Helping healthcare provider organizations modernize the full enterprise – innovating care delivery and operations while advancing research and education – through integrated transformation of strategy, operations, and technology

Provider Clinical Modernization

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Overview

Healthcare provider organizations face growing pressure to improve financial performance, address workforce constraints, and modernize across the enterprise. We help organizations rapidly identify and realize high-impact improvement opportunities across care delivery and operations, access to care and service lines, research and education, revenue cycle, and clinical technology — delivering measurable financial and operational value, increased workforce capacity, and scalable growth.


Market trends

$1T

in US healthcare spending will shift to digital-first, proactive care models by 2035

Source https://www.pwc.com/us/en/industries/health-industries/library/future-of-health.html
77%

of health leaders list AI as a top three tech investment priority for healthcare modernization

Source https://www.pwc.com/us/en/industries/health-industries/library/ai-and-healthcare-emerging-technologies.html
51%

of consumers say that the healthcare system is broken — underscoring the need for provider modernization

Source https://www.pwc.com/us/en/industries/health-industries/library/healthcare-consumer-insights-survey.html
25%

of US healthcare costs are from administrative overhead

Source https://www.pwc.com/us/en/industries/health-industries/library/future-of-health.html

Capabilities

Access to care

Expanding front-door capacity and modernizing scheduling, navigation, and referral pathways to drive margin improvement, capture market share, and enhance the patient and provider experience

Administrative and support operations

Reimagining administrative and support operations through modern workforce models, service management, and AI-enabled capabilities to drive scalable efficiency and support growth without added complexity

Clinical operations

Reimagining care delivery and site-of-care optimization to improve outcomes, increase throughput, strengthen workforce resilience, and enhance financial performance

EHR / clinical technology

Implementing and optimizing the electronic health record (EHR) and adjacent solutions — combining strategic advice with execution and an implement-to-operate (managed services) model — to advance clinical, operational, and strategic objectives and deliver tangible, value-based outcomes

Medical education and research

Transforming medical education and research operations through a strategy-led approach to shape the future clinical workforce, accelerate innovation, and advance discovery

Physician Enterprise

Optimizing physician enterprise and provider network models to expand capacity, strengthen provider alignment, optimize ambulatory performance and access, and drive sustainable clinical and financial growth

Revenue cycle

Modernizing revenue cycle operations as a critical strategic asset through clinically integrated workflows, scalable agentic workforce, and predictive analytics to optimize revenue, create sustainable cost models, and generate organizational value-based outcomes

Rural health

Supporting rural and critical access providers to design and implement sustainable care delivery models that strengthen financial viability, expand access, modernize clinical and operational infrastructure, and improve population health outcomes through data-driven and community-centered strategies

Service line transformation

Transforming care models and performance across clinical specialties to accelerate growth, improve profitability and patient outcomes, optimize resource utilization, and enhance market competitiveness

Strategic reimbursement

Developing and implementing strategies to optimize Medicare and Medicaid reimbursement and strengthen financial sustainability.


Insights


Contact us

Sarah Daubenspeck

Principal, PwC Sector Operations Practice Lead, PwC US

Scott Ramer

Provider Clinical Modernization Offering Sales Leader, PwC US

Allison Clemmons

Provider Clinical Modernization Offering Leader, PwC US

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