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HEALTHCARE OUTSOURCING: AN INTERGRAL STRATEGY IN THE NEW EPOCH OF HEALTHCARE

Author: Lovely Adhikari

Mentioning here the wordings of WHO- “Better health is central to human happiness and well-being. It also makes an important contribution to economic progress, as healthy populations live longer, are more productive, and save more.” One of the most important industries in the world is the healthcare sector. Every day, medical organizations look out for the health of their patients. A healthcare provider’s core competency, after all, is diagnosing and treating patients. Healthcare outsourcing is a thing because they require assistance just as much as they give it.

The majority of businesses and organizations are not new to the idea of outsourcing healthcare services. Industry analysts recommend healthcare organizations reinvent their business models to overcome the limitations of the traditional hospital-composed setting. As the industry becomes more competitive, health organizations must learn to deliver excellent patient care. In this article we will learn about what is healthcare outsourcing service; what is its market share and how it helps medical institutions and, in the end, will have a look at the major healthcare outsourcing companies in India.

What is Healthcare Outsourcing?

Outsourcing is the business practice of hiring a party outside a company to perform services or create goods that were traditionally performed in-house by the company’s own employees and staff. Outsourcing is a practice usually undertaken by companies as a cost-cutting measure.

Healthcare outsourcing is the practice of delegating non-urgent clinical or non-clinical functions to an external service provider or healthcare business process outsourcing company. As healthcare provider’s core competency, after all, is diagnosing and treating patients therefore by outsourcing non-core functions, providers can, reduce costs while improving service levels and patient satisfaction.

Commonly outsourced clinical services include medical and technical offerings such as laboratory, pharmacy, radiology, dialysis, magnetic resonance imaging, nuclear medicine, mental health services, physiotherapy and rehabilitation, occupational health therapy, medical tourism, and home-delivered healthcare. In addition to some non-clinical outsourced services now include facility management, sterilization, meals, patient transport, procurement, security, and more.

Healthcare outsourcing came into the picture when hospitals and clinics started employing technology to keep and maintain patient records. Since then, using healthcare outsourcing services has become a frequent tactic to boost revenue and service quality.

• The increased market trend of healthcare outsourcing:

The increasing need to reduce healthcare costs across the globe is creating a positive outlook for the market. Outsourcing is becoming increasingly prevalent in the world of healthcare information technology.

The global healthcare RCM outsourcing market size reached US$ 23.7 BILLION IN 2022. Looking forward, IMARC group expects the market to reach US$ 62.4 billion by 2028, exhibiting a growth rate (CAGR) of 17.4% during 2023- 2028.

Now talking about what are the main reasons which has led to such an increase the healthcare BPO services. The growing demand for integrating healthcare IT solutions is one of the main reasons fuelling market rise. Rising digitalization in nations, especially in emerging economies, is another factor contributing to market growth. Other significant factors that will present profitable market development opportunities include a decline in internal IT staff and a move toward patient-centric solutions.

Fig: The above figure shows the global Outsourcing market size by 2023-2028 (in billion US$)

• COMMON TASKS DELEGATED TO HEALTHCARE BPO

1. Medical Data Entry:

Healthcare organizations are responsible for maintaining countless medical records & processing unimaginable volumes of data. Physicians and other healthcare professionals use patient information as a basis for diagnosis and treatment recommendations.

Medical data entry tasks involve collecting all information related to the patient to build their medical portrait. This portrait is used to monitor patient progress and as a reference for other healthcare service providers. Some of the data it usually includes are:

• Medication Records
• Test Reports
• Lab Data Records
• Surgical Process Data
• Clinical Data
• Patient Information
• Appointment Information

2. Medical billing and coding:

Medical billing is way more complicated compared to other industries. Billers should be aware of the medical codes and terminologies used in coding each treatment and medication. It is a necessary process in collecting payments for various healthcare services, such as consultations, tests, and treatments. medical coding involves converting physicians’ notes and diagnoses into insurance codes. Insurance and healthcare providers use codes to streamline healthcare service billing and make it more accurate.

3. Insurance claim processing:

To avoid payment delays and denials, insurance claims processing makes sure that each of the previously described individual steps is completed accurately and on time. Processing claims entails extra “back-office work.” This function includes the complete procedure for verifying and approving a claim for insurance and medical benefits.

One person cannot easily handle claims, especially if healthcare providers receive a large number of applications every day. Even with online resources in place, a basic virtual assistant will be overburdened by this workload.

4. Medical Transcription:

Creating patient reports for filing and reference is a necessary component of a healthcare provider’s job. Medical transcriptionists typically take their time when evaluating audio dictations from doctors to arrive at a particular diagnosis.

Initially, healthcare providers may do this on their own or with assistance from internal staff. There will, however, undoubtedly be times when individuals feel overburdened by the sheer volume of audio files that need to be transcribed and analyzed.

To better manage their workload, the majority of them outsource this role to a BPO provider.

5. Data Mining Services:

The purpose of data mining is to identify useful patterns by analyzing large sets of data that help predict industry trends, and then give insights on what to do about them. In healthcare, you can use data mining for predictive medicine, customer relationship management, fraud detection, healthcare management, analyzing the course of actions, and measuring the effectiveness of certain treatments.

• Advantages of outsourcing healthcare services

1. Helps in business expansion: Work growth is made simple by the availability of a pool of qualified resources who can grasp your needs properly and provide you with solutions that are appropriate. For instance, hiring outside help to create a healthcare app is your best option if you want to expand your company’s reach through telemedicine.
2. Cost savings: When outsourcing, clients can also save as much as 70% on expenditures and resources. The majority of BPOs just charge a fixed monthly cost in addition to employee wages. Office space, energy, tools, and any other expenses incurred by their teams while working are already included in their costs.
3. Access to the skilled workforce: By hiring healthcare experts from outsourcing businesses, you can be sure that your team is qualified and capable of handling jobs of various complexity. These highly trained and experienced experts can do jobs meticulously to ensure that you receive the top-quality services, depending on your needs.
4. Improved focus on patient care: The primary responsibility in a hospital is to take care of the patients and give them the finest possible medical care. However, if one assigns his staff to handle back operations or other non-core processes, they end up being burdened with tedious and repetitive administrative work. Your medical personnel can completely concentrate on patient needs and provide high-quality care through outsourcing.
5. Avoid critical mistakes: The amount of data that medical businesses and hospitals handle makes it challenging to accurately enter, store, and manage it. Particularly complex operations like medical billing and coding require the highest level of accuracy to prevent losses. Unexpectedly, mistakes are present on 82% of medical invoices in total. You can have a committed and knowledgeable workforce by outsourcing these services to a reputable healthcare BPO.

SOME TOP HEALTHCARE BPO COMPANIES IN INDIA ARE:

At the end would coclude by expressing that as the world ventures post-pandemic, medical organizations will have a wider range of options for healthcare BPO around the world.