PublicationDate:May10,2002ResearchBriefHealthcareBusinessProcessOutsourcingMarketPoisedforChangeAbstract:Despiteinroads,overallutilizationofbusinessprocessoutsourcingbythehealthcareindustryremainssmall.HealthcareprovidersandBPOvendorsmustunderstandforcesthatarechangingthismarket.BySureshGunasekaranKeyIssueWhatistheroleofoutsourcingintheindustry?RecommendationsIItiscrucialthatITservicescompaniesinvestineducatingthehealthcareprovidermarketplaceonthevalueofBPOservices.ISuccessinthepayerBPOmarketplacewillbedeterminedbytheabilityofITservicescompaniestodelivervalue-addedservicesthatcanbeassessedthroughoverallcostandrevenueaccounting.IHealthcareorganizationsevaluatingBPOvendorsshouldfocusonrelevantapplicationcapabilitiesaswellasbusinessunitmanagementexperience.2HealthcareBusinessProcessOutsourcingMarketPoisedforChange©2002Gartner,Inc.May10,2002IntroductionBusinessprocessoutsourcing(BPO)istheuseofexternalserviceproviderstomanageabusinessfunctionorunitwithinanenterprise.Initially,thebusinessfunctionsmostoftenoutsourcedincludedjanitorialservices,cafeteriaservicesandequipmentmanagement.Increasingly,thislisthasexpandedtoincludebusinessfunctionssuchasfinance,payrollandcustomerserviceinmanyindustries.GartnerDataquesthasfocuseditsresearchinthismarketplaceonindustrybusinessprocessesthatareITintensive.ThisResearchBriefdefinesthehealthcareindustryprocessesthataremostsuitabletobeoutsourcedbyservicecompanieswithinformationtechnology(IT)capabilities.ProviderBPOMarketThehealthcareprovidermarketisdefinedbyorganizationsthatdirectlyprovidetherapeuticandclinicalservicestopatients;thismarketincludesintegrateddeliverysystems,hospitals,physicianoffices,long-termcarefacilitiesandsoon.Enterprisefunctionsmostoftenconsideredcorecompetenciesinthismarketinclude:IPatientcare—Allhealthcareprovidersfocusondeliveringhigh-qualityshort-termandlong-termtherapeuticcaretotheirpatientsinanefficientmanner.IPatientacquisition—Mostproviderspridethemselvesontheirdeeplocalinvolvementandtheirabilitytoacquirenewpatientsthroughcommunitychannels,includingpatientreferrals,andemployerandpayerrelations.ICommunityhealthmanagement—Mosthealthcareorganizationsmaintainsignificantpopulationmanagementgoalsandviewtheirabilitytocontributetolocalpublichealthmanagementasacorepartoftheirmission.Beyondthesecorecompetencies,healthcareprovidershaveexploredexternalbusinessprocessmanagementservicestomanagemanyimportantIT-intensiveenterprisefunctions.Figure1highlightsmajorBPOofferingsforthehealthcareprovidermarket.Broadly,theymaybedividedintofourmajorbusinessprocessareas:IAdministrationIRecordsanddocumentationIInsurancebillingIClinicalcareThemostmatureofferingsinthismarketplaceareintheareasofadministrationandrecordsanddocumentation.However,thegreatestdemandfornewservicesisintheareaofinsurancebilling.3©2002Gartner,Inc.May10,2002Figure1BPOMapforHealthcareProvidersDocumentManagementComputer-BasedPatientRecord106626-00-01BusinessProcessBPOOfferingTechnologyDepartment/BusinessUnitAdministrationRecordsandDocumentationInsuranceBillingClinicalCareERPFinanceHumanResourcesSupplyChainTranscriptionMedicalRecordsAccountsReceivableMedicalCodingNurseCallCenterPracticeAnalyticsPatientRegistrationEligibilitySystemsInsuranceCodingCSSApplicationCPROutcomesAnalysisAccountingHumanResourcesMaterialsManagementTranscriptionMedicalRecordsOfficeBusinessOfficeMedic...
