A rapidly changing healthcare industry is demanding adjustments to the priorities of internal auditors within hospitals and health systems, according to a new survey released by the Association of Healthcare Internal Auditors and Protiviti, a risk and business consulting agency.
The survey asked more than 1,000 internal auditors to evaluate their competency in about 150 different areas and indicate if they thought their current competency is adequate both for the organization they work for, identifying areas for greatest improvement. Respondents from U.S. healthcare providers comprised 9 percent of the total number and also responded to a unique section featuring areas specific to healthcare.
The goals of internal auditors have always been closely aligned with those of hospital administrators. "The competencies they're focused on improving should be the same areas that others in the organization are focused on.," says Susan Haseley, global healthcare leader of Protiviti. The results of the AHIA/Protiviti survey are not surprising in that "administrators know these are all important areas of focus," she says.
The results do become interesting when compared with the 2012 results. The shift in priorities over the course of the past year reveals a shift in priorities among healthcare organizations, namely, from looking to the future to focusing on the present.
As compared with the 2012 AHIA/Protiviti survey results, the 2013 results of auditors' top "need to improve" categories show a shift from mastering the basics of healthcare reform toward mastering the technology and techniques needed right now to improve performance, quality and revenue.
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2013 |
2012 |
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Health information exchanges |
Meaningful use compliance |
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Value-based purchasing |
Health information exchanges |
|
ICD-10 implementation |
Accountable care organizations |
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Payment bundling |
Electronic health records |
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Accountable care organizations |
ICD-10 readiness |
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Clinical documentation |
Coding (CPT, ICD-9) |
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ICD-10 impact and readiness |
Patient Protection and Affordable Care Act provisions |
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Pay-for-performance quality standards |
Clinical systems |
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State-specific privacy/security laws |
"One of the big trends is that auditors and providers are more focused on short-term strategic plans," says Richard Williams, managing director at Protiviti. Citing the quality measures that now affect Medicare reimbursements, he says providers now, more than ever, have to ensure no money is left on the table through a lack of understanding about current pay-for-performance, quality standards and ACOs — priorities that are reflected in the internal auditors' priorities above. "What hospital administrators are focusing on, what everyone is focusing on, is doing business smarter and doing business faster," he says.
The focus on the present may come at the expense of the future, though that's not necessarily a bad thing, says Mr. Williams. "The biggest trend right now is an uncertainty over where the government is going," he says.
The present-over-future priorities of internal auditors, and the similar priorities of administrators, are being driven by uncertainty over future laws and regulations. "Why tackle an issue today when it could change within the next 12 months?" he says. "Strategic planning used to look three to five years into the future. Now it's 12 to 18 months because if you look too far past that, what you see may quickly become moot."
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