Healthcare providers are facing challenges when they try to expand the scope of services and cover a larger number of patients while simultaneously controlling costs. The highly regulated and supervised nature of the industry adds to the challenge that the providers face. Insurers and health administrators need to look closely at ways to create greater efficiency and effectiveness of care through focus on improved and consolidated IT systems, greater automation and self service capabilities besides combining it with labor cost reduction. This involves transforming the service delivery model for back office functions besides the core healthcare administration and operational functions and processes.
One of the key challenges faced by this industry today is integrating the existing complex systems in the portfolio, processes, information and regulations to achieve a holistic view of a patient’s health management requirements. Outsourced service providers can partner with healthcare providers, payers and pharmacy benefit managers to offer the following services:
- Building enterprise data warehousing solutions that help obtain a comprehensive view of the enterprise performance by creating a platform for data analytics to provide various stakeholders with a common understanding of enterprise programs
- Legacy transformation initiatives aimed at modernizing legacy systems to enable delivery of services through various channels that support self-service options
- System enhancements to comply with changing regulations that range from the transition to ICD-10 and healthcare reform mandates, audits and quality reporting
Outsourced service providers are now focusing on moving beyond the traditional “lift and shift” method to those that embed business transformation into their service models. Service providers place a higher emphasis on industry/domain knowledge, the requirement for offshore based services and a global delivery model. This aligns well with the buyers of healthcare IT services buyers who are focused on reducing labor costs, improving time to market capabilities by leveraging a global delivery model (that has onshore, near shore and offshore delivery capabilities) while gaining access to a scalable pool of resources that are skilled in the required technology and domain areas.
From the traditional staffing based models and fixed price contracts, outsourced service providers have matured to providing services in a Managed Services model that is focused on outcomes and Service Level Agreements. The emergence of cloud based services have accelerated the trend towards engaging a distributed team that is spread across geographies, working in different time zones while seamlessly delivering services to customers. These services range from routine application maintenance and development besides business process outsourcing, analytics and system enhancements.
The healthcare industry is under extreme pressure to reduce costs while also expanding services and maintaining high service levels. The key to overcoming these challenges lies in the ability to address inefficiencies in delivering back-office and core operational services. The healthcare industry has lagged behind other industries in its uptake of alternative service delivery models. However, healthcare payers are aggressively pursuing a broader outsourcing agenda that combines traditional IT outsourcing with business and knowledge process outsourcing services. Outsourcing service providers targeting the healthcare space are starting to develop more targeted and compelling outsourcing offerings. Healthcare buyers are heeded to carefully reexamine their outsourcing strategy and plans in light of prevailing industry conditions.