Tackling Traditional Audit Plan Concerns and Expanding Focus on Fraud, Third Parties and Data

TACKLING TRADITIONAL AUDIT PLAN CONCERNS AND EXPANDING FOCUS ON FRAUD, THIRD PARTIES AND DATA

Key Findings From the Latest Survey Conducted by Protiviti and AHIA on Healthcare Provider Organization Internal Audit Plan Priorities

As the COVID-19 pandemic continues to wind down, many healthcare provider organizations are transitioning into a blocking-and-tackling mode, although it’s far from business as usual. Relieved of the constant pivoting that the public health emergency has demanded for more than two years, these organizations now seek to focus more attention on the “new basics” to deliver business results and plan for the future. Organizations also face the challenge of doing more with fewer resources while continuing to deliver on their mission to provide high-quality patient care — albeit in a changed world.

With this dynamic environment in mind, we discuss results from our latest Healthcare Internal Audit Plan Priorities Survey conducted by Protiviti and the Association of Healthcare Internal Auditors (AHIA) and provide our recommendations to internal audit functions based on their stated priorities. Our assessment is similar to what we offered in last year’s survey: Internal audit functions need more support to transform their organization and help it meet current challenges while preparing for what comes next. And now, a year later, the need to accelerate change and advance capabilities has become only more urgent.

TACKLING TRADITIONAL AUDIT PLAN CONCERNS AND EXPANDING FOCUS ON FRAUD, THIRD PARTIES AND DATA

Challenges healthcare provider organizations are facing

Fraud management tops the list of internal audit priorities in our 2022 survey, a reflection of the pressure that healthcare organizations are under to become adept at identifying and defending against rampant fraud.
The new basics for healthcare provider organizations include addressing the residual impacts of the pandemic on core healthcare functions, including back-office operations like billing and accounts receivable management.
Healthcare provider organizations’ focus on the new basics includes making new attempts to find solutions for challenges that are disrupting operations — and eroding the bottom line — well before the pandemic. These challenges include rising regulatory pressures, the fight against opioid and substance use disorders, and significant labor shortages amid fierce competition for skilled talent.
Many internal audit functions in the healthcare industry are at risk of not being able to help adequately support efforts to address pandemic-induced and long-standing issues while also pursuing new opportunities and charting a path for growth in a post-pandemic environment. The lack of advanced technological capabilities in internal audit is a key factor.

Top provider priorities for 2022

Key findings from our survey

Only 27% of internal audit functions in healthcare have already implemented or are optimizing advanced analytics — although another 21% report they’re currently implementing this capability. When surveyed about automation efforts, 10% of respondents have implemented or are optimizing automation, while 9% are in the process of doing so.
More than half (59%) of respondents reported that their function has either not completed or is not currently undertaking any transformation or innovation initiatives.
This year’s data continues to show a migration from methodology to governance. It appears that over 70% of respondents are between “currently implementing” and “optimizing” their internal audit strategic vision and organizational structure, both an increase from 2021.

As our 2022 survey shows, many internal audit organizations are at risk of falling behind technologically despite their desire to modernize tools and systems and expand their workforce. Ensuring that internal audit teams have the financial resources and other support necessary to advance their technological capabilities, build highly skilled and engaged teams and focus more on innovation is necessary not only to build a true, next-gen function, but also a future-forward healthcare organization.

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. ...