Introduction to healthcare BPO

Introduction

• As healthcare provider organizations wrestle with improving revenues while providing high-quality care, there has been a lot of conversation about Business Process Outsourcing (BPO) and Revenue Cycle Management (RCM) – with emphasis on back-end billing

• By taking a more holistic front to back-office approach, a true BPO solution can bring significant value to an organization by reducing administrative costs, increasing collection levels and dramatically lowering its percentage of aged receivables

Facts & Figures

• The net spending of US healthcare industry in outsourcing was US$ 29.5 billion in 2003-04
  
• In the first half of 2006 alone, the US healthcare industry accounted for 7.2% of the total outsourcing market value without restructuring, compared to 3.4% in all of 2005 and 1.6% in all of 2004
• However, the Indian service providers accounted for only US$ 225 million worth of offshore outsourcing contracts during 2005-06
• Claims processing and revenue cycle management are the major processes outsourced from US

The Problem

• Growing demand for affordable healthcare at a time when medical costs are increasing
• Increasing operating back-office costs and human resources
• Complying with HIPAA standards (Automate entire provider services) and Pay-For-Performance initiatives etc
• Chronic shortage of nurses, physicians, radiologists and other specialized staffing
• Financial strain of providing healthcare services to some 44 million uninsured citizens