Lightning-based admin interface. When regulations change, update the ontology — no Apex, no deploys, no sandbox testing.
Where It Fits
Any program where eligibility is determined by regulatory rules — and where someone might ask "why?"
Income thresholds, household size calculations, categorical eligibility — codified as auditable rules instead of scattered across validation rules and process builders.
MAGI-based and non-MAGI eligibility pathways with dependent rule chains. Every determination traced to federal and state regulatory authority.
Professional licensing, childcare, food safety, environmental permits — each with multi-condition approval criteria that change with legislative sessions.
Federal and state grant programs with complex qualification criteria, reporting requirements, and compliance checks that need to be consistent and documented.
Compliance Ready
See LexiPoint on Salesforce running against your program's actual rules. We'll show you the ROI on your data, not ours.
Starting at $10,000/program/month · No per-user fees · No long-term contract required
Sources & Citations
Every claim on this page is sourced from publicly verifiable data. We encourage human validation.