Medicine:Medical outsourcing

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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]

References

  1. Boyd, JB; McGrath, MH; Maa, J (January 2011). "Emerging trends in the outsourcing of medical and surgical care.". Archives of Surgery 146 (1): 107–12. doi:10.1001/archsurg.2010.308. PMID 21242454.  open access
  2. Barkholz, Dave (June 18, 2016). "AmSurg-Envision merger aims at hospital appetite for buffet of physician services" (in en-us). Modern Healthcare. http://www.modernhealthcare.com/article/20160618/MAGAZINE/306189965. 
  3. "Nu granskas Norrtäljes röntgenbilder på andra sidan jorden" (in sv). Dagens Medicin. https://www.dagensmedicin.se/artiklar/2017/02/17/nu-granskas-norrtaljes-rontgenbilder-pa-andra-sidan-jorden/. 
  4. Johansson, Christopher (2016-09-05). "Röntgenplåtar skickas till Australien" (in sv). Sveriges Radio. https://sverigesradio.se/sida/artikel.aspx?programid=97&artikel=6510593. 
  5. Nyheter, SVT (2010-05-03). "Röntgenbilder skickas utomlands" (in sv). SVT Nyheter. https://www.svt.se/nyheter/lokalt/vast/rontgenbilder-skickas-utomlands. 
  6. Creswell, Julie; Abelson, Reed; Sanger-Katz, Margot (July 24, 2017). "The Company Behind Many Surprise Emergency Room Bills" (in en). New York Times. https://www.nytimes.com/2017/07/24/upshot/the-company-behind-many-surprise-emergency-room-bills.html?dlbk. 
  7. MacDonald, Ilene (February 5, 2018). "Surprise medical bills: Some patients owe thousands, but most don’t have enough savings to pay for a $1K emergency" (in en). FierceHealthcare. https://www.fiercehealthcare.com/finance/surprise-medical-bills-some-patients-owe-thousands-but-most-americans-don-t-have-enough. 
  8. Shopes, Rich (21 February 2015). "Doctor says she was fired for reporting low staffing at Brandon Regional ER". Tampa Bay Times. http://www.tampabay.com/news/health/doctor-says-she-was-fired-for-reporting-low-staffing-at-brandon-regional/2218497. 
  9. "9 Thoughts on Outsourcing: When To Outsource and How to Do it Successfully" (in en-gb). www.beckershospitalreview.com. October 15, 2010. https://www.beckershospitalreview.com/hospital-management-administration/9-thoughts-on-outsourcing-when-to-outsource-and-how-to-do-it-successfully.html. 
  10. Rau, Jordan (January 10, 2018). "Outsourcing services leaves nursing homes underfunded, understaffed | BenefitsPRO". Kaiser Health News via BenefitsPRO. https://www.benefitspro.com/2018/01/10/outsourcing-services-leaves-nursing-homes-underfun/?slreturn=20180606015242. 
  11. Aiken, L. H. (1 February 2002). "Hospital staffing, organization, and quality of care: cross-national findings". International Journal for Quality in Health Care 14 (1): 5–13. doi:10.1093/intqhc/14.1.5. PMID 11871630.  open access
  12. Walker, Ben (July 17, 2017). "If you operate a medical practice, you should be outsourcing | Medical Economics" (in en). www.medicaleconomics.com. http://www.medicaleconomics.com/medical-economics-blog/if-you-operate-medical-practice-you-should-be-outsourcing. 
  13. Harris, Gardiner (25 March 2010). "More Doctors Taking Salaried Jobs" (in en). New York Times. https://www.nytimes.com/2010/03/26/health/policy/26docs.html. 
  14. Kacik, Alex (January 27, 2018). "More providers are outsourcing revenue-cycle management in order to cut costs." (in en-us). Modern Healthcare. http://www.modernhealthcare.com/article/20180127/NEWS/180129895. 
  15. Kacik, Alex (April 3, 2018). "Health systems could free up a significant amount of capital if they act like real estate investors." (in en-us). Modern Healthcare. http://www.modernhealthcare.com/article/20180403/NEWS/180409978. 
  16. Boyd, JB; McGrath, MH; Maa, J (January 2011). "Emerging trends in the outsourcing of medical and surgical care.". Archives of Surgery 146 (1): 107–12. doi:10.1001/archsurg.2010.308. PMID 21242454.  open access
  17. Lunt, Neil; Smith, Richard; Exworthy, Mark; Green, Stephen T.; Horsfall, Daniel; Mannion, Russell (2011). "Medical Tourism: Treatments, Markets and Health System Implications: A scoping review". OECD. https://www.oecd.org/els/health-systems/48723982.pdf.