Health Care Outsourcing

I recently posted a blog about indications some of the technology and call center jobs that had been outsourced to India are being pulled back because of quality problems related to communication problems. Don Lee of the Los Angeles Times has an article describing how some healthcare companies have begun to shift clinical services and even decision-making on medical care to primarily India and the Philippines. The practice is not new, but the health care law commonly called “Obamacare” is encouraging more jobs to leave the U.S. The new law requires that 80-85 percent of insurance premiums to be spent on medical care. That requirement, which I understand was put into the law to control insurance company profits, will have the unintended consequence of insurance companies reducing as many jobs as possible with outsourcing.

Jobs that had been previously outsourced involved medical activities such as reading X-rays and other diagnostic tests. Task now being outsourced include “pre-service nursing” to evaluate patient needs and to determine treatment methods. WellPoint, owner of Anthem Blue Cross, has formed Radian Services as a separate business unit to set up the outsourcing. A WellPoint spokesperson said there had been 925 jobs outsourced. The explanation why the outsourcing was being done through a separate business unit is that “…it has the technical expertise and can ensure compliance with laws.” My reaction to that quote is that the real reason is to protect WellPoint from lawsuits that might or are likely to be filed when someone has problems with their medical care.

The article says that companies can save 30 percent of labor costs by outsourcing jobs to the Philippines. However,  having medical treatment decisions made overseas sounds risky considering that companies are returning call center and computer work for quality reasons.  It isn’t surprising that nursing organizations are cautious. Patient privacy is also a concern because people’s medical information is being sent to other countries. I didn’t find the quote that “…nearly all countries have laws for protecting patient privacy…” to be all that reassuring.

One person who had processed medical claims for WellPoint was laid off after a colleague went to the Philippines to do training on how she did her job. I doubt that person would be too impressed that the part of a new law designed to control insurance company profits contributed to the decision to have the work done more cheaply in the Philippines.