Sunday, July 29, 2012

Another US jobs safe heaven going down?

I thought that this was happening long time back. I don't think this is new. However, interesting thing is how they are blaming new Obama care for acceleration in this area.. Apparently, as per new law insurers have to limit administrative costs below certain percentage of overall healthcare costs. Which makes sense.. but there is administrative work.. somehow it has to be done.. there is no magic into it.. unless you think outsourcing it to cheaper places.

I was thinking that this are was pretty much safe for US due to data privacy laws, but I am sure these guys must have figured out way to keep patient data safe some how ;-) For that matter, that data isn't that safe even in US. Actually, it could be more safer as they implement these outsourcing processes..

As long as I keep on getting better and cheaper care I don't mind whom I am talking to or who is giving me that care. Let the Capitalism take care of it. It is another lesson for US, to pour in more money into science and maths education and making college education more cheaper and affordable. Somehow, the scare against science and maths needs to go away from kids.. Despite one of the best education system, kids are not able to take advantage of it and many kids still drop out after high school to pick up basic service jobs. Currently there are plenty of jobs and it seems that for a young person they can make good enough money for that person to survive. However, these type of basic admin and service jobs will continue to get reduced.. Young kids and generation has to move into better high intellectual jobs. They better understand now vs.. when it will be too late..

Whatever, they are talking about getting manufacturing jobs back in US is just minor aberration at the best.. First of all, they are very few.. second, they are coming back only when there is no unions or essentially salaries are really very low as compared to what used to be. Capitalism will find its way to save money and generate more efficiencies and productivities. It is up to you how you benefit out of this capitalist system..


Big shift in health care jobs overseas


Many companies outsourcing work to Philippines, India


By Don Lee


Los Angeles Times


WASHINGTON — After years of shipping data-processing, accounting and other back-office work abroad, some health care companies are starting to shift clinical services and decision-making on medical care overseas, primarily to India and the
 Philippines. Some of the jobs being sent abroad include so-called pre-service nursing, where nurses at insurance firms, for example, help assess patient needs and determine treatment methods.

Outsourcing such tasks goes beyond earlier steps by health care firms to farm out reading of X-rays and other diagnostic tests to health professionals overseas. Those previous efforts were often done out of necessity, to meet overnight demands, for instance.

But the latest outsourcing, which have contributed to the loss of hundreds of domestic health jobs, is done for financial reasons. And the outsourcing of nursing functions, in particular, may be the most novel — and possibly the most risky — of the
 jobs being shifted. At the forefront of the trend is WellPoint, one of the nation’s largest health insurers and owner of Anthem Blue Cross, California’s biggest for-profit medical insurer.

In 2010, WellPoint formed a separate business unit, Radiant Services, aimed at advancing outsourcing and other cost-saving strategies. WellPoint has eliminated hundreds of jobs in the U.S. over the past 18 months as it has moved jobs overseas, a company spokeswoman acknowledged.

The spokeswoman, Kristin Binns, said WellPoint’s shifting of clinical jobs overseas was a small part of the outsourcing and being done through Radiant because it has the technical expertise and can ensure compliance
with laws. Nursing organizations, however, were cautious. “It’s obviously a very disturbing trend,” said Chuck Idelson, a spokesman for the California Nurses Association. “There are serious questions if you’re talking about utilization reviews ... and making recommendations on procedures.” Nursing experts said there also may be licensing issues as states generally require certification for those practicing and dispensing health information. 

Current and former Radiant executives declined to comment or weren’t available. It’s not clear how many other U.S. health care firms have contracted with Radiant or other outsourcing specialists, but industry experts said companies were increasingly looking at more health care tasks that could be outsourced globally as they face greater cost pressures and sweeping changes in how they do business. Aetna has an arrangement with EXL Service, a U.S.-based company with operations in Manila, to provide “targeted caremanagement support,” spokeswoman Cynthia Michener said. Health Net, which is laying off dozens of information technology and accounting workers whose jobs are being sent to India, said its outsourcing has generally been confined to administrative and IT functions. UnitedHealth Group, the nation’s largest health insurer, didn’t respond to inquiries. Outsourcing jobs out of the country has become a hot issue in the presidential campaign: President Obama is pounding Republican challenger Mitt Romney for his private equity firm’s involvement with companies that sent jobs abroad. Although such outsourcing has been going on for years, American manufacturers in recent years have brought some jobs back to the U.S. as labor costs have risen in China and elsewhere. 

Some experts argued that sending jobs abroad could help U.S. companies by enabling them to tap global talent and efficiencies, making them more profitable. When U.S. companies are stronger, the thinking goes, it creates more opportunities for American workers. Also, shifting operations to lower-wage countries can help consumers by holding down prices. 

Labor costs 

Outsourcing jobs to places such as the Philippines can save U.S. health care firms 30 percent in labor costs, according to experts. But the practice remains controversial, especially with the U.S. unemployment rate hovering above 8 percent. Patient advocates worry about crucial decisions involving a patient’s care being in the hands of foreign insurance adjusters. Analysts said there was another concern as well: patient privacy. Even something as straightforward as medical transcription can raise questions, said Uwe Reinhardt, a health care economist at Princeton University. Over the last year, Iowa Health System and hospitals in Utah and Washington state have joined other medical centers that have outsourced the transcribing of doctors’ notes and other records. 

“Suppose I’m an AIDS patient,” Reinhardt said. “That person in India would know — and ‘the information’ could be valuable to someone. ... For the U.S., there’s nothing more personal than health care.” Dr. Kaveh Safavi, head of the North American health practice for Accenture, a major consulting and outsourcing firm that has partnered with Well-Point’s Radiant, said nearly all countries have laws for protecting patient privacy. 

And to safeguard patients’ records, he said, health care companies store and maintain their records locally. 

As for outsourcing services that are more clinical in nature, he said, “People are looking at all the tasks that can safely and responsibly be moved. It’s still an emerging market. We’re still trying to understand the market’s tolerance for it.” 

In general, hospitals are moving more slowly than health insurers to send jobs overseas. But with financial pressures intensifying and the uptake of electronic record- keeping accelerating, analysts and industry people see more consolidation and outsourcing ahead. 

Virtual call center 

“Whenyouhavepeople’s medical, billing and other records kept electronically, then it opens it up to establishing a call center virtually anywhere,” said Steve Trossman, a Los Angeles spokesman for the Service Employees International Union, which represents hospital workers. “There is no longer a reason for it to be physically in the same place as the paper records.” 

Moreover, the health care reform law could prod insurers to move more jobs to cheaper-wage countries. The new law requires companies to spend 80 percent to 85 percent of premiums on medical care, limiting the amount available for administrative expenses. 

Few have been as aggressive as WellPoint, which made a profit of $2.65 billion last year on revenue of $60.7 billion. WellPoint’s total employment at the end of last year was 37,700, down from 40,500 two years earlier. 

In one of its recent efforts, WellPoint laid off pre-service nurses in Colorado and Nevada so the work could be done in Manila, according to a Labor Department filing by a WellPoint human resource manager in Denver. Well-Point spokeswoman Binns said none of the decisions that involve denial of procedures or treatment for patients are made overseas. 

Overall, Binns said, fewer than 2.5 percent of the 37,000 employees, or at most 925 workers, had lost jobs in the last 18 months as a result of work sent overseas. Only about 50 of those positions involved clinical management of care, she said. 

WellPoint’s “sourcing strategies have enabled us to make our services more effective, accessible and affordable to our customers, while allowing us to expand our programs and maintain our service levels,” she said. 

Shannon Cunningham of Columbus, Ohio, who processed medical claims for WellPoint, was laid off last month after a colleague went to the Philippines to train people to do her job. 

Cunningham, 43, said she received eight weeks of severance pay. She and others working in medical claims earned $30,000 to $40,000 a year with health benefits, she said. 

“I know other countries need work,” said Cunningham, a company employee for three years. But “I just felt like it wasn’t fair. We’re having a rough time too.” 




MICHAEL J. DOOLITTLE/BLOOMBERG NEWS 

Health insurer Aetna has a deal with EXL Service, a U.S.-based company with operations in Manila, to provide “targeted care-management support.” 

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