3 Ways to See Outsourcing in a New Light for Executives to Promote a Healthy Workforce

E - Sport For The Future

We don’t live in a bubble. We are a globalized economy. Until artificial intelligence has total capability in healthcare, the human touch is what sets us apart from just carrying out a set of functions efficiently. Since the COVID-19 pandemic landed, it has had an unprecedented impact on most countries, and an already taxed U.S. health system regarding mental health and well-being of healthcare workers. According to the Brain & Behavior Research Foundation, serving your well-being may be in the form of eating healthy, exercising, or fostering healthy relationships.1

Chief executives can improve well-being among their employees and community by creatively utilizing outsourcing. Here are three ways senior leaders can use outsourcing as a lifeline to keep operations healthy, making for an exceptional patient care experience and simultaneously promoting their healthcare workers’ health and well-being.

As I heard on a recent webcast by Tony Robbins, “We are no longer in an age of information. There is so much information that bombards us. We are now in the age of attention,”2 and not just the ‘look at me type of attention,’ most importantly, we need to pay attention. We need to take inventories of the waste and drain on our energies and resources. I’m not necessarily speaking about taking stock of how many drape packs or pulse oximetry sensors we have on hand, although that is important; I’m talking about taking an inventory of ourselves. How can we expect our patients to engage in self-care if our healthcare providers and allied healthcare workers are not encouraged or empowered to engage in self-care?

The National Center for Biotechnology Information posits that we can achieve a healthier environment for our workers and patients by enacting a systems approach to design thinking. By continuously testing and adapting the interventions to the unique situation, a strategic approach to building the well-being of workers and the resilience of organizations can be developed.3 So, what criteria do we test and adapt?

Larger Hospital and Health Systems Morph into a Portfolio of Offerings

Every day we hear about a hospital merging with another healthcare facility or a health system acquiring a smaller medical center. According to the latest Kaufman Hall report, 2021 had the largest percentage of mega-merger transactions in the last six years at 16.3%, almost double the percentage in 2020.4 (see figure 3)

figure 1

Additionally, the research revealed that the number of transactions in 2021 had decreased; however, the average size of the smaller partner by annual revenue has increased at a compound annual growth rate of roughly 8.0%.5 (see figure 5)

figure 2

Before the COVID-19 pandemic, independent hospitals joined healthcare systems to defray rising healthcare costs and respond to the challenges of managed care. Improved integration efforts have opened a vein for consumers, health plans, and healthcare operators allowing providers, both legacy and new, the opportunity to differentiate themselves by providing better, more affordable care faster. Segue to the COVID-19 pandemic that has further altered the healthcare landscape by disrupting its core operations over the past two years. Add to that, disruptions in the supply chain, labor market and societal impacts, healthcare organizations strive for a new stable post-pandemic normal. In the years to come, many hospitals and health systems will create and pursue a portfolio of offerings augmented to the needs of consumers. With the addition of these long-term offerings, a larger pool of providers, nurses, and H.I.M. specialists, namely coders, will be needed.

Currently, the administrative landscape in healthcare is bleak. A study conducted by Morning Consult, revealed 1 in 5 healthcare workers have quit their jobs since COVID-19 hit the U.S.6 Many more healthcare workers are burnt out or stressed. Moreover, Morning Consult states that additionally 19 percent of healthcare workers are considering leaving the healthcare field entirely.7 Health systems cannot operate well with this kind of resource loss.

View Outsourcing as a Permanent Extension of Your Team

To play the long game, a cost-effective and creative way for chief executives to handle the drain on existing resources and demand for more is to look at using outsourcing as a permanent extension of their team versus supplementary to it. Supplementation is a short-term solution to a long-term problem. Pete Lauth, the Vice President of a large outsourcing firm states, “It would be less costly for large hospitals and health systems which require a larger number of FTEs to use an outsourcing platform that focuses on great quality, project management, and quick turnaround time for coding.”8

Although, Bibi Von Malder, the Corporate H.I.M. Director at Signature Healthcare agrees with Lauth that “Offshore coding runs roughly about half the price of domestic coders. Von Malder adds, I prefer domestic coders because I feel they understand our payer rules and coding guidelines more efficiently, [and] it is challenging to communicate with offshore coders due to language barriers.”9

Outsourcing Offers a Variety of Offshore and Domestic Options

Many people use the words outsourcing and offshoring interchangeably; however, outsourcing and offshoring have two different meanings. According to the Merriam-Webster dictionary, outsourcing means to produce under contract with an outside buyer and offshoring implies the practice of basing some of a company’s services overseas.10 Just as people do not realize there is a difference in these terms, people may not realize that all offshore outsourcing companies do not operate the same or produce the same results. When a U.S. health system is working with an offshore company, it is essential to ask these questions.

  • Are the coders credentialed?
  • How are you assured health information is kept secure and confidential?
  • If a disaster occurs, do you have back-up systems in place?
  • Is there a business associate agreement in place with all workforce members who access patients’ protected health information?
  • What notification, communication, remediation, and escalation policies for client problems, questions, and issues are in place?
  • Are your coders HIPAA certified and receive privacy training and privacy retraining thereafter?
  • Do you provide a U.S.-based coding manager to conduct quality assurance and work with the offshore operations project manager? Are they included in the price quoted?
  • Do you follow the U.S.-based holiday calendar?
  • Are your coders fluent and proficient in English?
  • What hours are your coders available to work?
  • Do you charge per hour, per chart, or by length of stay?

Additional Criteria to Promote a Healthy Workforce

Lauth, states, “Depending on the situation and budget of the hospital or health system, outsourcing will help provide a better work-life experience and improve morale for in-house coders.”11 Not taking time off for vacations or sick days due to coder shortages promotes a toxic environment. In the long run, it is a higher price to pay in overtime charges, sick team members, and possibly permanent loss of good staff.

Moreover, Lauth says, “Partnering with an outsourced company allows in-house coders to sign off at a reasonable time for the day and be with their families while our outsourced company coders work the night shift.”12 This has a positive cascading effect on not simply the coder’s mental health and well-being, but the health of the organization and its patients. Comment below and tell us how you will use outsourcing to help promote a healthier workforce and organization for your community?


1. https://wwwbbrfoundation.org/blog/self-love-and-what-it-mean

2. Robins, Tony (Producer). 2022. The Ultimate Challenge Breakthrough 2022    Challenge [Video].

3. https://www.ncbi.nlm.nih.gov/books/NBK540859/

4-5. https://www.kaufmanhall.com/insights/research-report/2021-ma-review-new-phase-healthcare-partnerships

6-7. https://morningconsult.com/2021/10/04/health-care-workers-series-part-2-workforce

8, 11-12. Lauth, P. (2022, February 25). Personal communication [email].

9. Von Malder, B. (2022, February 21). Personal communication [email].

10. Merriam-Webster. (n.d.). Offshoring. (11th Ed., p. 862). Springfield, MA: Merriam-Webster’s collegiate dictionary

11. Merriam-Webster. (n.d.). Outsourcing. (11th Ed., p. 882). Springfield, MA: Merriam-Webster’s collegiate dictionary.

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