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HealthIntelligence™: AI decision support

An AI-enabled decision support and operations platform built to help Medicaid agencies apply policy, data, and documentation with greater speed, consistency, and auditability.

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AI for Medicaid decision support

HealthIntelligence is Deloitte’s AI-enabled decision support and operations platform for supporting Medicaid. It combines policy, operational data, and business playbooks to generate explainable analyses, guided recommendations, and traceable outputs that can give agencies the opportunity to improve workflow efficiency, defensibility, and oversight.

HealthIntelligence at a glance

Built for Medicaid complexity, HealthIntelligence combines policy, data, and workflow support for faster, defensible operations.

60+

Medicaid AI and automation use cases.

20+

AI agents with specialized skill sets

Why HealthIntelligence stands out

Core platform features

Policy ingestion

Ingests state and federal Medicaid policies, handbooks, bulletins, regulations, and procedures.

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MMIS integration

Works within or alongside existing Medicaid management information system (MMIS) through screen support, application programming interfaces (APIs), batch delivery, and chatbots.

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Reasoning trace

Generates summaries, recommendations, citations, confidence scores, and a reasoning log.

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Security layer

Supports end-to-end encryption, role-based access, guardrails, and Health Insurance Portability and Accountability Act (HIPAA)-aligned handling.

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Operational use cases

HealthIntelligence can be deployed across high-volume, policy-driven Medicaid workflows to support workforces, manual effort and generate more consistent decisions.

Our AI-powered decision support system identifies suspend reasons, missing elements, and likely fixes to help staff resolve claims efficiently. The platform has the ability to surface relevant policy, summarize case context, and recommend next steps with rationale.

HealthIntelligence analyzes policy and case documents to confirm whether requested services meet coverage and clinical criteria. It can flag documentation gaps, summarize findings, and support more timely, defensible reviews.

Our AI-powered decision support system compiles timelines, summarizes clinical and administrative records, identifies missing evidence or citations, and generates draft, policy-aligned recommendations to support appeals and medical record review.

Get in touch

Don Hoag

Don Hoag

Principal | Government & Public Services | Deloitte Consulting LLP
+1 412 402 5292
Geetika Tandon

Geetika Tandon

Managing Director | Government & Public Services | Deloitte Consulting LLP
+1 571 882 5074
Ankan Mitra

Ankan Mitra

Associate Vice President | Government & Public Services | Deloitte Consulting LLP
+1 717 215 9694