By Laurie Morgan, Capko & Morgan
In the little corner of the Internet that I spend most of my time in – the blogs, feeds, groups and pages of physician practice owners and managers, and the vendors and consultants who serve them – outsourcing has reemerged as a hot topic.
I think the trend is driven largely by the emergence of cloud-based, integrated EHR and billing systems. Many of these systems are dramatically superior to the ones they replaced, and their reliable remote access capabilities have made third-party medical billing (AKA revenue cycle management) much more efficient and appealing for practices. In turn, sources like the Black Book (www.blackbookmarketresearch.com) now report that the majority of medical practices are at least considering outsourcing their billing.
With a critical function like billing becoming easier to outsource successfully, it’s not surprising that physicians would look to outsource other business functions – and that vendors would quickly emerge to provide more options. It is a powerfully attractive idea: let someone else take care of all the ‘grunt work,’ and providers can focus on their patients. It’s especially tantalizing to owners of smaller practices, who still wonder if they’ll be able to stay independent.
In fact, many commenters seem convinced that outsourcing is the key to small medical practice survival. But I’m not sure it’s right for every practice or every ‘mundane’ function. In my experience, outsourcing done well can be a godsend for a resource-constrained practice. But ‘done well’ is the key. Outsourcing is not without pitfalls of its own, and if physicians and managers are not aware of them, they can be very hard to spot before significant damage is done.
For example, it is tempting to assume “that’s off my plate” after outsourcing. But this often leads to problems when the external resources aren’t managed closely. Sometimes, physicians and their owners are even intimidated by the expertise of the firm they’ve hired, and are reluctant to ask important questions.
Choosing which tasks to offload is another delicate area. One outsourcing option generating a lot of interest is inbound call-handling. But we’ve already seen how wrong this can go with the experiences of big technology company call centers – customer frustration with them is a business cliché. It goes without saying that the patient-practice relationship is even more delicate and easily damaged than a typical consumer one.
Similarly, practices that lack social media experience are often eager to outsource rather than scale the steep learning curve. But social media has become a primary platform of interpersonal relationships – and an external ‘expert’ may understand the medium better, but not necessarily the messages that need to be sent and received.
I’m most leery of outsourcing functions like these that involve significant patient contact. Outsourcing office cleaning, IT network support, and payroll processing may be easier decisions (although there are still risks there, too – think HIPAA and theft as two examples). Outsourcing things like social media or billing are more complicated. Although few practices know they can consider it, sometimes the best approach is a hybrid. For example, a practice can temporarily engage a social media expert to perform the function while also training staff. Or, rather than outsourcing, sometimes two practices can share an employee. This way, both practices will worry less about being “just another client” of an outsourcing firm while also avoiding overcommitting on staffing.