Outsourcing clinical workflows to offshore partners is becoming increasingly popular and is highly cost effective. But there are challenges that come with outsourcing,

More than 500,000 registered nurses are expected to retire by 2022, and the U.S. Bureau of Labor Statistics estimates that 1.1 million new RNs are needed to both replace the retirees and avoid a growing shortage.

The increasingly complex health care system is in high demand for clinicians to work in non-traditional care settings, too. Health plans desperately need to scale to handle the rising number of claims in a post-pandemic world. But it’s a daunting task to find the right qualified talent—and quickly to handle the growing pile of complex clinical workflows.

Outsourcing clinical workflows to offshore partners is becoming increasingly popular and is highly cost effective. It can save you the time and money it costs to hire, train, and launch your own clinical teams.

But there are challenges that come with outsourcing, like maintaining quality and scaling quickly, that can make finding the right partner an overwhelming task. Here are seven things to look for when choosing the best health care business process outsourcing (BPO) partner:

1. Dedication to quality
As health plans know, quality is costly. It is a common fear that by partnering with a health care BPO to increase efficiency, you are sacrificing quality. All health care BPOs promise to increase efficiency, so look for a partner that emphasizes quality.

At Shearwater Health, we have developed a training framework that instills a feedback loop between quality and training to ensure a seamless knowledge transfer process. We monitor the team’s performance daily to identify and address any knowledge or skills gaps. We also provide quality reporting to our client that includes training opportunities and action plans. As a result, we’ve achieved a 99 percent quality rating for medical record reviews in HEDIS®.

2. Modes of transparency
A common stereotype with outsourcing is that it can operate like a black box, with little to no insight on how quality standards are being met. A great vendor should feel like an extension of your team, not a mystery third-party.

Look for a partner that offers a designated account manager. This person serves in a liaison role to help facilitate communication between you and your outsourced team, provide insight into the quality and production of workflows, and offer support as needed.

3. Ability to handle complex clinical workflows
It’s important to look for a partner who invests in the talent recruitment process to ensure that clinicians with the highest skillset are assigned to your clinical workflows.

At Shearwater Health, we rely on talent from the Philippines because their nursing curriculum is comparable to U.S. nursing. We look for nurses with an average tenure of 2+ years and we’ve built retention strategies to keep our top talent engaged and help them grow professionally.

4. Meet highest standards of security and compliance
A health care BPO facility can be just as secure as their U.S. clients—sometimes, even more secure—but only if they meet the highest security and compliance standards. Look for health care BPO partners that are HITRUST and URAC certified, SOC 1 & 2 compliant, and can validate HIPPA compliance through external audits. It’s also important to ensure that all data is stored in the United States and they have a strong business continuity plan.

5. English proficiency
There exists an assumption that anyone from outside the United States is going to have a thick accent that’s difficult to understand over the phone. The top BPO companies will invest in countries like the Philippines that are English-educated. Look for companies that have tests for telephonic capability and provide accent neutralization training.

6. Seamless implementation process
While outsourcing clinical workflows can feel daunting and appear time-consuming to implement, the right partner will utilize strategies that create a quick and seamless implementation. Look for a BPO company that operates like a turn-key solution.

7. Health care expertise
Many BPO partners offer services in a variety of different industries, not just health care. It’s important to look for a partner who has tenure working in the health care space and has a large percentage of their operations based in health care. A reliable partner will also have strong references and well-known clients. At Shearwater Health, all our services are health care focused.


About Shearwater Health
Shearwater Health provides global health care solutions by expanding clinical capacity worldwide. There is a significant nurse shortage in the United States that is only growing. We believe there’s a responsibility for companies like Shearwater Health to provide solutions that help mitigate this shortage. Since 1973 we have continually developed our clinical staff to meet the needs of health care providers, payers, and any company with needs that require skilled clinical experience. Our desire to provide high quality nursing staff and Clinical Process Outsourcing® (CPO®) fuels the solutions we provide to our clients.