Internal Audit ROI Calculator

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Number of auditors

The time healthcare payer delegation/vendor oversight executives spend on compliance and operational vendor-related issues can vary, but here are some general estimates:

Small to Medium-Sized Health Plans: Typically have around 2 to 5 compliance staff.

Larger Health Plans: Often have more extensive compliance teams, with 6 or more compliance staff.

Overall, the average size of a compliance team in health plans is about 5 compliance executives, fluctuating with the specific needs and regulatory requirements of the organization.

Average time spent on Audit & Compliance Activities

The time healthcare payer delegation/vendor oversight executives spend on compliance and operational vendor-related issues can vary, but here are some general estimates:

Average Time Spent Daily Monitoring: Executives might spend around 10-15 hours per week on vendor oversight activities, including daily monitoring, addressing compliance issues, and coordinating with vendors.

Weekly: Executives often dedicate additional time each week to analyze and interpret the implications of updates — another 8 to 15 hours per week.

Monthly: This can add up to approximately 40-60 hours, spent on detailed reviews, compliance checks, and strategic planning meetings with vendors.

Average time spent on Operational Activities

Average time spent on Administrative Activities

Wage/per hour ($)

The wage range for delegation oversight executives tends to be higher due to the scale and complexity of their operations. Research indicates an approximate hourly wage range of $37 to $60 per hour, depending on the specific role, experience, and location.

No. of plan membership

Solution cost ($) – One-time implementation

One-time Implementation Cost Includes:

Initial setup and configuration
Data migration from existing systems
Customization to meet specific needs
Initial training for staff
Integration with existing tools and systems

Solution cost ($) – Recurring monthly subscription

Recurring Monthly Subscription Cost Includes:

Ongoing access to the SaaS platform
Regular updates and maintenance
Customer support and helpdesk services
Continuous training and onboarding for new features
Data storage and security measures

Assumptions

*This calculator is a guide, not a quote.

Your ROI Summary

Based on the information provided

Fill in your details and click “Calculate ROI” to see your results.

Assumptions

Time Savings Assumption: The solution reduces manual effort by 70% based on automation and reporting features.
Implementation Accuracy: The solution effectively interprets and processes regulatory updates with high accuracy (e.g., 95-98%), leveraging advanced NLP and machine learning models. The system includes human-in-the-loop oversight, allowing compliance experts to verify and correct outputs as needed for critical or edge-case scenarios.
Time Spent: Users provide an average time per update, and the calculator assumes consistent effort for all updates.
Hourly Wage: The hourly wage input represents the average wage of compliance team members involved in regulatory tracking and management.
Solution Cost Range: A default solution cost is assumed which may vary from case to case.
Integration and Scalability: Integration into existing workflows and scalability is seamless, leading to minimal disruption and immediate benefits.
Adoption Rate: Training costs are considered part of the implementation and are factored into the assumed solution cost.
Excludes Other Costs: Additional costs for external audits, integrations, or upgrades are not included.
Membership/Enrollment: For up to 20,000 members, the one-time implementation and monthly recurring costs are fixed at $40,000 and $8,000, respectively. The implementation and recurring increases by $0.35 for each additional member. These numbers are indicative only.
Efficiency Gains: 40% for Audit & Compliance Activities, 60% for Operational Activities, and 90% for Audit & Administrative.