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Health Plans

With the passage of the Affordable Care Act, the reality for health plan businesses has changed and caused significant confusion. The decline of fee-for-service care, the increasing role of government as a primary payor, ever-changing consumer preferences, and increasingly challenging competition have dramatically altered the profitability model for businesses like yours. At the same time, there is opportunity. The potential of big data and analytics is only now coming into focus. Changing demographics can create possibilities for strategically positioned businesses and organizations. The industry culture of continuous performance improvement presents an opportunity to determine which capabilities remain strong and which areas might no longer be relevant.

Experience: the Prescription for Change

Our proven prescription for these challenges and opportunities is teaming with an experienced health care industry partner that can apply financial and market-driven strategies to your accounting, technology, and operational needs.

Our health plan services include:
  • Financial statement audits and reviews
  • Internal financial, technology, and risk-based control audits
  • Tax strategy related to operations and employment
  • Due diligence and merger and acquisition support
  • Reimbursement audits and reviews
  • Data analytics and information technology assessments and solutions
Because the health plan business is so interconnected, you need an advisor with the broadest healthcare industry experience. The EKS&H healthcare practice serves virtually every kind of business and organization in the industry, including large and local health plan companies, and is one of the fastest growing industry groups within our firm. You can be confident in the services our healthcare professionals provide.