Top Compliance Priorities for U.S. Healthcare Organisations in 2025
Protiviti’s risk and compliance experts weigh in on the top compliance priorities for healthcare organisations in 2025 and what these changes mean under a new administration. Providers, payers, and life sciences organisations must refine their strategies to comply with evolving regulatory requirements and enforcement, while also capitalising on the opportunities presented by emerging technologies.
Key Takeaways:
Regulatory Landscape Shifts: Adapt to evolving regulations and enforcement priorities with agility, foresight, and a proactive approach to stay ahead of the curve.
Strategic Role of CCOs: Discover how Chief Compliance Officers, serving as strategic advisors, can embrace the challenges ahead and lead effective compliance programmes in a highly dynamic environment.
Focus Areas for Compliance: Gain insights into key compliance areas that will shape healthcare practices such as emerging technologies, quality and safety, data privacy, fraud, waste and abuse, Medicare Advantage, and marketing and advertising.
Overview of industry compliance priorities
The provider, payer and life sciences segments each have unique compliance priorities while similarly trying to ensure, at their core, they achieve exceptional patient, consumer and member care along with high levels of satisfaction and employee retention.
Providers | Payers | Life Sciences |
Management of emerging technologies | Medicare Advantage | Artificial Intelligence |
Privacy and data security | Risk adjustment | Privacy and data security |
Quality and safety compliance | Fraud, waste and abuse | Marketing and advertising |
Billing and coding compliance | Vendor and FDR management | Third-party relationships |
| Privacy and data security | Anti-corruption |
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