The global Healthcare BPO market size is all set to witness runaway growth between 2021 and 2027 spurred by the rising need of healthcare providers to divest their non-core activities to third party vendors and focus on core competencies. The rise is expected to catapult to US$ 475.9 billion from an estimated US$ 290.1 billion at an estimated compounded annual growth rate of 11.2%. The growth of this sector will also be because of the growing outsourcing needs of sectors like the pharma and biopharma, that have an equally pressing need to curtail rise in operational costs. Besides, the burgeoning demand for niche services such as fraud detection and well documented processes will make healthcare BPO services indispensable in the years to come.
The important question, however, is how prepared is the healthcare BPO industry in shouldering this huge responsibility? What is it that it needs to do to take on the persistent challenges of attrition, talent scarcity, uncertainties like the pandemic, changing regulatory requirements etc.? And most importantly, how should it prepare itself to make hay while the sun shines.
In the coming years, healthcare BPO organizations have their task cut out -to solve larger issues, including but not restricted to claims accuracy, network management, and medical cost management at a scale that would be larger than what they have handled before. Their competence in carrying this out will enable all stakeholders to compete more effectively in unpredictable market conditions. To help realize these goals and cash in on the upcoming opportunities, it’s imperative for healthcare BPOs to overhaul their business workflows across the spectrum of outsourcing services. This calls for bringing strategic thinking and innovation into modern day operations.
Strategic Management for Customized Offerings
Strategic management is all about aligning your company’s capabilities and resources with the goals of your clients. While this is what BPOs have been striving to do in the past, in the coming years the concept of this alignment is going to change and BPOs need to embrace this change to grow and thrive. In the face of growing competition, providers within the healthcare industries will try to differentiate their business along core competencies. Each provider will develop service differentiators to gain competitive edge. Healthcare BPOs will need to focus on supporting the unique requirements of providers with customized offerings.
Healthcare BPOs can customize service offerings in the below ways:
- Build relationship that transcends the standard customer– client agreement model and moves towards a gain-sharing revenue model
- Acquire extraordinary industry expertise with deep knowledge of healthcare requirements and capabilities to tailor customized solutions.
- Significant and thoughtful investments in manpower and training to move up the value chain
- Higher attention on staff quality with renewed skill management, attrition management and talent retention.
As providers become increasingly reliant on healthcare BPOs, they will evaluate BPOs on each of these parameters. Only BPOs that have strategic planning integrated to their business objectives will be able to survive the test.
| Almost 60% of Healthcare BPOs believe embracing advanced technology will help them become 30% more efficient and save 25% more every year. |
Rapid Scale Technology Adoption
The common healthcare tasks outsourced to healthcare BPOs such as appointment scheduling, insurance verification, claims management, billing procedures, and inventory management require a great degree of manual effort, which is why these tasks are time consuming and prone to errors. Still worse, BPOs have to manage these demanding tasks with the ongoing struggle of losing out talent to attrition. To get control over issues like these that can bring processes to a standstill and remain in the forefront of competition healthcare BPOs must go for end-to-end process automation. With robotic process automation (RPA) they will be able to significantly reduce and even completely eliminate the manual effort required to carry out such back-office activities.
Here’s how RPA will make these tasks look like in future:
RPA driven chatbots will collect relevant medical data required from the patient, to set an appointment.
Chatbots can precisely calculate bill amount with proper codes, at an unbeatable pace, thereby improving billing efficiency and preventing miscalculated bills and payment delays.
Chatbots optimize information collected from various sources across multiple systems for insurance claims processing, with the accuracy needed to reduce transaction times to 1 min from 10 mins.
| AI-powered tools in the healthcare sector is expected to exceed $34 billion by 2025, which means this technology will shape almost all facets of the industry. |
Chatbots assist supply chain managers track the inventory required in a hospital, such as needles, medicines, gloves, PPE kits or syringes based on real time study of demand and supply patterns.
While benefits abound, the associated ease of integrating RPA makes the shift to an automated process all the more beneficial. There is no need for back-office integration through APIs; it works seamlessly with all types of interfaces and applications; and is custom built to work with data-intensive processes, across multiple domains and healthcare verticals.
Adoption of RPA will further assist healthcare BPOs streamline the process of strategic management of offerings. For instance, automation will assist BPOs to respond to external stimuli with greater degree of readiness and precision. Further, it can provide clear audit trials and bring inherent data protection and integrity across systems. In a new world order where due diligence will matter the most in cherry picking healthcare BPO providers, automation will arguably stand out as the most important distinguishing factor.
Back office and Front Office Integration
In the days to come, outsourcing will no longer be a task just related to back-office functions. Healthcare providers will look more into a vendor’s capability to integrate back-office and front office processes. While these two processes differ immensely, it has been seen that the bulk of customer dissatisfaction is related to problems in the back office, even though 60 percent of interactions happen with front office processes. A well-integrated back-office and front office process enhances visibility and eliminates chances of misaligned priorities. Some of the key questions in the providers mind would be
- Can we view all account activities such as claims processed, accounts receivables, claims settled and other financial information online?
- Can our customer support team get full visibility to all billing information and payment postings prior to interactions with clients?
- Can the back-office team get updated visibility into physician notes and diagnostic information
- Can our management team see revenue generated, operational issues and payer hurdles in an easy to use and integrated manner?
Automation can assist healthcare BPOs integrate operations end-to-end. It can assist them unify case management and equip themselves with reporting capabilities to reduce the effort needed to interact with customer service team, anticipate and allocate workloads before they are delegated and staff accordingly and even forecast biller and coder requirements to meet sudden influx of claims filing and meeting deadlines. A BPO with the right integrated solution can provide a holistic and centralized view of the blended workforce that a management seeks to have to build improvement programs to continuously raise the performance of the practice.
Who We are and What Makes Us an Expert?
This article has been brought to you by MedBillingExperts, a specialized BPO company with over 10 years of experience in service offerings to US-based healthcare practice. We work with flexible operating models, and integrated solutions for the proper implementation of automation and analytics. Our integrated processes have supported over 500 clients with a range of customized solutions for RCM, claims denials, insurance verification, patient relationship management etc. If you are looking for any of these services including advanced, IT solutions for your practice get in touch with our experts now.
