Medical outsourcing

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

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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

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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

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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

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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

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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.
2. ^ Barkholz, Dave (June 18, 2016). "AmSurg-Envision merger aims at hospital appetite for buffet of physician services". Modern Healthcare.
3. ^ "Nu granskas Norrtäljes röntgenbilder på andra sidan jorden". Dagens Medicin (in Swedish). Retrieved 2018-07-06.
4. ^ Johansson, Christopher (2016-09-05). "Röntgenplåtar skickas till Australien". Sveriges Radio (in Swedish). Retrieved 2018-07-06.
5. ^ Nyheter, SVT (2010-05-03). "Röntgenbilder skickas utomlands". SVT Nyheter (in Swedish). Retrieved 2018-07-06.
6. ^ Creswell, Julie; Abelson, Reed; Sanger-Katz, Margot (July 24, 2017). "The Company Behind Many Surprise Emergency Room Bills". New York Times.
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". FierceHealthcare.
8. ^ Shopes, Rich (21 February 2015). "Doctor says she was fired for reporting low staffing at Brandon Regional ER". Tampa Bay Times.
9. ^ "9 Thoughts on Outsourcing: When To Outsource and How to Do it Successfully". www.beckershospitalreview.com. October 15, 2010.
10. ^ Rau, Jordan (January 10, 2018). "Outsourcing services leaves nursing homes underfunded, understaffed | BenefitsPRO". Kaiser Health News via BenefitsPRO.
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.
12. ^ Walker, Ben (July 17, 2017). "If you operate a medical practice, you should be outsourcing | Medical Economics". www.medicaleconomics.com.
13. ^ Harris, Gardiner (25 March 2010). "More Doctors Taking Salaried Jobs". New York Times.
14. ^ Kacik, Alex (January 27, 2018). "More providers are outsourcing revenue-cycle management in order to cut costs". Modern Healthcare.
15. ^ Kacik, Alex (April 3, 2018). "Health systems could free up a significant amount of capital if they act like real estate investors". Modern Healthcare.
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.
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" (PDF). OECD.