Written by Dion Jay Tality
Clinics, hospitals, and other medical institutions constantly face operational problems. Think of unmanageable patient records and complex medical coding and billing. Healthcare BPO can help with these problems.
Healthcare business process outsourcing (BPO) gives you access to expert professionals, advanced technologies, and ample resources. They help optimize your operations to focus on your core function: delivering quality patient care.
But when taking this route, keep a few things in mind. Below are eight performance indicators to consider when outsourcing in healthcare.
Performance Indicators To Consider for Outsourcing in Healthcare
The healthcare BPO industry is still growing. According to Grand View Research, its global market has grown from nearly $271 billion in 2019 to $340.4 billion in 2020. It might reach $679.2 billion by 2027 at a compound annual growth rate (CAGR) of 10.4%.
Given this growth, consider outsourcing in healthcare to reap its many practical benefits. However, assess your current operations, identify problems, and list your organizational needs.
To make informed outsourcing decisions, here are critical performance indicators to consider:
1. Detailed Service-level Agreement
A service-level agreement (SLA) is a commitment between you and your service provider. It details your business objectives and the key metrics to hit. It also enumerates your vendor’s responsibilities and your client obligations. More importantly, an SLA defines the mutual relationships between both parties.
When tapping into healthcare BPO services, create a comprehensive SLA with your service provider. Ensure both sides agree with all the terms and conditions. Ultimately, a well-drafted SLA protects both parties and ensures outsourcing success.
2. Defined Key Performance Indicators
When outsourcing in healthcare, setting metrics is integral to your BPO success. Develop specific key performance indicators (KPIs). Note that they vary from one business function to another. But whether medical billing or patient care, below are the fundamental key metrics:
- Service Efficiency: This KPI measures how fast customer service representatives accomplish their tasks. Healthcare call centers track agents’ average handling time (AHT). The faster they assist customers and resolve issues, the better.
- Service Quality: This metric measures the service representatives provide. Specifically, it ensures agents’ adherence to standard workflow and business policies. Quality analysts (QAs) monitor and audit patient contacts in telehealth services.
- Patient Satisfaction: This KPI is the most important of all. It measures through surveys whether patients are satisfied or dissatisfied with the service.
3. Streamlined Operational Processes
Clinics, hospitals, and other medical institutions have organizational problems to solve and operational needs to meet. They outsource to improve their healthcare operations.
When employing healthcare BPO, hire a service provider with streamlined processes. Below are healthcare functions commonly outsourced:
- Medical Billing: This healthcare process involves generating bills, creating claims, and invoice submission. As the most commonly outsourced process, the market might reach $55.6 billion by 2032. Look for a BPO partner with automated calculation, data accuracy, and efficient billing.
- Data Management: This function manages medical records by ensuring protected health information (PHI). PHI includes verified insurance details and secured medical reports. Work with a HIPAA-compliant BPO vendor for data protection.
- Medical Transcription: This healthcare function entails transcribing doctors’ audio files into text formats. Ensure your BPO provider employs transcriptionists with medical backgrounds.
- Clinical Operations: Healthcare BPO providers have started covering clinical operations. On top of these are direct patient care, telehealth, and remote patient monitoring. Look for a service provider that employs health professionals and uses advanced technologies.
- Administrative Functions: Health providers outsource tasks such as payroll, HR, and IT support. Consider this option to focus on treating patients, saving lives, and promoting health.
4. Cutting-edge Technology
Technology is integral to various industries, and the health sector is no exception. The pandemic has further amplified the need for digital transformation and technological integration.
When outsourcing in healthcare, choose a service provider with the latest technology. Consider the following digital tools and technological resources:
- Automation: This technology automates processes and eliminates manual work. It assists employees and makes them more efficient. Use automation for healthcare functions such as medical billing and data management.
- Artificial Intelligence: AI is the simulation of intelligence in machines. Consider AI healthcare customer service, robot-assisted surgery, AI-integrated imaging, and wearable technology. Note: The global healthcare AI market is expected to grow from $10.4 billion in 2021 to 208.2 billion by 2030.
- Big Data Analytics: BDA provides insights based on patterns from recorded data (algorithms). Think of predictive analytics for disease diagnosis amid the pandemic. It has become a game changer in the health industry.
- Cloud Technology: Cloud computing enables internet access to databases, networks, and servers. This technology is best for healthcare outsourcing because customer service representatives work with patients remotely.
- Customer Relationship Management: This software helps a company manage communications and interactions. CRM is beneficial in healthcare outsourcing for patient communication and data management.
- Computer Telephony Integration: This technology enables computers to work with the internet. It is currently the most popular system used in call centers. Look for a service provider that uses CTI for your healthcare customer service.
- Contact Center as a Service: This software is a cloud-based, provider-hosted platform. Like CTI, CCaaS is suitable for healthcare customer service. But the difference between the two is the communication channel. CCaaS offers omnichannel solutions such as phone calls, email, and live chat support.
5. Skilled and Trained Health Professionals
The workforce is the most valuable asset in your business. Employees run your organization by ensuring smooth operations.
When hiring medical BPO services, examine the workforce. Make sure they employ health professionals or those with medical backgrounds. They must also provide proper training and production support. Below are healthcare BPO roles.
- Medical Coders and Billers: They code and calculate medical services. Then, they create bills and submit medical claims to insurance providers. The goal is to receive optimum reimbursements for the medical services rendered.
- Insurance Specialists: They serve as customer service representatives. They either handle benefit verifications or claim inquiries. Patients or healthcare providers call to verify health coverage or discuss processed claims.
- Data Specialists and Analysts: They record and manage patient information and medical reports. They sometimes perform data analysis and business forecasting.
- Medical Transcriptionists: They transcribe audio files into text formats. They usually cover doctors’ reports on medical services rendered to patients.
- Remote Doctors and Nurses: Health professionals provide virtual medical consultations, diagnoses, and treatments. Digital tools and communication technologies have made telehealth plausible.
- Administrative Roles: Healthcare providers often outsource their administrative departments. They tap into payroll officers, HR personnel, and IT support specialists. These third-party employees can help run your operation.
6. Outstanding BPO Credentials
Many BPO providers are available in the market, ready to serve clinics and hospitals. But looking for a BPO partner best suited for your organization is challenging.
When outsourcing in healthcare, consider these BPO credentials as a performance indicator:
- BPO License: Look for a service provider with the license to operate. That’s proof of its legitimacy as a business. While at it, factor in their industry experience and areas of expertise. Hire a BPO vendor with a proven track record in the healthcare industry.
- Business Certification: Besides the license, hire a healthcare BPO provider with business certifications. One perfect example is the International Organization for Standardization (ISO) certification, which provides a seal of approval to companies living up to international standards.
- Awards and Recognition: Hire a healthcare BPO partner with awards and accolades. They are proof of its credibility, competency, and outsourcing success. When filtering your prospects, pick those with BPO recognition.
7. Full HIPAA Compliance
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) consists of privacy rules governing the use of protected health information (PHI). It aims:
“To protect sensitive patient health information from being disclosed and used without the patient’s consent or knowledge.”
Healthcare outsourcing entails entrusting patient information to a third-party vendor. Hire a 100% HIPAA-compliant BPO partner to ensure data privacy and network security.
Ultimately, doing so helps you avoid patient complaints and legal implications.
8. Patient-centric Operations
The healthcare sector caters to patients. It commits itself to treat them, saving lives, and fostering well-being. Thus, it should always make patients its top priority.
When outsourcing in healthcare, hire a service provider with patient-focused operations. The right BPO partner prioritizes patients, whether performing medical billing or telehealth. If they value your patients, they’ll serve them in the best way possible.
With these in mind, you can take advantage of healthcare BPO.
The Bottom Line
Health institutions should employ healthcare BPO when facing operational problems. Consider outsourcing non-clinical processes such as medical coding and billing. Also, start entrusting some clinical functions and administrative functions, such as HR and IT support, to a third-party service provider.
Healthcare outsourcing improves your processes and optimizes your operations. More importantly, it lets you focus on what you do best: quality healthcare delivery.
But to make the most of it, consider the eight performance indicators mentioned above. Keep these in mind when outsourcing in healthcare. Hire the right BPO partner, and you’ll be on the right track.