By: Anna Daly
Healthcare organizations in the United States, both payer and provider alike, are laser-focused on delivering the highest quality care at the lowest possible cost. Despite that, the cost of healthcare continues to skyrocket along with the staggering data that American life expectancies are going down and the risk of chronic health issues is increasing compared to other countries (see Exhibit 1 below).
Most providers of healthcare would say that patient care is priority #1—but then how, in our modern age, can the industry be so far off when it comes to achieving that goal? One of the greatest impediments to success in healthcare operations and care delivery is the disproportionate amount of time and resources that healthcare professionals spend dealing with purely administrative issues.
Many organizations outside of the healthcare industry have gained tremendous financial and operational results from outsourcing non-core administrative functions—yet the healthcare industry has been reluctant to outsource anything that will make providers’ loads a little lighter. The only way that healthcare organizations can expect to see the lower cost/better care equation work in their favor is if they start making tough decisions and let go of some of those administrative tasks. So, what’s the low-hanging fruit when it comes to outsourcing? Here are 3 administration-heavy functions to outsource now—and why doing so can deliver results fast.
- Pre-authorization: Several studies have shown that the resources required to get the greenlight on a single procedure or medication from an insurance company can be far disproportionate to reasonable expectations (and time is money). Over time, both the pure cost and people-hours required for pre-authorizations can really add up. Outsourcing these functions can make a huge difference in an organization’s overall costs—particularly at a time when providers are suffering from a shortage of doctors, nurses and other staff members.
- Prevention: When it comes to preventive services, or identifying at-risk patients and working with them to prevent issues or complications, U.S. healthcare organizations have a huge opportunity. Not only does a robust preventive program improve the quality of care. It can also have a big impact on patient satisfaction scores while mitigating the risks and costs associated with a less proactive approach to healthcare management. Preventive care programs also bring a large administrative burden that many operators are not equipped to handle.
A strong outsourced technology partner can quickly integrate themselves with the healthcare operation and deliver the analytics, interoperability and payer organization integration required to get your preventive program up and running and deliver long-term results.
- Community Outreach: Community outreach and outpatient engagement is another area where healthcare organizations could benefit greatly from outsourcing. For example, providers can use software platforms to identify wellness resources (diabetes education classes, wellness centers, community gardens) in their area—rather than doing all the research manually. Instead of clinical staff calling to remind patients of their appointments or to schedule lab tests, healthcare operators can employ easy-to-use technology that automates these interactions using voice, text and email (channels that most patients prefer).
By employing technology or outsourced human resources to take the burden of outreach off clinical staff, healthcare operators can see big wins in terms of both patient and provider satisfaction—as well as balancing care and costs in the process.
Download our Executive Brief, Thinking Outside the Box – How Outsourcing Can Help Rein in Spiraling Administration Costs in Healthcare, for more industry research, insights and details about this mission-critical topic.