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Healthcare

At Protiviti, we know healthcare. Our global reach continues to expand at a rapid pace as we serve leading healthcare organizations amid accelerating change. We know industry changes that are imminent and their drivers. And, we know how to advise our clients to effectively address industry changes to best manage, protect and create substantial value in their healthcare delivery systems. Our team of experienced professionals and our Healthcare Center of Excellence are your resources for understanding and managing the multitude of changes and risks affecting healthcare. Whether your organization’s chief concern is payment reform, regulatory compliance, revenue growth, cost management, cybersecurity or digital transformation, Protiviti is here for you.

2024 Top Risks in the Healthcare Industry

Identify the potential risks in healthcare sector with Protiviti’s top risk survey 2024. Download the report to address challenges and strengthen your strategy.
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Challenges and Opportunities facing the Healthcare Industry

Protiviti's healthcare industry team helps provider and payer leaders make better decisions by managing the risks they face today, as well as illuminating the risks and unforeseen consequences inherent in their strategies for future growth and opportunity
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September 25, 2023

Healthcare Internal Auditors Prioritize Cybersecurity, Business Performance and Technology Modernization

According to the latest Healthcare Internal Audit Plan Priorities Survey conducted by Protiviti and the Association of Healthcare Internal Auditors (AHIA), the top audit priorities for healthcare organizations in 2023 are encompassed in seven themes which are highlighted below and discussed in further detail in the report that follows.
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Sectors We Serve

Protiviti's healthcare industry team helps payer and provider leaders make better decisions by managing the risks they face today, as well as illuminating the risks and unforeseen consequences inherent in their strategies for future growth and opportunity
Pro Briefcase

Healthcare Providers

Protiviti brings deep industry knowledge and skills to help healthcare provider organizations manage risks and maintain their financial health. Our tailored solutions span clinical excellence, digital & advanced analytics, enterprise applications/ ERP modernisation, financial & operational performance, information technology & cybersecurity, innovation, mergers & acquisitions, next-gen internal audit, revenue integrity, risk & compliance and other top provider concerns.

 
Pro Document Consent

Healthcare Payers

Specialize in helping health plans and PBMs across Medicare, Medicaid, and commercial lines of business operationalise and execute solutions to enhance business performance and drive sustainable growth. Whether we are assisting with strategic planning, revenue enhancement, cost savings, or process improvement initiatives, we apply innovation, collaboration, and technology acumen across your organization.

 

Our services for Healthcare Organizations:

Healthcare is a strategic industry at Protiviti with dedicated professionals and a Healthcare Center of Excellence that is organized to innovate industry-specific solutions with a primary goal of becoming a mission-critical strategic partner to each of the organizations we serve.

Protiviti’s world-class internal audit (IA) services provide effective insight and confidence to leaders that their organizations can meet the demands of the ever-changing business environment.  Management is leveraging IA more than ever as a strategic resource to provide guidance based on broad and deep skill sets and perspectives; analytical and digital capabilities; and internal knowledge of operations, strategic goals, and risk and control structures.  Our IA services help ensure that healthcare organizations become more innovative and explore new technologies, identify and mitigate emerging risks, develop creative solutions to address complex business challenges, and encourages best practices to enhance business functions. Healthcare Internal Audit and Financial Advisory services include:

  • IA Assurance and Advisory Services
  • IT Audits
  • Next-Gen Auditing & Analytics
  • IA Program Assessments & Benchmarking
  • Risk Assessment & Audit Plan Development

Protiviti provides solutions to help providers and payers ensure they have a robust, effective compliance program to prevent and detect instances and events of legal and regulatory violations. Healthcare Risk & Compliance services includes:

  • Co-sourcing/outsourcing
  • Assessment & Remediation
  • Audits & Investigations
  • Compliance Program Effectiveness
  • Compliance Projects
  • Compliance Risk Assessments
  • Enterprise Risk Management
  • Independent Review Organizations
  • Interim Compliance Officer / Supplemental Staffing

Protiviti provides agile services through a unique, blended model of flexible staffing services and consulting expertise whether your need is project, program, or skill based in nature.  From coordination and management of IT projects to full outsourcing of labor-intensive technology support and implementation services, we help you thrive amid the numerous challenges  in the following areas so you can focus on your strategic initiatives. Healthcare Technology Consulting services include:

  • Cloud Solutions
  • Compliance and Frameworks
  • Custom Development Services
  • Cybersecurity
  • Data and Advanced Analytics 
  • Emerging Technologies 
  • Enterprise Application Solutions
  • Managed / Outsourced Solutions
  • Technology Strategy and Operations

Financial & Operational Performance services increase enterprise value by transforming business processes and driving sustainable change. The best Finance, Revenue Cycle, and Performance Management professionals deliver proven results in challenging environments by effectively leveraging technology and leading practices, using tested and proven program management techniques and capabilities, and bringing an intense focus on change management. Concurrently, Protiviti and Robert Half partner to share the workload/burden with our clients to address performance or project issues in key business functions while also filling operational roles in a unique arrangement, using proven results-oriented professionals.  Healthcare Business Performance Improvement services include:

  • Clinical Excellence
  • Finance Process Improvement
  • Managed Services
  • Revenue Cycle Redesign
  • Supply Chain
  • Legal Consulting

Protiviti helps healthcare organizations make the promise of digital transformation a reality. We help payers and providers alike uncover a deep understanding of the risks and opportunities presented by emerging technologies and think creatively about how these technologies can be used to improve performance and ensure interoperability. Avenues of rapid transformation are driving the need for consistent innovation throughout healthcare organizations that strive for a competitive market presence. Protiviti supports our clients in recognizing and effectively responding to the need for consistent innovation through training, discovery and ideation workshops, prototyping, Customer Experience (CX) initiatives, and implementation. Healthcare Digital Services include:

  • Customer Care and Service Automation
  • Customer and Digital Transformation Strategy
  • Customer Experience
  • Innovation
  • Creative and Design
  • Content
  • Sales and Marketing Acceleration
  • Digital Experience Platforms

INFOGRAPHIC

Infographic | 2024 Top Risks in the Healthcare Industry

The analysis of risk insights from global executives for both 2024 and a decade out reveals several interrelated challenges that could result in disruptions significant enough to test an organization's agility and resilience.

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Using Data Analytics to Identify Physician Coding Opportunities

The big picture: Provider organizations face increasing regulatory scrutiny on professional fee billing practices but have finite auditing resources to address these challenges. What’s new: Employing data analytics when executing professional fee...

WHITEPAPER

Internal Audit Benchmarking Trends in Healthcare

Internal audit (IA) functions continue to undergo significant changes ranging from the expanded use of emerging technologies, including robust data analytics and artificial intelligence (AI), and options on where their people work (i.e., remote,...

BLOG

Rethinking Strategy: High vLicense Renewal Fees Have Healthcare Providers Questioning How, Where to Host Workloads

As healthcare organizations face mounting pressure to modernize infrastructure while managing budget constraints, the rising costs of on-premises infrastructure licensing and support services present a significant challenge to operating expense (OpEx...

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Generative Artificial Intelligence

You need to learn not only about generative artificial intelligence’s potential uses for delivery and management of healthcare, but also about its capabilities to support internal audit activity. At the same time, you need to understand hazards...

WHITEPAPER

Revenue Integrity: Leveraging Data to Enhance Collaboration Across the Revenue Cycle

In today’s complex healthcare environment, hospitals and health systems and other provider organizations have little room for error within the revenue cycle. Faced with tight margins, growing labor and supply costs, and volatile markets, every dollar...

INFOGRAPHIC

Infographic | Healthcare Internal Auditors Prioritize Cybersecurity, Business Performance and Technology Modernization

As the healthcare industry struggles to return to business as usual, providers and payers continue to face notable headwinds as they try to keep pace with emerging digital technologies, market consolidation, aging populations, workforce constraints...

Global Health Services Company Modernizes Data and Applications with Microsoft

A global health services company needed to execute on its corporate promise to deliver affordability and convenience to its patients. However, the company discovered that there was a disconnect between that promise and intended delivery.
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Cloud-based Healthcare Analytics Company Expands Solutions and Customers

d2i is a cloud-based healthcare analytics solutions firm that’s on the move leveraging AWS. The company provides an unparalleled data analytics application that aggregates, harmonizes and enriches diverse data sources to some of the largest hospital emergency departments (ED) in the United States.
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Leadership

Richard Williams
Richard is a founding member and Protiviti's Global Healthcare Practice Leader and Global Lead for Pharma and Life Sciences. He has extensive experience providing operational, financial, and regulatory consulting and internal audit services to the healthcare industry. ...
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Alex Robison
Alex is a Managing Director in Protiviti’s Healthcare Industry practice and has more than 23 years of professional experience providing operational, financial, revenue cycle, regulatory compliance and internal audit services to the Healthcare Industry.  Alex leads ...
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Beau Fidler
Beau is a founding member and Protiviti’s Healthcare Payer Practice Leader. He has over 22 years experience providing operational, financial, and IT consulting and internal audit services across the healthcare industry. In addition to leading numerous business ...
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