healthcare solutions

Is Outsourcing Healthcare Bad?

As the demand for quality care increases and medical costs continue to spike, outsourcing has become a trend in the growing healthcare information management (HIM) industry. At present, many hospitals and health systems choose to outsource their medical transactions and processes such as back-office tasks and medical transcription and billing to third-party firms. But still, whether or not outsourcing healthcare services is bad remains a disputed issue.

More hospitals in US outsourcing healthcare services

In a recent article, Penn State News quoted Jonathan Clark, Assistant Professor of Health Policy and Administration at Penn State University, as saying that around 90%of hospitals in the United States are now outsourcing some portion of their radiology services. He also points out that hospitals are also outsourcing in other areas including their anesthesiologist staffing and emergency physician staffing.

Companies can save money with outsourcing and even improve their capabilities, according to Clark. “I believe outsourcing is something we should think about, especially when it fuels efficiency and expands access to health care, but we need to be intelligent about it so as not to put patient safety at risk.”

Removing taboos associated with outsourcing healthcare services

It turns out more healthcare providers are finding new ways to lower costs without compromising patient care. Healthcare Purchasing News has published an article that talks about removing some of the taboos associated with the outsourcing of products and services in healthcare.

Quoting Niklaus Fincher, Vice President of VHA Inc., the article said reprocessed single-use devices can significantly improve an organization’s operating limits. Many other healthcare systems are also stepping up efforts to outsource products and services that allow their organizations to function optimally in a continuously changing environment.

Why healthcare providers outsource their medical processes

Along with its growth are challenges that drive healthcare providers to outsource their medical processes. One of which is the increasing pressure to lower health maintenance costs while meeting the government standards in providing medical services. These challenges have made support functions of hospitals and health insurance companies expensive to maintain, so outsourcing has aided in those areas while hospitals focus on their main duty, which is to give direct care to patients.

Also by outsourcing, hospitals and health systems no longer have to maintain an in-house department or own a typing platform and dictation system. Thus, expenses previously allocated for equipment and people were devoted to improving the core health services, instead of spending on transcription-related manpower and facilities.

On top of all, some of the most common billing issues patients face such as getting charged for more than the insurance limit, being billed twice for one treatment, being billed for the wrong medicine, and getting unexpected charges, are now eliminated with the help of a well-structured system of an outsourcing provider.

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Why Kaiser Permanente’s Health Care Model Works

Kaiser Permanente (KP) is the largest non-profit and non-governmental integrated health care delivery system in the United States. European countries are closely looking into it as a model for their own healthcare systems. This structure, known as Kaiser Permanente’s Health Care Model, provides its 8.7 million members and patients with high-quality, cost-effective care.

It is remarkable that Kaiser Permanente can achieve such seamless integration and strong results even if it is not one organization but several cooperating entities. It operates in nine states and the District of Columbia and comprises of 8.7 million members, 14,000 doctors, and 160,000 employees. About three-quarters of these members and employees reside in California, where the company began in 1945 and has its headquarters. The program owns and runs 421 medical office buildings (for ambulatory care only) and 32 medical centers (hospitals with ambulatory care).

Bernard J. Tyson, Kaiser Permanente’s CEO, shares that this is feasible because all their employees, from its physicians to its administrative employees, share a common vision: to deliver coordinated, comprehensive, cost-effective health care that keeps patients as healthy as possible.

Why Kaiser Permanente’s Health Care Model Works

Kaiser Permanente coordinates primary, secondary, and hospital care; places a strong emphasis on prevention; and extensively uses care pathways with the help of technology using a strong IT system and electronic medical records.

Care Pathways: An End-to-End Experience

From primary, secondary, chronic disease management, ambulatory care to medicine dispensing, rehabilitation and therapy and support groups – patient care is integrated. A patient comes in at Kaiser Permanente and can get a consultation, surgery, therapy, and medicines all in one place. Care pathways have protocols involving all aspects of patient care, having multidisciplinary teams in each area. Roles and accountabilities are clearly defined in care pathways’ protocols.

For example, physicians play a part in patient care but nurses, pharmacists, and other team members are closely involved. From check-in to discharge and even follow-up treatments or consultations, the care pathway is always consulted, different and personalized for each patient.

Integrated care requires everyone involved in the patient’s care to work as a team. Each team member must focus not only on the particular treatment he or she is providing but also on the entire care pathway.

KP HealthConnect: Bringing the Power of Technology into Patient Care Management

A strong IT system is critical to making sure care pathways are followed and consulted. Patients can seek medical care across all Kaiser Permanente hospitals and accredited centers and their records and care pathways (history, treatment, maintenance, etc.) can be accessed and referred to. This is the power of KP HealthConnect. It facilitates the care pathways – bearing documentation templates, alerts, reminders, and other clinical-decision support capabilities.

KP HealthConnect has also given the health care system in Kaiser Permanente with so much information (known as big data). Whereas it was originally built to be an access point for patients’ electronic records, physicians saw the value these data can bring to research and development. They developed registries for diseases, allowing them to do research, spot trends, do preventive measures and improve care pathways.

Focus on Patient Involvement & Engagement

Kaiser Permanente intensely focuses on prevention, health education, and care management. Using these programs, they have systematically reduced the death rate from cardiovascular disease and colon cancer significantly below the California average.

They recognize that even the best care pathways will be unsuccessful unless patients take active responsibility for their own health. This is one of the reasons KP works so hard to ensure that care delivery is seamless. They encourage patient involvement by giving them electronic access to their health information and letting them consult their physicians via e-mail. They are continuously improving to help build relationships with patients, leading to trust. KP wants to make sure their patients trust and believe in them – which they can help them stay healthy and live longer.

Integrated Care: Key to Kaiser Permanente’s Health Care Model

A combination of a strong, functioning IT system with a secure data environment, strong end-to-end care pathways and a focus on patient involvement create integrated care.

No matter how cliché the statement, “Health is wealth” can be, it is definitely something that each individual should take into account. Need not worry though, because we can provide your medical institution all the assistance you’ll need through our exceptional patient services such as billing, coding, and even back-office responsibilities. Learn more!

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