Impact of Digital Transformation on Healthcare Payment Fraud

This research report, sponsored by GHX, discusses the increasing threat of payment fraud in healthcare and the critical role of digital transformation in mitigating these risks. It outlines the current landscape, highlighting that the U.S. government anticipates recovering over $3 billion in fraudulent payments in 2023. The report details concerns among hospital financial executives regarding AI-influenced fraud, with a significant percentage expressing worry about account takeovers and payment fraud. It emphasizes that delays in digital transformation due to macroeconomic pressures have left healthcare organizations vulnerable to fraud. The report also notes the impact of mergers and acquisitions on fraud risk, as differing processes can increase vulnerabilities. Despite these challenges, the report indicates a renewed focus on digital transformation, with a notable percentage of hospital leaders planning to increase technology investments to enhance fraud prevention. Specific areas of investment include electronic health record systems and accounts payable automation, which are seen as essential for reducing fraud risks.