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HEALTHCARE OUTSOURCING IN INDIA AND ABROAD: A REVIEW

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Author: Mallika Rane

 

Arguably, one of the best business models, outsourcing, in most organizations has evolved from being an assistant to now being a crucial component of strategy. It could be more alluring than ever to think about outsourcing your administrative tasks as companies try to cut costs in a struggling economy made worse by rising energy bills. However, a query is raised. The objective of a private company is to maximize shareholder value as much as possible. While healthcare which emphasizes on caring for patients with compassion, altruism and doing the right thing every single time. How can two things with such different objectives work effectively together? Healthcare is a service profession with a business aspect. Ethical, legal conundrums continue to be complicated problems that might arise at any time. A point to keep in mind is that profit is okay. Profit can drive good things. For organizations which choose to play in the healthcare sector, the bar is rightfully held to higher standards than other sectors.   Healthcare providers all around the world are principally centered on improving the patient experience from the first diagnostic stage through the recovery stage. The time spent on administrative formalities can be invested in treating the patients.

The global medical billing outsourcing market size was valued at USD 11.1 billion in 2021 and is expected to expand at a compound annual growth rate (CAGR) of 12.0% from 2022 to 2030[1]. India is a reliable partner for outsourcing financial services because of the greater complexity of medical billing and the significant workforce scarcity in the first world countries. It is more of a provider than a receiver of these services. Let us explore the factors which make India such a trustworthy ally for the healthcare BPO services. The financial strain placed on hospitals to stay up-to-date with emerging technology and sustain clinical expenditures is tremendous. This is when companies like WNS Global, based in Mumbai, India come into play. They offer revenue integrity, revenue recovery, patient access, and patient finance. India’s dominance in the outsourcing sector is due to its cheap services and flexible pricing. Moreover, the cost of living and income brackets of the citizens are less as compared to other countries. For instance, a developer in the US would bill between $60 and $90 per hour, yet the same resource might be available for as little as $20 in India. Companies have the opportunity to select from a variety of solutions according to their budget without compromising the quality of work.

One of the critical barriers when working with outsourced companies is the communication gap. There is no dearth of English-speaking population as India is the second largest English-speaking nation in the world. Thus providing them an edge over their competitor countries like the Philippines and Mexico. India’s successful development is primarily in my opinion, due to its stable governance and favorable policies for the investors. It is simpler for American businesses to develop lasting alliances with Indian companies owing to India’s continually stable government over the years. One wouldn’t be willing to bet their capital in say, Pakistan where the doctrine of necessity is abused to justify the military takeover from the democratically elected government. This extreme instability and economic crisis makes Pakistan appear less enticing to foreign investors even though it has the 3rd most English-speaking citizens in the world. Indian healthcare BPOs adhere to certain standards when providing services to their international clients. They hold HIPAA compliance which  is a series of regulatory standards that outline the lawful use and disclosure of protected health information, coders who are AAPC trained[2]. Indian companies invest a lot in advanced technology as a result of which American companies benefit from cheaper start up costs as they do not have to pour their resources into purchasing compatible technology. Indian universities produce a sizable number of professionals every year who have the basic skills, discipline and consistency required for such IT jobs. The tech staff are routinely trained and well-versed with the latest machinery.

For all of its advantages, outsourcing is something of a double-edged sword. With the allure of saving your organization millions of bucks, effective implementation is totally overlooked. Essentially, we are looking at two contradictory things. Sometimes quality means you pay for more but if you are paying the cheapest rate while expecting the highest efficiency, 3-4 years down the line  if you receive a service that is subpar, you cannot claim that the provider is only in it for the money and does not care about the quality of the service. One has to be clear what one wants from outsourcing. Do we want the cheapest way to provide services to the taxpayers or do we want to buy quality?  For instance, problems  arose when a firm’s existing configuration management tool, Microsoft Visual SourceSafe, which worked fine locally, was a total bust when used collaboratively between two groups 8,000 miles apart. This is what happened with a medical firm in the U.S.A when they outsourced their IT tasks to a company in India, putting them behind on a day’s worth of work. Ultimately it was the customers who had to bear the brunt of this un coordination. Thus, the need to evaluate your infrastructure before moving forward is detrimental.

Traditionally, healthcare BPO deals with non-clinical aspects like revenue cycle management which includes setting up appointments, billing etc which helps providers earn more money while spending less time on administrative and clinical tasks thus enabling them to focus on  providing patients with premium care. More frequently than at any other moment in the history of science, medical breakthroughs are affecting a greater variety of clinical fields. To keep in pace with this, outsourcing in healthcare is expanding from non-clinical to in-house services, which directly impact patient care like radiology, laboratory services[3]. For instance , the concept of offsite radiologists is understandable in the case of smaller institutions which do not have enough resources to employ an in-house radiologist round the clock but financially sound hospitals who can afford to have a radiologist throughout should typically not invest in teleradiology as medical practice is essentially centered on clinical observation and inquiry. offsite radiologists do not have the benefit of listening to or observing the patients which aids in better diagnosis. At times the reports maybe interpreted incorrectly, putting the patient at risk . Not knowing the credibility of who is treating you, leads to poor patient trust. Such concerns are valid as it is your life which is it at stake. As a result, more money is spent checking the accuracy and dependability of the reports, which results in more spending as your primary objective was to boost productivity and cut expenses, this completely defeats the point of employing an outsourcing company. Therefore the risk to the institution is directly proportional to how much the service impacts both value and quality. Outsourcing to laboratories for can be a risky business as it could lead to undesirable outcomes such contaminated samples, delayed response times for test results,  faulty testing, and issues with delivery services.

Every trade has been impacted by COVID-19, triggering budget revisions by corporations.So it has become necessary to employ methods which enhance productivity and cut costs. As a result of COVID-19, the tendency to outsource revenue cycle tasks has increased dramatically. Even before the start of the pandemic, the continual technological advancements and policy reforms in the world  had been prompting businesses to invest in more efficient procedures. Outsourcing administrative tasks to companies proved quite useful during the pandemic by effectively handling inventory management, accounting, payrolls, and website maintenance, allowing hospitals to fully concentrate on the raging virus and better administer public healthcare. As non-core tasks could be completed from the convenience of one’s home while maintaining social distance protocols, outsourcing offered an immediate solution to the possible risk of employees getting the virus. Consequently, only key personnel such as doctors and nurses were present at the hospitals.

Intellectual property is the oil of the 21st century. A company’s intellectual property rights are just as valuable as its total equity, if not greater. Protection of intellectual property is vital for encouraging innovation. Without it, companies and individuals would not benefit fully from their creations and would devote less time to research and development. Through outsourcing, businesses are able to focus on core activities , control costs  and enhance customer service. However, there are obvious risks. among them are dangers to the protection of their intellectual property rights. How to prevent this situation from arising in the first place? Prior to signing a contract with a client, it is crucial to perform careful background research on the vendor. This includes testing their capacity to protect your IP, how they would react in the event of an internal data breach and their reputation in the market. If you are hiring a firm from a different country, you should ensure that the legal system there is powerful enough to safeguard your IP and on the off chance if your intellectual property is violated, what options do you have? The selection of an appropriate firm involves all of this meticulous management. The need for a non-disclosure agreement (NDA) with the provider should go without saying[4]. The NDAs should be valid for a few more years even after the completion of the project and should bind on all employees assisting with that task. Since there is no one absolute or guaranteed method to prevent data theft, it’s essential to keep a comprehensive recovery strategy in mind. Only those individuals who need access to your server and data in order to carry out the outsourced assignment should be granted access in such a way that that you can closely monitor them and trace back to the source in the event of a breach.

In the contemporary age, given the dynamic and always demanding economic market around us, outsourcing would be the rational and holistic approach to avoid  frequent business difficulties and also overall boost profitability. When examined and maintained efficiently, outsourcing may be a very powerful instrument for boosting an organization’s competitive position. outsourcing and globalization go hand in hand. The integration of economies of several nations , leading to a common global economy has been facilitated through outsourcing. It’s not as though globalization wouldn’t have occurred without outsourcing. It is just that globalization is occurring more swiftly now. If it weren’t for outsourcing, we wouldn’t have gained such unique ideas and perspectives from people of different cultures which is very crucial in the innovation process.

 

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