What Deloitte gets wrong in Healthcare
Deloitte's healthcare payer practice has one defining characteristic: it sells technology transformation and delivers consulting reports. The Medicaid managed care information system failures across 20+ states are the clearest evidence — payers contracted Deloitte to build working systems and received documentation, project management, and a managed dependency instead. The CMS certification failures that resulted cost states hundreds of millions and delayed care access for millions of Medicaid beneficiaries.
Payer technology is existentially compliance-driven. CMS interoperability regulations, state Medicaid managed care contracts, ACA reporting obligations, and the No Surprises Act create a compliance environment that changes faster than a quarterly review cycle. Deloitte's compliance model is to staff a separate advisory workstream that produces compliance reports. The engineering team builds the system; the compliance team assesses it after the fact. The gap between these workstreams is where compliance failures originate.
Prior authorization workflows are the highest-stakes technical system a payer operates — affecting patient access to care, physician relationships, and CMS regulatory standing simultaneously. Deloitte's prior authorization implementations have produced systems that process authorization requests correctly in test environments and fail under production load, with the failure mode being denials that should be approvals. That is a legal liability, not a bug.
What we deploy instead
We build payer platforms with CMS interoperability mandates and No Surprises Act compliance embedded from the first sprint. Prior authorization workflows that are tested under production-realistic load before they go live. Claims adjudication systems that generate audit-ready evidence automatically.
Our payer technology teams have built across Facets, TriZetto, and QNXT environments. We know the integration patterns, the data model constraints, and the CMS certification requirements before we scope the engagement.
HIPAA and SOC 2 built into the architecture from day one — enforced automatically by ALICE at every commit.
Fixed-price engagements. Production system in 8-20 weeks. No discovery phase. No change orders.
Domain-qualified engineers with healthcare experience. The senior engineer who scopes the engagement is the senior engineer who delivers it.
Full source code and documentation transferred at close. No licensing. No managed services dependency.
The compliance difference
CMS FHIR mandates, No Surprises Act prior authorization requirements, state Medicaid managed care compliance, ACA reporting, HIPAA. Payer compliance is not a consulting deliverable — it is the system architecture.
What switching from Deloitte looks like
Payer technology engagement: 14-22 weeks for a defined production system. Team: 10-16 engineers with payer-specific experience. Fixed price. Full IP transfer. CMS certification support included.
Architecture review and scope definition. We review existing deliverables and identify gaps.
Scope locked, team assembled, first sprint underway. Working code from week two.
First production milestone — a working integration or system component, not a document.
Full IP transfer. Source code, documentation, operational runbooks. Your team runs the system.
Failed Vendor Recovery Playbook
Step-by-step framework for recovering from a failed Deloitte engagement — from emergency stabilisation through full re-platforming. 4-phase playbook covering stabilise, assess, transition, and normalise.