Medical outsourcing

Outsourcing of emergency department physicians, as well as radiologists and anesthesiologists in operating rooms, grew rapidly in the United States in the 2000s due a combination of several economic forces, and medical staffing companies developed niche expertise in various medical specialties.[1][2] Since 2008 a number of Swedish hospitals have used teleradiology services to outsource their emergency night-time radiology to Australia where daytime staff cover Swedish nighttime patients.[3][4][5]

Physician outsourcing has led to an increase in the number of people who received catastrophically large medical bills due to the outsourced physicians billing at out of network rates.[6][7] A doctor in Tampa Bay claimed in 2015 that an emergency department she was staffing while working for a division of Envision Healthcare had chronically purchased the services of too few doctors, leading to excessive waiting times there.[8]

Some organizations have used outsourcing through nursing agencies or other medical staffing agencies to deal with the nursing shortage and as a way to save money.[9][10][11]

Some small practices have outsourced business functions to management services organizations.[12][13]

Hospitals and medical centers also outsource revenue cycle management functions[14] and real estate management.[15]

People needing or wanting healthcare sometimes make decisions to seek care in a different jurisdiction; the decision may be based on lack of quality, availability, or legality in the person's home jurisdiction, or it may be a business decision based on the cost of acquiring the care. This form of medical outsourcing on the consumer side is generally called medical tourism.[16][17]