Health care companies send nursing jobs overseas

(Charlotte Observer) 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 companies, for example, help assess patient needs and determine treatment methods.

Outsourcing such tasks goes beyond earlier steps by health care companies 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 has 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 Inc., 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 last 18 months as it has moved jobs overseas, company spokeswoman Kristin Binns acknowledged.

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. She said no decision that involves denial of procedures or treatment for patients is made overseas.

Nursing organizations were cautious.

“It’s obviously a very disturbing trend,” said Chuck Idelson, a spokesman for the California Nurses Association.

Nursing experts said there 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 companies have contracted with Radiant or other outsourcing specialists, but industry experts said companies were increasingly looking at more healthcare tasks that could be outsourced globally as they face greater cost pressures and sweeping changes in how they do business.

Aetna Inc. has an arrangement with EXL Service, a U.S.-based company with operations in Manila, to provide “targeted care-management support,” spokeswoman Cynthia Michener said.

Health Net Inc., 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.

Although 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.

Outsourcing jobs to places such as the Philippines can save U.S. health care companies 30 percent in labor costs, according to experts. But the practice remains controversial, especially with the U.S. unemployment rate hovering above 8 percent.

 

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