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.Protiviti Healthcare also serves the Pharmaceutical and Life Sciences Industry. Learn more here. Navigating critical healthcare areas through internal audit The latest Healthcare Internal Audit Plan Priorities Study, conducted by Protiviti and the Association of Healthcare Internal Auditors (AHIA), revealed six key areas of focus for internal auditors. Read more 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. Read more 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. Explore collection What we do Read recent blogs Sectors we serve Our services Subscription Insights Leadership 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 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. Pro Document Consent 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. Pro Building office Healthcare Life Sciences The life sciences industry comprises companies operating in the research, development and manufacturing of pharmaceuticals, biotechnology-based food and medicines, medical devices, biomedical technologies, nutraceuticals, cosmeceuticals, food processing, and other products that improve the lives of organisms. Protiviti supports life science clients at all stages of their evolutionary lifecycle and for the products / services they develop and bring to market. Whatever the challenge, our combination of industry, technical, security, and regulatory experts provide the necessary insights and guidance to enhance enterprise value. 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. Healthcare Internal Audit and Financial Advisory 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 ServicesIT AuditsNext-Gen Auditing & AnalyticsIA Program Assessments & BenchmarkingRisk Assessment & Audit Plan Development Healthcare Risk & Compliance 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/outsourcingAssessment & RemediationAudits & InvestigationsCompliance Program EffectivenessCompliance ProjectsCompliance Risk AssessmentsEnterprise Risk ManagementIndependent Review OrganizationsInterim Compliance Officer / Supplemental Staffing Healthcare Technology Consulting 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 SolutionsCompliance and FrameworksCustom Development ServicesCybersecurityData and Advanced Analytics Emerging Technologies Enterprise Application SolutionsManaged / Outsourced SolutionsTechnology Strategy and Operations Healthcare Business Performance Improvement 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 ExcellenceFinance Process ImprovementManaged ServicesRevenue Cycle RedesignSupply Chain Healthcare Digital Innovation 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 AutomationCustomer and Digital Transformation StrategyCustomer ExperienceInnovationCreative and DesignContentSales and Marketing AccelerationDigital Experience Platforms Healthcare Legal Consulting 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 DisputesDigital Forensics and eDiscoveryLegal complianceLegal department resilience and optimizationContracts management, remediation, drafting and redliningLegal privacy and riskLitigation readiness Featured insights BLOG Navigating AI for Healthcare: The Ideal Copilot The healthcare industry is facing unprecedented challenges, with varied causes. People are living longer, so demand for care continually increases, particularly for chronic diseases. There’s a shortage of skilled labor, and workloads are becoming... WHITEPAPER Price Transparency MRF Requirements Hospital Price Transparency Rule - CMS has finalized new changes to increase standardization of the machine-readable files (MRF) to help deliver on the promise of hospital price transparency. Ensure that your hospital complies to enhance the public’s... 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. INSIGHTS PAPER Key Medical Coding Audit Topics Compliance Auditors Should Consider The average cost to rework a claim or appeal a denial is approximately $118 per claim for hospitals and $25 per claim for physician practices. Failing to document, code and submit clean claims properly can impact your organization’s bottom line via... BLOG 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... BLOG Labor Costs, Economic Conditions and Talent Lead Risk Concerns for Healthcare Leaders What’s new: Healthcare organizations continue to face familiar challenges in 2024, including rising labor costs and talent shortages, increasing inflationary pressures, and continued changes in the regulatory environment, according to our Executive... Button Button 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. Read more 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. Read more 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. Learn 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. Learn More 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. ... Learn More 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 ... Learn More 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 ... Learn More