The article aims to discuss how Healthcare Outsourcing is changing the healthcare landscape.
The healthcare industry is one of the most dynamic and demanding business landscapes. The industry is constantly evolving, and healthcare providers are always searching for ways to streamline their operations and improve their bottom line. Outsourcing has become an increasingly popular solution for healthcare providers looking to achieve these goals.
Outsourcing is changing the industry in countless ways. In this article, we will explore the latest trends and insights on how outsourcing is changing the healthcare landscape.
What is healthcare outsourcing?
The global healthcare BPO market size was valued at USD 334.15 billion in 2021 and it is expected to hit around USD 755.76 billion by 2030, poised to grow at a compound annual growth rate (CAGR) of 9.49% between 2022 to 2030.
Healthcare outsourcing involves contracting with an outside company or organization to provide services that would normally be performed internally. Outsourcing is suitable for healthcare providers that want to provide quality patient care. Healthcare outsourcing services can include a wide range of services, such as medical billing and coding, clinical research, telehealth, and more. Outsourcing these services allows healthcare providers to focus on their core competencies while reducing costs and improving efficiency.
Outsourcing in healthcare is not a new concept. In fact, it has been around for quite some time. However, with the rise of technology and demand in the healthcare industry, outsourcing has become more prevalent than ever before. Today, outsourcing is a significant component of the healthcare industry, and it is transforming the way healthcare providers operate.
How Healthcare Outsourcing is Changing the Healthcare Landscape
Functions that can be outsourced in Healthcare Outsourcing
Medical providers often adopt services provided by third-party Healthcare outsourcing companies to assign non-clinical or medical functions such as:
Eligibility Verification and Pre-Authorization: Eligibility verification specialists contact insurance providers to verify if a patient’s insurance coverage is eligible and active. They also verify that the data entered from the claim form is accurate and complete to enable the claim to be processed correctly by insurance payers. Outsourced staff conduct can be assigned functions such as submitting and following up preauthorization to various insurance companies.
Outsourcing Collections: Outsourcing providers lets practices hire experienced healthcare staff such as medical billing specialists to review that the data entered from the claim form is accurate and complete to enable the claim to be processed correctly.
Payment and Cash Posting: Outsourced Healthcare Support staff can provide payment posting services such as posting for all Credit cards/Checks and cash insurance payments and conducting AR Spreadsheet month end closing.
Medical Claims Appeals: Outsourced Medical Claims Appeals staff can be offloaded claims appeals services such as correcting denied claims, sending corrected claims and managing denials. These Medical Claims Appeals staff are in charge of checking claim statuses online, correcting denied claims, resolving discrepancies and processing refund requests or settlements, and sending corrected claims.
Patient Scheduling: Healthcare support staff act as the dedicated resource to help businesses set up patient appointments and consultations. Patient Schedulers manage the appointment calendar and status, and confirm, cancel or reschedule appointment requests via online appointment software.
Telehealth: Virtual practices assign functions to well-trained professionals who can conduct remote patient assessments, reviews of previous record, and virtual check-ins, and brief patients prior to the procedure.
This enables healthcare organizations and provider to prioritize on providing quality health services.
Trends in Healthcare Outsourcing
AI and RPA Use Cases
To meet growing patient needs, medical providers seek prompt responses to inquiries, appointments, and requests. Healthcare outsourcing companies use AI and RPA to automate repetitive administrative functions. This frees up the time of medical practices so they can not only reduce costs, but also focus on improving their healthcare products and services. These technologies also streamline communication with patients, answering their inquiries and directing them to the appropriate healthcare professionals if necessary.
Specialized Telehealth services
Telehealth or telemedicine is the practice of applying technology to provide remote healthcare services or functions.
In April 2020, overall telehealth utilization for office visits and outpatient care was 78 times higher than in February 2020. (McKinsey)
The increase in the demand for specialized telehealth services during the Covid-19 pandemic has highlighted the importance of Healthcare outsourcing providers who have been essential in aiding companies expanded telehealth support. Healthcare outsourcing providers deliver customer service across integrated communication channels or provide omnichannel support, accelerate and personalize telehealth support, seeking innovative ways to extend telehealth channels even as patient preferences evolve.
Remote Patient Care and Monitoring
Remote patient care monitoring has also become more popular during the Covid-19 pandemic. Healthcare outsourcing enables medical practitioners to conduct check-ins or monitor their patients’ vital signs and symptoms without meeting with them onsite.
Medical organizations partner with third-party outsourcing companies to streamline the visit with provider as much as possible, keep an updated record of patient information and electronic health record management, reducing costs on hiring additional staff and associated costs in the implementation of new equipment and technologies.
Conclusion
The healthcare outsourcing industry is constantly evolving due to technological trends, market trends, and global issues.
The global healthcare outsourcing market is expected to grow due to the high demand for specialized healthcare services and increasing need to reduce healthcare costs. Key trends in healthcare outsourcing that is changing the healthcare landscape include expanded AI and automation use, extended telehealth support, and improved remote patient monitoring.
Practices are outsourcing internal activities like insurance verification, medical billing and IT services because of the need for specialized support. Outsourcing healthcare IT services is becoming more popular due reduced costs.
Connext Global Solutions is a business process outsourcing company that provides fully customized outsourcing solutions for healthcare organizations looking to improve healthcare operations.
Our Healthcare Outsourcing Services
- Revenue Cycle Management
- Telehealth
- Patient Support
- Office Administration
- Data Visualization and Reporting
Industries Connext Caters to:
- Healthcare Providers
- Distribution
- Telecommunications
- Title and Escrow
- Property Management
- Accounting
- Banking
- Technology
- E-Commerce
- Retail
- Construction
- Professional Employer Organization
- Insurance
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References:
“Healthcare BPO Market (By Provider Service: Revenue Cycle Management, Patient Enrolments, Patient Care; By Payer Service: Claims Management, Product Development Business Acquisition (PDBA), Member Management, Provider Management, Care Management, Integrated Front-End Services and Back-office Operations, Billing and accounts management services, HR Services; By Life Science Service) – Global Industry Analysis, Size, Share, Growth, Trends, Regional Outlook, and Forecast 2022-2030”. Precedence Research. https://www.precedenceresearch.com/healthcare-bpo-market
Oleg Bestsennyy, Greg Gilbert, Alex Harris, and Jennifer Rost. “Telehealth: A quarter-trillion-dollar post-COVID-19 reality?” McKinsey. https://www.mckinsey.com/industries/healthcare/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality. Published July 9, 2021.
Tabitha Lieberman. “The Peaks And Pains Of Healthcare IT Outsourcing”. Forbes. https://www.forbes.com/sites/forbestechcouncil/2022/12/01/the-peaks-and-pains-of-healthcare-it-outsourcing/?sh=45e38f48b075. Forbes.com. Published Dec 1, 2022.
Photo from Tima Miroshnichenko
