Do What You Do Best, Outsource the Rest

How many times have you heard “Do what you do best and outsource the rest?” Personally, we’ve heard it hundreds of times. While it makes great sense, there is always the huge fear that letting go of “control” of something will put us on a path of total destruction. There are usually three reactions to the advice:

1. How hard can it be just to do it in-house?

2. The cost is not going to warrant the increase in time I’ll have available to me or to my staff to do other things.

3. There is no way someone outside of my establishment can do a better job for me at a cheaper rate.

These reactions are all warranted, but to just stop there and not further investigate is doing a major disservice to your practice, yourself, and possibly your patients, as well.

Let’s take the first objection, “How hard can it be?” In the not too distant past, the actual business functions of a medical office were not half as complicated as they are now. Some of you probably remember or have heard of the times when an insurance company would just pay you what you billed and everyone was happy. Now there are contracts with reimbursement levels that can change when you’re not looking, insurance coverages which change for the patients at a whim it seems, IT needs that were never an issue prior to Bill Gates, etc. Then you can add in all the requirements that the government is now putting on medical providers and you should see that it can be pretty hard.

The next objection is that the cost doesn’t warrant that you will have more time to do things like see patients, see family, have a life outside of medicine. I will fervently argue that the more time you are given because you don’t have to worry about IT, 5010, ICD-10, billing, contracting, process, and people flow is a good thing. Outsourcing opens up time for you to see more patients or, conversely, to spend more time with each of your patients. You can delegate to others who love to do what you hate and you can do what you love. Trying to figure out what you will do with more time is an excellent “problem” to have.

The last objection is that there is no way anyone else could do a better than what you or your office are already doing. Implied in that objection is that your practice can do it cheaper, better, and faster than anyone else. Let me ask a few questions: When your biller quits on you with no notice, what do you do? When your IT person gets sick or the actual technology “crashes,” what do you do? When it is time to negotiate with the insurance companies your contracts and you don’t have a lawyer who specializes in healthcare, how do you know you are getting the best possible deal available? When the country switches over to 5010 and ICD-10, and your in-house coder and biller are sick, do you just wait around until somebody is available? How much are you actually paying your staff to do those services that can be outsourced (supplies, salary, overhead, extra room you could use differently)? When you are running in and out of exam rooms, is everyone doing their own job properly and not just “chipping in” with someone else?

The good part of outsourcing is that those people you outsource go through constant continuing education. Usually their pricing is very reasonable. They want you to succeed as badly as you want to. They want you to succeed so that they’ll get more business. Be sure that someone actually reads the reports provided and manages the jobs that those outsource companies perform.

Now, there is some due diligence that needs to be done before you outsource. Get a list of current clients and check with them their thoughts on the company. Ask them their opinion of the services and ask them also what they would change about their relationship with that company. That can tell you more than a glowing reference.

Check with the Office of the Inspector General (OIG) to make sure a company you are interested in hiring is not listed as having a Corporate Integrity Agreement. A Corporate Integrity Agreement (CIA) is an agreement between an entity and the government through the OIG. This agreement is made because the OIG investigated the entity and found a problem the entity had that was not in compliance with government law. So, the entity had to enter into the agreement that promises they will fix their issues and must report to the OIG on a regular basis the progress of their “fix” in order to stay in business. Sometimes working with a company that has a CIA could end up being more problematic than you’d want.

Check with the Better Business Bureau and any other agency in your area that might have information on that company. If you can, check with Dun and Bradstreet and that will give you a hint as to the company’s likelihood of being in business down the road.

By doing what you do best and outsourcing the rest, you should make more money, save money, have more free time and have less stress!

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