Care Coordination Programs: Insource Vs. Outsource
Your practice is ready to provide care coordination and wellness services to patients. You’ve decided to implement one, two, or all of these programs into your practice:
- Chronic Care Management (CCM)
- Behavioral Health Integration (BHI)
- Annual Wellness Visits (AWV)
- Transitional Care Management (TCM)
- Remote Patient Monitoring (RPM)
One of the biggest challenges healthcare providers face is deciding whether to insource or outsource the care.
Both are viable options, with their own benefits and drawbacks. Deciding which option is best for your practice largely depends on a variety of factors.
At ThoroughCare, our software is tailored towards practices looking to insource the provision of these programs.
Through our clinician friendly software, we’ve helped over 400 healthcare providers successfully implement these programs resulting in improved health outcomes and increased revenues.
We’re not trying to fool you though. After reading this, you may decide that outsourcing these programs is the best option for you and that’s okay.
But we also have the experience and success stories to show that insourcing these programs can be an easy, profitable, and rewarding option for many healthcare providers.
In this article, we’ll walk you through the pros and cons to both options, giving you the information without bias to make the best decision for your practice.
So without further ado, let’s dive in.
The Pros and Cons of Insourcing Care Coordination
Insourcing care coordination programs has become more and more popular in recent years with the rising popularity of telehealth and the patient-centered care model.
Healthcare providers that insource care coordination utilize their own staff and clinicians to manage the programs.
Below we walk through the pros and cons of insourcing care coordination.
Pros of Insourcing Care Coordination
Insourcing care coordination has clear benefits that impact the cornerstones of successful medical practices. Let’s dive into the specifics.
Improved Relationships with Patients
This is first on our list, as it’s really the most important aspect of care coordination outside of improved health outcomes.
Relationships with your patients make the clinician’s job easier, the staff’s job easier, and the patient’s experience better. Everyone wins.
By insourcing, those who manage your care coordination programs will already have pre-established relationships with the patients from which they can build upon.
This increases the comfort level of patients, which tends to lead to better patient engagement, and ultimately better health outcomes.
By insourcing care coordination, providers maintain control over the entire process from hiring and/or training staff, to managing their reputation.
When everything stays in-house, you are undeniably able to better manage and coordinate the care you provide.
Insourcing also allows you to more easily adjust as needed. Whether you need to provide more training, handle service issues, or simply communicate with your care managers, you’ll be able to more readily respond to change if your care coordination is insourced.
New Revenue Streams
Regardless if you choose to insource or outsource care coordination, you’ll be creating a new revenue stream for your practice by simply implementing care coordination programs.
The benefit of insourcing is a higher chance of creating additional revenue streams.
How? You know your patients better than a 3rd party.
If you’re providing Chronic Care Management (CCM) services, you may find that the patient can benefit from other care coordination programs like Remote Patient Monitoring (RPM) or Behavioral Health Integration (BHI).
With your own staff coordinating that care, identifying patients for other care coordination and wellness programs becomes easier and more efficient.
Getting your own staff engaged with their work leads to increased productivity and morale. By giving your staff ownership of the care coordination programs, they’ll become more engaged in the process by default.
Furthermore, outsourcing care coordination services could lead to a “us vs them” mentality, instead of a cooperative working environment.
Cons of Insourcing Care Coordination
By now, you can see that insourcing provides a great number of benefits. But there are some drawbacks you should consider.
Upfront Financial Investment
There is going to be an upfront financial investment with both insourcing and outsourcing.
Insourcing, however, may require a bit more of an investment because you’ll need proper software and may need to hire additional dedicated staff to manage these programs.
While you can manage these programs via your own Electronic Health Record (EHR), most EHRs don’t make managing care coordination programs easy.
Having intuitive software can mitigate most, if not all, of the cons to insourcing care coordination.
An intuitive, clinician-friendly software makes your staff more efficient and productive, allowing them more time to care for the patients instead of stressing over clunky user interfaces and hard-to-use software.
If your current staff is able to take on the additional workload of managing these programs without hiring new staff, they may still need to be trained to be care managers.
They will also need to be trained in how to use the software to do so effectively.
This training can cost you time and money. Again, this is part of that upfront financial investment mentioned earlier.
In the end, however, the revenue gained from providing this care will usually outweigh the initial costs of implementation.
Insourcing care coordination tends to have a longer implementation time than outsourcing.
With the potential for hiring, training, and implementation of software and workflows, it takes time to start care coordination services inhouse.
By outsourcing to a 3rd party that is already setup and established in these processes, you’ll reduce the amount of time in getting started.
Complex Regulations and Codes
This last one many healthcare providers are quite familiar with. The Centers for Medicaid and Medicare (CMS) have complex regulations and codes for providing care coordination.
In fact, many healthcare providers cite that as a prime reason they avoid offering these programs to their patients.
There are a number of software solutions that eliminate the complexity and ease the billing process through automation, ensuring your practice adheres to CMS regulations.
So if you’re leaning towards insourcing care coordination, it’s clear that choosing the best software to assist you is vital.
The Pros and Cons of Outsourcing Care Coordination
Outsourcing care coordination programs to a 3rd party company allows providers to offer these programs without the need to dedicate internal staff time to doing so.
Historically, this has been the more popular method of care coordination for healthcare providers due to perceived lower costs and less hassle.
But with advances in technology enabling providers to better manage these programs themselves, and the rising demand for the patient-centered care model, the decision between insourcing vs outsourcing has become harder.
Below we walk through the pros and cons of outsourcing care coordination.
Pros of Outsourcing Care Coordination
Outsourcing is often considered the easier of the two options. Afterall, if you don’t have to actively manage the programs yourself, isn’t that less hassle?
We’ll examine the pros of outsourcing below.
Efficiency and Scale
One of the most obvious benefits to outsourcing care coordination is that your practice will gain access to a much larger pool of talented healthcare professionals to manage the care coordination programs for you.
This allows practices to provide care for more patients than they otherwise would have been able to.
More patients means more revenue for your practice.
Of course, outsourcing to a 3rd party isn’t free, though the increase in patient capacity usually outweighs the cost of outsourcing.
Furthermore, these 3rd party care coordination agencies already have the trained staff to administer care coordination services, reducing implementation time.
By choosing outsourcing you’ll naturally have less overhead expenses, mostly from a reduction in labor, training, and technology costs.
In the healthcare industry, profit margins can be small. Furthermore, the public perception of increased patient costs can have adverse consequences for providers.
The highly competitive healthcare industry demands providers keep costs low and profits high to stay ahead of the competition and remain profitable.
Wider Service Offerings
Not all healthcare providers have the physical or financial resources to offer all care coordination programs and services. This can be especially true for more rural practices.
By outsourcing to a 3rd party that already has these capabilities built in, you’ll provide your patients with more options for care.
And as time goes on and healthcare leans more and more towards a patient-centered approach, more options are what patients want.
Cons of Outsourcing Care Coordination
As you can see, outsourcing does have its benefits. But what are the drawbacks?
Let’s take a look.
Lack of Control
By the very nature of outsourcing care coordination, you will be sacrificing some control. For many providers, this can be the hardest decision to make.
Healthcare providers put heavy emphasis on their reputation and the quality of care they provide to their patients.
By outsourcing, you’re relying on staff you have never worked to uphold the standard of your practice. Additionally, 3rd parties can experience their own issues out of your control, such as service interruptions and high turnover among care coordinators.
Weaker Patient Relationships
Many healthcare providers consider the relationships built with patients to be a critical part of the service they provide.
Patients build relationships not only with the clinicians treating them, but the staff at your practice as well. By outsourcing, you’ll be relying on care coordinators that your patients have not met and have no prior relation with.
And what if the 3rd party vendor experiences high turnover rates among care managers? Your patients could lose the care manager that has worked with them for weeks or months.
That relationship has to start all over again and that damages the ability to build strong relationships.
And strong relationships between provider and patient leads to higher patient engagement and ultimately better health outcomes.
Most 3rd party care coordination vendors require providers to enter into a service contract. These contracts can be long, locking the provider into a commitment that can last years.
As mentioned above, problems can arise with that vendor that are beyond your control and can ultimately affect the reputation of your practice and quality of care you provide.
Which Is Best, Insourcing or Outsourcing Care Coordination?
As you can see, both options have their benefits and drawbacks. So how do you decide?
You want to make the best decision for YOUR practice. How do you do that?
Examine what matters most to you.
Do you prioritize the relationships you’ve built with your patients? Insourcing care coordination has the advantage in that regard.
Would you like to offer care coordination, but don’t have all the resources to do so? Outsourcing may be the better option.
Is cost your biggest concern? That makes the decision less clear.
Historically, outsourcing had been the more cost-effective option. But due to the rise in popularity and capabilities of technology, the gap has closed.
A more nuanced look at your own practice and what programs you’d like to support will ultimately determine the cheaper option.
Clinician-Friendly Software Makes Insourcing Easier
If you know ThoroughCare, you know that our software is built around providing care coordination in-house.
Our intuitive, clinician-friendly software equips providers with the tools needed to insource and manage care coordination and wellness programs easily and effectively.
Over the years, we’ve helped over 400 healthcare providers successfully implement and manage these programs, increasing revenues and improving patient health outcomes.
We encourage you to explore all your options, but we’re confident that we can help you maximize revenues and provide the highest quality of care for your patients.
Schedule a discovery call with us to find out how!