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We bring together passionate problem-solvers, innovative technologies, and full-service capabilities to create opportunity with every insight.

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What is culture? Culture is how we do things around here. It is the combination of a predominant mindset, actions (both big and small) that we all commit to every day, and the underlying processes, programs and systems supporting how work gets done.

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Strengthening program integrity

Helping federal program managers effectively deliver their mission while reducing fraud, waste, abuse, and improper payments.

With the shifting executive and regulatory priorities impacting the U.S. healthcare system, advances in technology, and the ever-growing scope and complexity of access, care, and payment models, federal healthcare agencies must change the way they oversee and operate their healthcare programs.

For the path forward, KPMG’s Program Integrity offering can help agencies determine clear strategies for accomplishing mission objectives that go beyond chasing fraud, waste, and abuse. It can be used to continually monitor mission results and risks as well address potential problems. When applied holistically, our Program Integrity offering enables the use of technology, including data and analytics and intelligent automation, to drive transformation of current processes and create opportunities to eliminate repetitive manual tasks; allowing employees to focus on strategic initiatives. Just as critical, it can breakdown internal barriers, emphasizing the importance of collaboration, teamwork and lasting partnerships with key stakeholders across public and private sectors.

How KPMG can help

At KPMG, we understand the intricacies of delivering innovative technical services within the multifaceted federal healthcare, regulatory, and business environment. KPMG’s Program Integrity service offering is risk-based and agile, with technology infused in every aspect, to deliver the strategic and operational capabilities federal agencies need. We help our clients obtain deep insights in planning how to move forward so they can achieve outcomes that are focused on the effectiveness, efficiency, accountability, and transparency of a program achieving its goals.

Our insights

Payment Integrity Information Act of 2019

A new law to improve efforts to identify and reduce government-wide improper payments presents several changes to prior legislation, including the addition of more risk indicators and contributing risk factors, enhanced reporting requirements, and mandatory recovery audits.

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Leading the way in program integrity

The U.S. healthcare system is undergoing rapid changes and growing steadily. Spending on healthcare has reached $3.3 trillion, comprising nearly 18 percent of the U.S. economy.

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Challenges and opportunities of program integrity for Federal Healthcare

Federal healthcare spending is expected to rise to almost $1.5 trillion for fiscal year 2023. In turn, federal leaders are under enormous pressure to endure the complex array of healthcare programs meet mission objectives and public expectations.

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Maximizing Mission Integrity

A candid survey of program officers at federal healthcare organizations

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Federal healthcare agencies provide a new perspective on the challenges of achieving program integrity

Programs suffering from waste, fraud, abuse and increasing improper payments are low-hanging fruit when it comes to cutting federal spending, since they require little-to-no political will to address; government efficiency is a nonpartisan issue.

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