ヘルスケア

プロティビティは、ヘルスケア産業を熟知しています。私たちは、加速する変化の中で、主要な医療機関にサービスを提供するため、グローバルでの展開を急速に拡大し続けています。私たちは、目前に迫った業界の変化とその推進要因を知っています。また、業界の変化に効果的に対応し、医療提供体制を最適に管理、保護し、実質的な価値を創造するためのアドバイスをお客様に提供する方法を知っています。当社の経験豊富な専門家チームとヘルスケアセンターオブエクセレンスは、ヘルスケア産業に影響を与える多数の変更とリスクを理解し、管理するためのリソースです。決済改革、コンプライアンス、収益拡大、コスト管理、サイバーセキュリティ、デジタルトランスフォーメーションなど、お客様の関心事が何であれ、プロティビティはお客様を支援します。

プロティビティのヘルスケア産業チームは、支払者や医療機関のリーダーが、現在直面しているリスクを管理し、将来の成長と機会のための戦略に内在するリスクや不測の事態を明らかにすることで、より良い意思決定を行えるよう支援します。

Survey

August 19, 2025
6 min read

Evolving Risk Landscape Refocuses Healthcare Audit Priorities

Protiviti & AHIA’s 2025 survey highlights key healthcare audit focus areas, from risk management to compliance and governance best practices. Download the full report.

Challenges and Opportunities facing the Healthcare Industry

Healthcare organizations face complex challenges in an ever-evolving environment. Our healthcare collection brings unique insights and expert guidance to help payer, provider, and life sciences leaders make better decisions, manage inherent challenges and risks, and make long-term transformational change.

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

Healthcare Providers

Protiviti stands at the forefront of the healthcare industry by bringing our in-depth industry knowledge and skills to help provider organizations manage risks, improve operations and preserve revenue by leveraging our expertise, analytics and accelerators. Our wide range of offerings include harnessing AI, driving clinical excellence, designing and implementing digital and advanced analytics strategies, and modernizing enterprise applications. We leverage cutting-edge IT security measures, foster innovation, manage mergers & acquisitions, ensure revenue integrity, and address risk & compliance diligently.

 

Healthcare Payers

Protiviti helps health plans, PBMs, TPAs, state Medicaid agencies, employers, and FEHB carriers operationalize and execute solutions to enhance business performance and drive sustainable growth. Whether we are assisting with strategic planning, design initiatives, or process improvement, 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:

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

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

Our multidisciplinary team comprises attorneys, CPAs, CFEs/CFFs, data privacy professionals, and technology specialists who work with global healthcare organizations to maximize efficiencies while minimizing legal risk in the face of growing healthcare litigation exposure and regulatory inquiries.Offerings include:

  • Fraud, Investigations, and Disputes
  • Digital Forensics and eDiscovery
  • Legal compliance
  • Legal department resilience and optimization
  • Contracts management, remediation, drafting and redlining
  • Legal privacy and risk
  • Litigation readiness

Featured insights

Healthcare's The Pulse

Explore the latest edition of Protiviti's healthcare newsletter, The Pulse, where we share a roundup of our most recently released thought leadership, past and upcoming events, key industry news, and much more.

Protiviti Preference Center

Sign up for Protiviti email and get the thought leadership, surveys, event invitations, and more that will help you gain an essential edge.
Loading...