Medical outsourcing explained

Medical outsourcing is a business process used by organizations like hospitals, nursing homes, and healthcare provider practices to obtain physician, nursing, healthcare technician, or other services in a managed services model.

Physicians

Outsourcing of emergency department physicians, as well as radiologists and anesthesiologists in operating rooms, grew rapidly in the United States in the 2000s due a combination of several economic forces, and medical staffing companies developed niche expertise in various medical specialties.^{[1] [2]} Since 2008 a number of Swedish hospitals have used teleradiology services to outsource their emergency night-time radiology to Australia where daytime staff cover Swedish nighttime patients.^{[3] [4] [5]}

Physician outsourcing has led to an increase in the number of people who received catastrophically large medical bills due to the outsourced physicians billing at out of network rates.^{[6] [7]} A doctor in Tampa Bay claimed in 2015 that an emergency department she was staffing while working for a division of Envision Healthcare had chronically purchased the services of too few doctors, leading to excessive waiting times there.^[8]

Nurses

Some organizations have used outsourcing through nursing agencies or other medical staffing agencies to deal with the nursing shortage and as a way to save money.^{[9] [10] [11]}

Management functions

Some small practices have outsourced business functions to management services organizations.^{[12] [13]}

Hospitals and medical centers also outsource revenue cycle management functions^[14] and real estate management.^[15]

Medical tourism

People needing or wanting healthcare sometimes make decisions to seek care in a different jurisdiction; the decision may be based on lack of quality, availability, or legality in the person's home jurisdiction, or it may be a business decision based on the cost of acquiring the care. This form of medical outsourcing on the consumer side is generally called medical tourism.^{[16] [17]}

Notes and References

1. Boyd . JB . McGrath . MH . Maa . J . Emerging trends in the outsourcing of medical and surgical care. . Archives of Surgery . January 2011 . 146 . 1 . 107–12 . 10.1001/archsurg.2010.308 . 21242454. free .
2. News: Barkholz . Dave . AmSurg-Envision merger aims at hospital appetite for buffet of physician services . Modern Healthcare . June 18, 2016 . en-us.
3. News: Nu granskas Norrtäljes röntgenbilder på andra sidan jorden. Dagens Medicin. 2018-07-06. sv.
4. News: Röntgenplåtar skickas till Australien. Johansson. Christopher. 2016-09-05. Sveriges Radio. 2018-07-06. sv.
5. News: Röntgenbilder skickas utomlands. Nyheter. SVT. 2010-05-03. SVT Nyheter. 2018-07-06. sv.
6. News: Creswell . Julie . Abelson . Reed . Sanger-Katz . Margot . The Company Behind Many Surprise Emergency Room Bills . New York Times . July 24, 2017 . en.
7. News: MacDonald . Ilene . Surprise medical bills: Some patients owe thousands, but most don’t have enough savings to pay for a $1K emergency . FierceHealthcare . February 5, 2018 . en.
8. News: Shopes . Rich . Doctor says she was fired for reporting low staffing at Brandon Regional ER . Tampa Bay Times . 21 February 2015.
9. News: 9 Thoughts on Outsourcing: When To Outsource and How to Do it Successfully . www.beckershospitalreview.com . October 15, 2010 . en-gb.
10. News: Rau . Jordan . Outsourcing services leaves nursing homes underfunded, understaffed BenefitsPRO . Kaiser Health News via BenefitsPRO . January 10, 2018.
11. Aiken . L. H. . Hospital staffing, organization, and quality of care: cross-national findings . International Journal for Quality in Health Care . 1 February 2002 . 14 . 1 . 5–13 . 10.1093/intqhc/14.1.5 . 11871630. free .
12. News: Walker . Ben . If you operate a medical practice, you should be outsourcing Medical Economics . www.medicaleconomics.com . July 17, 2017 . en.
13. News: Harris . Gardiner . More Doctors Taking Salaried Jobs . New York Times . 25 March 2010 . en.
14. News: Kacik . Alex . More providers are outsourcing revenue-cycle management in order to cut costs. . Modern Healthcare . January 27, 2018 . en-us.
15. News: Kacik . Alex . Health systems could free up a significant amount of capital if they act like real estate investors. . Modern Healthcare . April 3, 2018 . en-us.
16. Boyd . JB . McGrath . MH . Maa . J . Emerging trends in the outsourcing of medical and surgical care. . Archives of Surgery . January 2011 . 146 . 1 . 107–12 . 10.1001/archsurg.2010.308 . 21242454. free .
17. Web site: Lunt . Neil . Smith . Richard . Exworthy . Mark . Green . Stephen T. . Horsfall . Daniel . Mannion . Russell . Medical Tourism: Treatments, Markets and Health System Implications: A scoping review . OECD . 2011.