Navigate risk and regulatory complexity

Transform risk and complexity to your advantage

In the new Health Economy, the most successful players will capture value by both uncovering strengths and developing new capabilities. More sources of risk and complexity are emerging, ranging from new technologies, cyber threats and regulatory requirements to changes in accounting and tax rules. A seemingly simple regulatory change can have significant ripple effects across many areas of a company’s business.

As executives develop new strategies, products and services – and implement structural changes – the holistic management of risk and regulatory complexity is increasingly key to success.

Health industry entities face this increasing complexity on a daily basis, as market-driven innovation rapidly outpaces the regulatory framework in an environment rife with government enforcement actions. Health Services organizations in particular must satisfy multiple strategic, customer and regulatory priorities, including the rapid evolution to patient-focused, value-based care, all while navigating a complicated, dynamic risk and regulatory environment. The ability to move quickly and confidently in the midst of the resulting uncertainties is critical to both creating value through achieving strategic goals and protecting that value from the consequences of regulatory non-compliance.

How PwC can help

PwC Health Industry professionals offer depth and breadth in risk and regulatory services for payers and providers.  Here are some of the ways we can help:

  • Strategic risk
  • Medicaid fraud, waste and abuse
  • Pharmacy, compliance and operations
  • Enterprise risk management
  • Financial crimes and anti-money laundering
  • Regulatory-driven change
  • Financial and treasury management
  • Model risk management
  • Healthcare and regulatory compliance
  • Controls testing & monitoring
  • CMS rating risk
  • 340B provider risk
  • Third party risk management
  • Research and higher education compliance risks
  • Service organization controls (SOC) reporting
  • Revenue risk
  • Internal audit
  • Clinical risks
  • Business continuity
  • GAAP changes
  • Media and advertising risks
  • IT project risks
  • EHR system risks
  • Cybersecurity and privacy risk
  • Cybersecurity assurance – readiness assessments and attestation reporting
  • Business application risk, controls and compliance solutions
  • System implementation assurance
  • Business application security and GRC strategy and implementation
  • GRC technology
  • Global investment opportunity


Contact us

Sundar Subramanian
Principal, Health Industries, Risk and Regulatory Consulting Leader , PwC US
Tel: +1 (718) 419 3082

Mitchel Harris
Principal, Health Industries Risk & Regulatory Consulting, PwC US
Tel: +1 (646) 471 2477

Tim Weld
Health Services Assurance Leader, PwC US
Tel: +1 (646) 471 2477

Terry Puchley
Health Services Risk Assurance Leader, PwC US
Tel: +1 (602) 821 2759

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