The evolution of payment integrity from siloed initiatives to a coordinated, enterprise payer strategy
Foreword
As healthcare costs and administrative complexity continue to rise, payers are under increasing pressure to deliver smarter, more sustainable solutions.
One of the most powerful strategies emerging is enterprise payment integrity (PI). No longer confined to isolated audits or recovery functions, PI is evolving into a coordinated, cross-functional initiative that touches every part of a payer’s organization.
This paper shares practical insights to help payers move from fragmented PI efforts to a unified, enterprise strategy. It offers clear steps—like assessing current programs, building formal governance, and enabling real-time data sharing—to improve accuracy, efficiency, and long-term value.
Whether payers are just starting their enterprise strategy or refining an established framework, expanding cohesive efforts can deliver a range of benefits that lead to significant financial savings and streamlined operations.