Government Programs: Medicare & Medicaid

Health Plans

​In this environment of high-stakes change and growth, many health plans are scrambling to stand up their approaches to government health programs. Deloitte’s top-ranked health plans practice stands apart with mature, first-hand, practical knowledge of government programs based on years of investment and involvement.

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​​An experienced approach for your new focus of growth

Public-sector programs that fund and regulate government health care programs are more important than ever for most plans. Medicare, Medicaid and dual-eligible members will make up more of your business and, you can’t operate within the value chain it takes to serve them—from strategy to operations to compliance—without interacting with the government.

Our practitioners have deep experience not only with Deloitte, but also in federal and state health care programs as well as access to Deloitte’s public- and private-sector specialists—and our multidisciplinary approach can help broaden your government-sponsored business and make it more profitable.

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​Our approach

  • Strategy: From an assessment of your competitive landscape to product and benefit design, our qualitative and quantitative tools help you make the big decisions that frame other decisions.
  • Performance improvement: Insights that can help drive better plan performance and improved member satisfaction and health outcomes.
    Medicare Stars: Improving your Medicare Star rating to help boost your health plan’s profitability.
  • Organizational design and resource modeling: We can help you assess how many people you need where, and how to design your organization to drive government programs growth and performance.
  • Revenue: Knowing the ins and outs of risk adjustment and the regulations that govern these payments helps get the most reimbursement you can while staying on the right side of the rules.
  • Other services including fraud, waste and abuse detection and prevention program assessments; technology services support; platform migration; and compliance evaluations.

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​Our approach

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