Skip to main content
Welcome to Deloitte

If we have selected the wrong experience for you, please change it above.

HealthPerform™ for program oversight

HealthPerform delivers innovative solutions to enhance program performance and help government-funded health programs overcome operational challenges that can contribute to significant overheads.

Get in touch

How HealthPerform works

HealthPerform is a cloud-hosted, configurable platform that helps state health leaders streamline oversight and decision-making. It’s used across state Medicaid and long-term services and supports (LTSS) programs as well as state-based exchanges (SBEs). It applies human-led AI and automation to improve performance beyond compliance—strengthening quality, access, outcomes, planning, and efficiency across provider, quality, compliance, population, and financial domains.

HealthPerform by the numbers

HealthPerform helps state Medicaid and LTSS programs and SBEs strengthen program oversight, planning, and efficiency through AI-enabled automation—supporting users including Medicaid directors, state program executives, and program staff.

40+

solutions for comprehensive program oversight across domains

1,000+

active users supported in program oversight functions

HealthPerform’s features

HealthPerform is a scalable, AI-enabled tool that allows for effective program oversight and analytics in an easy-to-use modular platform.

HealthPerform: Program oversight across key domains

HealthPerform helps state Medicaid and LTSS programs and SBEs strengthen program oversight, planning, and efficiency through AI automation across a five-domain data footprint: provider, quality, compliance, population, and financial.

Contractual compliance

Oversee health plan compliance with state contracts, enhance oversight operations, and streamline federal reporting processes.

Find out more

Program quality

Track quality of care outcomes across health plans and demographic segments and oversee quality improvement initiatives.

Find out more

Provider network

Promote access to care by identifying coverage gaps spanning provider types, geographies, and health plans.

Find out more

Trend monitoring

Monitor population demographic programs and enrollment trends in state programs.

Find out more

Financial management

Track program financials to pinpoint high-cost programs and care and identify opportunities for savings.

Find out more

Effective applications of HealthPerform

HealthPerform supports more than 30 distinct applications across five program implementations—meeting a broad range of user needs, workflows, and operational scenarios.

HealthPerform automatically extracts standards (clauses) directly from state contracts and agreements, enabling effective compliance monitoring for MCOs. The tool uses Generative AI to process lengthy contracts, pull standards verbatim, and integrate them into the contract monitoring application—increasing the effectiveness and speed of contract compliance monitoring and review.

HealthPerform conducts secret shopper surveys to evaluate provider experience and accessibility. The results are used to further assess and improve provider data quality, provider network oversight analytics, and reporting. 

Users can apply the performance-based contract monitoring tool for targeted support of nontraditional provider contracts, including those for intellectual and developmental disabilities (I/DD) waiver services. It promotes value and efficiency in state Medicaid program spending; motivates providers to focus on real, person-centered outcomes; and increases transparency and accountability in service delivery.

Users can leverage the integrated quality dashboard (IQD) to access a centralized view of national and state-specific quality measures across multiple data sets, reports, and domains. IQD compares data across health plans, regions, and demographics to identify care disparities. It enables users to create and export visualizations for analysis and external reporting.

  • Improved oversight with contract monitoring

    A large managed-care state needed support to comply with oversight requirements defined by the Centers for Medicare & Medicaid Services (CMS), including those for quality measurement, accountability, and comparability across MCOs. Deloitte supported the state with a customized instance of HealthPerform’s contract monitoring tool. It replaced a time-consuming manual review process with efficient contract oversight, progress tracking, trend analysis, and corrective action management to meet the state’s evolving needs.

  • Better insight into the beneficiary experience

    A state Medicaid program faced limited visibility into the beneficiary experience and outcomes related to health care access. Working with Deloitte, the state implemented HealthPerform’s network adequacy analysis tool to visualize gaps in beneficiary coverage, population needs, and provider locations—enhancing network monitoring and managed care oversight capabilities.

  • Streamlined provider contracting

    Streamlined provider contractingA state engaged Deloitte to support implementation of a new, performance-based contracting approach with providers serving individuals with developmental disabilities. HealthPerform centralized provider data collection, automated elements of the review process, and improved transparency to promote stronger program oversight and better outcomes.

  • Improved provider network data accuracy

    A state Medicaid agency faced challenges with inaccurate provider directories and compliance with federal regulations. The agency leveraged HealthPerform’s Access2Care tool to conduct secret shopper surveys, validated provider network data, and resolved discrepancies—improving network accuracy, oversight, and timely access to care.

Get in touch

Don Hoag

Don Hoag

Principal | Government & Public Services | Deloitte Consulting LLP
+1 412 402 5292
Matthew Mardorff

Matthew Mardorff

Managing Director | Deloitte US
+1 717 395 7259