BPO Outsourcing Companies Can Support Next-Generation Business Models

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Like every other industry, the healthcare sector has been deeply impacted by COVID-19. Between 2012 and 2019, profit pools (earnings before interest, taxes, depreciation, and amortization – or EBITDA) grew at a compound average growth rate of approximately 5%. This was partially boosted by the 2010 Affordable Care Act, which triggered incremental health spending, resulting in $130 billion of incremental healthcare spending by the federal government.

The next three years are predicted to be less rosy for the industry however, for several COVID-related reasons. The October 2020 unemployment rate of 6.9% suggests that a large group of individuals may have moved from employer-funded insurance to other options. In fact, based on research trajectories, it is expected that between $70 and $100 billion in funding may leave the healthcare system by 2022 – driven by product buy-downs, coverage shifts out of employer-sponsored plans and Medicaid rate pressures at the state level. Those numbers are hard to ignore, and healthcare companies need to look at the big picture and develop strategies to navigate a post-pandemic economy.

Significant chances to innovate will present themselves. Out of the payer vertical, estimates are that Medicaid profit pools could increase by 10% as a result of post-pandemic enrollments and normalized margins. In the provider vertical, the surge of telehealth and other virtual care models offer major options for outpaced growth. Developing new and innovative business models will be critical to supporting the level of EBITDA growth that the healthcare industry experienced over recent years. The opportunities are out there.

Healthcare leaders that have shown their willingness to embrace new models are now proactively and fundamentally reshaping how the industry operates, and how healthcare is delivered. These systems are delivering better care and generating higher returns through the use of care integration, data and advanced analytics. Additionally, payers that are deploying next-generation care models are better serving individuals with complex healthcare needs, chronic disease and other long-term conditions that require more continuous management.

As alternative care sites have expanded (physician practices, ambulatory surgery centers, urgent care centers), the returns being generated are exceeding expectations. These innovative systems have been able to lower costs, enhance coordination and improve patient experience and outcomes, while maintaining or enhancing the quality of service. These are the structures that are positioned to succeed. Factor into this dynamic that consumer adoption of telehealth has skyrocketed (11% of US consumers using telehealth in 2019 to 46% using telehealth in 2021) and the trend is clear. Pre-COVID, total annual revenues of US telehealth stakeholders were estimated at $3 billion. With the acceleration of alternative care sites and the extension of telehealth, it is predicted that up to $250 billion of US healthcare spend could be virtualized. Tech-enabled care is the true healthcare wave of the future.

Another big innovation is the direct-to-consumer pharmacy space, which now includes non-healthcare players such as Amazon (through its acquisition of PillPack in 2018). COVID-19 triggered powerful growth within this model, and the trend toward delivery of pharmaceutical care at home continues. As in most other industries, technology is playing a huge role in the healthcare industry. Healthcare stakeholders need to consider how their business models must change to create value in the future healthcare world, how to rewire their organizations to design them for efficiency and speed, and how to prime their operating processes and technology platforms to maintain a competitive edge.

Such an edge can be seamlessly introduced through partnerships with experienced BPO / outsourcing companies. Anexa is an award-winning business process outsourcing company with two decades of expertise and dedicated teams of business process specialists. Whether your needs are customer-centric with tech support, social media management or marketing campaigns; or non-core business processes that include back-office solutions, Anexa has a team for that. Factor in that we also specialize in bilingual services (English/Spanish), and this is a call that you can’t afford NOT to make.

Have questions? Reach out today for information on how Anexa can support your post-pandemic business processes.