Outsourcing in Healthcare- Key Trends to Watch Out For

Blog: MattsenKumar Blog

By 2024, the Healthcare industry will be outsourcing projects worth $105.60 billion. The expenditure on outsourcing is expected to grow at a CAGR of 7.5%. Technological advancements have introduced a disruption that is irreparable for established organizations. To develop the requisite capabilities, prominent enterprises are now leaning on outsourcing.

Leading global organizations have spoilt users by letting them choose the way they want to be served. The growing demands of quality customer experience are putting tremendous pressure on traditional healthcare organizations to revamp their entire modus operandi.

The healthcare industry is expected to witness a surge in outsourcing opportunities because Fintech and E-commerce players are changing the dynamics. With online order, payment and delivery of medicines and other requisite medical equipment, traditional players are under great pressure to cope up. To build technical arms that can cater to millennials, healthcare agencies must leverage the power of outsourcing.

Why do Healthcare Organizations see Outsourcing as a Worthy Partner?

Taking a cue from what happened to retail, banks and local cab companies, the healthcare sector is vigilant towards the threat in the form of online medical stores. The growth of the online market has coaxed established practitioners to reassess the traditional way of selling.

Healthcare players also understand the risk of starting everything from scratch hence they are relying on partners who have a proven track record. With outsourcing healthcare players will benefit the following ways:

Helps traditional players adapt to the changing dynamics of the market
Offers genuine insight into challenges and road ahead
Leverages latest technology and methodologies to simplify the transition
Generates enough confidence in the key-stakeholders to pursue change

The most outsourced processes from the Healthcare Industry

The Healthcare industry is worth $12 trillion and spends over $33 billion on marketing. While marketing helps the healthcare industry spread information about their services to people in need, the outsourcing budget helps healthcare entities offer a better service. IT Outsourcing alone costs the healthcare industry $65 billion every year.

Apart from IT development some of the top processes outsourced by Healthcare industry includes:

Data Entry Services: Protected by compliances and international regulations, the personal data of patients’ needs to be safeguarded against unauthorized access. By enrolling an industry expert for data entry, hospitals can weed out irregularities and threat of data breach.

Claim Settlement: Healthcare workers should spend their maximum time and incomparable skills in serving and caring for people. Outsourcing repetitive processes like claim settlement and insurance management can allow healthcare professionals to focus on helping people.

Processes like claim settlement require accuracy and eyes that can identify frauds. With professionals handling claim settlement and invoice preparation, hospitals can shed the fear of running into loss. Outsourcing agencies are now leveraging the latest technology and methodologies to achieve accuracy and process more settlements in a day.

Medical Billing: While globalization has helped industries witness growth, it has also coaxed them into following international standards. Millions of businesses had to get their codes re-written and processes revamped to get in line with the international regulations.

In the medical field, organizations must follow international codes and represent medicines and illnesses just the way it is mentioned across the globe. By handling over the medical billing to industry professionals, who are trained and experienced in creating bills, hospitals can impart unwavering attention to patients.

Key Emerging Trends from the Healthcare Industry

Healthcare outsourcing grew at an impressive 36% rate in 2017, by 2019, it slowed down to 7.5%. While the growth rate has slumped but the valuation and adaption continue to grow. The urgency and sensitivity that comes as baggage with the healthcare industry ensure that the uptick is here to last. With almost every traditional player trying to blend with the demands of millennials, the outsourcing industry will experience a surge in demand.

Here are the trends that will rule

1. Online Presence Development

With millennials handling 75% of decision making roles in MNCs, they are making rules that goes hand-in-hand with the technology. Traditional players are dreading to build an online presence and tap into the millennial audience base. The millennial generation is known to shop frequently from a trusted partner, which reflects impressively in customer lifetime value. In times of increasing churn rate, every enterprise is focusing on customer retention, which puts millennial generation at the helm of all executive decisions.

2. Online Payment Management Capabilities

The first e-commerce transaction occurred almost 25 years ago. Back then things were simple, you had a card? You can pay online, but the growing cybersecurity threats and card frauds have led to numerous checks being established. To keep up with all the compliances and rules, organizations need to have a dedicated team.

With outsourcing healthcare sector can develop the requisite capability to manage online payments without building an in-house team. When compared to an in-house team, outsourcing makes sense because:

Companies are not required to hire and train employees
Organizations do not have to take care of their seating arrangement
Enterprises get access to proven expertise in the field
Ample time to focus on research and medicine study

Here’s all that online payment management includes:

A system to receive money online
Requisite checks to ensure that all data is being accessed by authorized personnel only
A system that sees medical insurance and card payments differently and processes them accordingly.
A process that generates reports and offers analysis
A mechanism to fight fraud and chargebacks

3. Building One Window System

Today, customers want to access their medical reports from last year and all medical bills within seconds. Backed by mobile applications, customers are enjoying their newfound freedom. Any healthcare organization that fails to offer a similar experience is expected to face incomparable loss in the coming times.

Building one window system is now the priority of almost every healthcare agency. Not willing to risk a millennial user base, hospitals have lined up at the doors of IT companies to build a system that caters to the multiple requests of a user. Here’s everything a healthcare app should offer:

Entire medical history
Receipt of all payments
Information of doctors who attended the patient
Details of all medicines prescribed
Details of insurance partner
Information related to upcoming tests and medical appointments

4. Putting up with the Compliance Needs

All healthcare organizations that leveraged technology to build an online presence have run into a dilemma. HIPAA, which stands for Health Insurance Portability and Accountability Act is now a compulsion in the United States. Other countries have also followed suit and introduced similar compliances.

Getting HIPAA compliant ensures that healthcare players are compliant with other healthcare compliances. HIPAA protects the personal data of patients because:

When accessed wrongly, it can be used by burglars to cash in the name of the illness
Such data invades the privacy laws, which is a fundamental right
When landed in wrong hands can jeopardize personal and professional life

What are the other compliance healthcare enterprises are expected to furnish?

PCI DSS: A compliance that ensures all cardholders’ data are protected from unauthorized access, it is compulsory for every organization that receives, stores or transfers cardholders’ data.

Note: A hospital or healthcare agency that receives payment via Point of Sale machine needs to ensure that its card payment facilitator is PCI DSS Compliant.

ISO Family: The ISO family is made up of multiple compliances that simplify third-party integration. In the age of digital presence, healthcare organizations are expected to partner with multiple third-party services and players. Getting ISO compliant ensures easier transmission of data and also increases the trust of third-party players.

KYC: Any healthcare agency or hospital that has collaborated with insurance players to sell insurance at their premises is required to fulfill KYC Compliance. Know Your Customer Compliance is designed to protect entities from getting used as a means of money laundering for banned activities like money laundering and terrorism funding.

AMC: Anti-money laundering when combined with Know Your Customer compliance becomes the best protective wall against people who misuse such services for funding terrorism. By furnishing KYC and AMC compliances, hospitals can be sure that they are functioning under a safer blanket and within the international laws concerned with terrorism and trafficking.

5. Proactive Approach Instead of Reactive

In the coming times, hospitals will be looking forward to having a proactive approach towards medical emergencies and technology will play an eminent role in it. When leveraged efficiently, technology can be used to settle the chaos and create a system that predicts medical emergencies.

Multiple testing labs are using available data to drive awareness among the patients. For example, a sugar patient is often prompted to get a checkup done. When patients miss regular check-ups, they are either reminded through text or a representative gets in touch with them overcall.

In the coming times, the healthcare industry will leverage predictive analytics technology like e-commerce players to offer a proactive approach. Based on medical history, age and trend, healthcare organizations will be able to recommend tests or checkups to help patients keep themselves safe.

Conclusion

With the government letting private and nascent players create an exemplary experience for patients, traditional players are under immense pressure. First e-commerce killed retail, then Fintech organizations took over the bank’s user base and now Internet-based healthcare start-ups are changing the way people access healthcare services.

One-click order, instant test results, card-based payment and online consulting have got millennials addicted and now there’s no going back. All traditional healthcare enterprises must follow suit or they will lose their market share, reputation and billion-dollar revenues to start-ups with small teams.

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