US healthcare reform to boost BPOs

Windfall For Indian Cos Specialising In Med Insurance, Claims Processing

Bangalore: US president Barack Obama's $871-billion healthcare reform bill has brought cheer to Indian healthcare BPO and IT service providers. 

    Although the reform may not result in heavy healthcare technology outsourcing from the US — as it does not talk about any major re-architecturing, re-engineering or system overhauling of the existing platforms — it is expected to bring in windfall benefits to domestic BPO providers which are focused on insurance and claims processing domains. Indian healthcare IT providers mostly focus on systems integration, application management, maintenance and legacy modernisation. 
    Minneapolis-based healthcare expert Saji Salam said: "All existing IT systems, including the electronic medical records, patient information systems and other technology platforms are going to stay untouched, barring some minor to medium tweaking, which will mean some additional work for existing providers like IBM, Accenture and EDS (HP). It's possible that minor portions of these might get shifted to India as well, but the sizable opportunity is for BPOs.'' 
    The reform will bring 32 million poor and emigrant Americans under insurance cover. Insurance firms will look at outsourcing partners to help them enrol new members and process their call and claim needs. Rising cost pressures will force insurers and hospitals to concentrate only on a few core functions such as benefit and services design, sales and marketing, while outsourcing back-office functions like member database management, claims processing, support services and enrolment processing. 
    Sanjiv Kapur, head, Patni BPO, said he saw significant healthcare outsourcing opportunity in BPO and IT areas. "The reform extends coverage to millions of Americans, which means we will see a significant influx of the newly insured into the healthcare system. The additional enrollees will need to be administered as and when it happens. This means a lot more work in areas of claims processing, enrolments, underwriting support and customer support.'' 
    The reform also brings a huge opportunity for medical transcription providers as electronic health records (EHRs) implementation is likely to undergo some changes. "It will mean a change from paper records to electronic ones, mandatory for all healthcare institutions,'' said Raman Kumar, CEO, CBay Systems, a medical transcription firm. 
    Obama has already apportioned $37 billion of stimulus funding to drive the adoption of EHRs. McKinsey estimates the resulting growth in EHRs will require an overall spend of $175 billion over the next 10 years. While adopting the system, US hospitals will need help in system set-up, installation, beta-testing, conversion of archival data into compatible formats and training of clinical and administrative staff to use the new system.

The reform will bring 32 million poor and emigrant Americans under insurance cover 
Insurance firms will look at outsourcing partners to help them enrol new members and process their call and claim needs 
Rising costs will force insurers and hospitals to concentrate only on a few core functions such as benefit and services design, sales and marketing, while outsourcing back-office functions like member database management