Healthcare At Protiviti, we know healthcare. Our global reach continues to expand at a rapid pace as we serve leading healthcare organisations 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 organisation’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 organisations 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 insights 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 brings deep industry knowledge and skills to help healthcare provider organisations 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 Specialise 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 organisation. Our services for Healthcare Organisations: Healthcare is a strategic industry at Protiviti with dedicated professionals and a Healthcare Center of Excellence that is organised to innovate industry-specific solutions with a primary goal of becoming a mission-critical strategic partner to each of the organisations 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 organisations 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 organisations 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 OrganisationsInterim 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 organisations 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 organisations that strive for a competitive market presence. Protiviti supports our clients in recognising 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 organisations to maximise efficiencies while minimising 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 optimisationContracts management, remediation, drafting and redliningLegal privacy and riskLitigation readiness Featured insights FLASH REPORT Trump 2.0: Possible Winners and Losers President-elect Donald Trump will take office in January 2025 with Republican control of both the Senate and the House and with a conservative-leaning Supreme Court. The president-elect has moved quickly to appoint cabinet members, agency heads and... 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... 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... 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... 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... Button Button Global Health Services Company Modernises 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. 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 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 Lauren Brown Lauren is the country lead for Australia. With over 14 years' experience in governance, risk, and internal control, she specialises across multiple industries including health, higher education, government, consumer products, and energy. She is an active member and ... Learn More