Reimagining Healthcare Internal Audit: Leading Through Change

Key findings from the latest study conducted by Protiviti and AHIA on
internal audit plan priorities for healthcare organizations

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What healthcare internal audit leaders are prioritizing in 2026.

6 min read

Each year, Protiviti and AHIA survey healthcare internal audit leaders to better understand the challenges shaping internal audit plans. The 2026 Internal Audit Plan Priorities Study shares insights into the top internal audit plan priorities, innovation in healthcare internal audit including AI and advanced analytics, and departmental benchmarking.

Designed for healthcare internal audit, risk, compliance and executive leaders, the research highlights where organizations are focusing attention to strengthen governance, resilience and performance in the year ahead.

Key findings at a glance

The continuing rapid rise of AI, alongside evolving regulatory expectations and growing operational complexity, is reshaping the healthcare risk landscape at a never-before-seen pace.
What is different in 2026 is not simply that these risks remain on the radar; it is how quickly they are converging.
Cyber threats, including ransomware and AI-enabled attacks, remain pervasive.
Expanding reliance on third parties, complex workforce models and emerging technologies continue to introduce new dimensions of risk.
Ongoing margin pressures, supply chain disruptions and heightened scrutiny over revenue cycle integrity, financial stewardship and compliance further elevate the importance of a robust and forward-looking internal audit (IA) function.

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The future of healthcare audit is risk-informed and AI-enabled.

Cross-segment
Provider
Payer

Cross-segment

The cross-segment priorities

The healthcare risk landscape is becoming increasingly interconnected. As organizations embrace AI and digital transformation, new efficiencies are emerging alongside these new risks. Managing those opportunities and risks requires governance models that can adapt as quickly as the environment itself.

What this means:

Healthcare organizations should evaluate whether audit plans address not only today's highest risks, but also the governance and resilience capabilities needed to support long-term performance.

Provider

The provider priorities

Healthcare providers are navigating rapidly evolving care delivery environments while balancing workforce, operational and financial demands. Strengthening governance, enhancing operational effectiveness and providing assurance over key clinical and business processes support the organization.

What this means:

Providers should assess whether audit coverage extends across the full revenue cycle, from front-end operations, through charge capture and transparency requirements to back-end revenue cycle operations.

Payer

The payer priorities

Healthcare payers are facing increasing regulatory scrutiny and heightened expectations for accuracy, transparency and member experience. Effective oversight helps manage compliance and operational risks while maintaining trust and supporting organizational objectives.

What this means:

Payers should evaluate whether audit resources are aligned to high-impact operational processes where errors, compliance issues or control weaknesses can affect financial performance and member outcomes.

How can we use AI, analytics and other tools/technologies on every audit we perform and throughout the entire audit lifecycle?

Next steps for internal audit leaders

Leading internal audit functions are challenging themselves by asking, “How can we use AI, analytics and other tools/technologies on every audit we perform and throughout the entire audit lifecycle?” For provider and payer organizations alike, internal audit continues to be looked to as a strategic partner, supporting innovation, evaluating emerging risks and enabling informed decision-making. By aligning audit plans to these evolving priorities, organizations can better anticipate disruption, protect financial and operational performance, and maintain trust with management, patients, members, regulators and other key stakeholders.

How can we use AI, analytics and other tools/technologies on every audit we perform and throughout the entire audit lifecycle?

FAQs

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Why does cybersecurity remain healthcare's top internal audit priority?

Cybersecurity remains healthcare's top internal audit priority because healthcare organizations continue to face frequent cyberattacks, ransomware and data breaches. As digital transformation and AI adoption accelerate, internal audit plays a critical role in evaluating cyber risk, resilience and governance.

What risks are shaping healthcare internal audit plans in 2026?

According to Protiviti and the Association of Healthcare Internal Auditors’ 2026 Healthcare Internal Audit Plan Priorities Study, healthcare internal audit plans are increasingly focused on cybersecurity, AI and emerging technologies, third-party risk, operational resilience and ongoing workforce and financial pressures. Together, these risks reflect internal audit's expanding role in strengthening governance and organizational resilience.

How should healthcare organizations audit AI and emerging technologies?

Internal audit should assess whether AI is being deployed responsibly and effectively. This includes evaluating AI governance, risk management, inventories of AI use cases, monitoring controls, human oversight and whether AI investments are delivering expected business value. Importantly, internal audit's responsibility extends beyond auditing AI. The function should also model responsible AI use within its own activities, ensuring appropriate governance, transparency and human oversight in how AI is leveraged throughout the audit lifecycle.

What are the biggest third-party and outsourced service risks facing healthcare organizations?

As healthcare organizations rely more heavily on vendors and outsourced services, internal audit must evaluate risk areas related to cybersecurity, privacy, regulatory compliance, operational disruption, contract performance and business continuity.

How should healthcare organizations prepare for workforce, payroll and labor compliance risks?

Internal audit should assess payroll practices, employee classification, overtime calculations, leave requirements and related compliance controls. Ongoing monitoring can help organizations reduce regulatory risk and strengthen workforce governance.

How can internal audit strengthen organizational resiliency and business continuity?

Internal audit can strengthen organizational resilience by assessing business continuity plans, disaster recovery capabilities, third-party dependencies, recovery testing and crisis response readiness. These assessments help organizations prepare for and recover from disruptive events.