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5 difference-makers when you hire a healthcare-exclusive BPO


From closing health equity gaps to optimizing CMS Star ratings and keeping pace with digital health technologies, healthcare organizations have plenty of big picture topics that need their attention and focus.

Yet health plans and providers have to deliver top-quality customer service, too. For all the promises of technology, healthcare remains highly personal, and trust – or lack thereof – can make or break a relationship.

It’s a tricky balancing act for any healthcare leader: Providing trusted, high-quality services and support without spreading resources too thinly across different platforms.

Here’s where healthcare business process outsourcing (BPO) can really pay off. By outsourcing healthcare call center needs to a BPO focused on the healthcare industry, health plans and providers can save time and money, while providing patients and members the top-tier health-specific services they want and need.

Do your members need help navigating open enrollment? Are patients asking questions about their medication refills? A healthcare-focused BPO can answer questions like these with empathy and expertise.

Increasingly, plans and providers are turning to healthcare engagement outsourcing. The international healthcare BPO industry is projected to grow to almost $500 billion by 2026.

Here are some of the key advantages you’ll gain from choosing a healthcare BPO:

1) Healthcare BPOs provide deep subject matter expertise

The U.S. healthcare ecosystem is complex and subject to change. So are its workforce challenges as healthcare workers need to maintain specialized, up-to-date knowledge. Similarly, healthcare BPO workers know the latest industry rules and regulations, and they have the communication skills to match their technical chops

Unlike generalist BPOs that manage multiple industries, healthcare call center workers understand government regulations, licensing requirements and service-level mandates. They know about compliance programs, and have the Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) accreditations in place to ensure high-quality operations.

Larger BPOs that cover more than one industry can’t match the specialized knowledge base of a healthcare BPO and won’t be focused on evolving industry needs.

2) Healthcare-focused BPOs save you time

Working with multiple vendors for overlapping services just isn’t efficient. Yet many major health plans still outsource about 25% of their customer touchpoints, typically with 6-7 different suppliers. Many want to consolidate services to reduce costs and platform conflict, while still communicating with members quickly and effectively.

A healthcare BPO can provide a one-stop solution that consolidates all your healthcare call center needs in one place.

Your teams won’t need to learn about multiple systems’ workflows, and your IT department won’t struggle with integrating and maintaining multiple vendors’ software. Member engagement will strengthen as consumers experience more meaningful interactions with your healthcare call center, deepening trust.

Startups in emerging markets like fitness technology that are considering whether to build or buy a customer service solution can feel confident that a healthcare BPO will align with their specific needs as they scale.

Whether your organization is established or emerging, healthcare customer support outsourcing can free up your time to focus on growing your offerings and optimizing the quality of care.

3) Outsourcing saves money

All organizations want to save money. The bottom line matters in economic times, whether flush or lean. Employers know this, and also know that employees have evolving healthcare needs. As a result, employers want to expand health services while also managing healthcare costs.

Healthcare organizations themselves are no different. Many major health plans have large in-house call centers that require time and resources to maintain. Healthcare customer service outsourcing may be a way for your organization to continue to offer best-in-class operations and support, while benefiting from cost savings, too.

Choosing a healthcare customer service outsourcing provider to manage multiple aspects of your business can also boost customer familiarity, satisfaction and loyalty.

4) Customer service expectations are rising, too

Consumer expectations are soaring and many consumer health behavior changes during the pandemic are here to stay. In a recent study, 83% of consumers said their experience with an organization is as important as the product—but 47% said healthcare organizations care more about their own needs than those of their patients.

Investing in healthcare customer support outsourcing with a health-focused BPO is one way to close this gap. When patients and members feel they’ve been treated personally while also getting the answers they need, loyalty can grow.

patient-centric approach is one way to provide great customer service in healthcare. With a healthcare BPO, you’ll gain the advantage of deep industry knowledge, delivered by customer support teams that understand the importance of empathy and kind gestures during everyday  interactions.

5) Digital transformation is here – yet customers still need a human touch

The pandemic also quickened adoption of new digital tools and technologies. From telemedicine to AI chatbots to online mental health services, digital tools are transforming healthcare.

But human-to-human telephone interactions remain crucial in healthcare customer service.

Despite the allure of AI solutions, communication skills are particularly valuable in the field of healthcare, which is one of the most personal of all industries. Additionally, healthcare impacts nearly every consumer at different points of life.

And some customers prefer to engage with a human being, not an algorithm.

Healthcare BPOs like Carenet Health understand these unique pain points and can be trusted partners for health plans and providers.

By working with a healthcare-focused BPO, you won’t be just a random division of a generalist BPO. This can help you free up organizational time to focus on improving health outcomes with confidence, knowing that your customers have a knowledgeable, kind source of support.


ABOUT CARENET HEALTH- Carenet Health is the nation’s premier healthcare clinical and consumer engagement partner—providing 24/7 telehealth, engagement, clinical support and advocacy solutions on behalf of 250+ health plans, providers, health systems and Fortune 500 companies. More than 65 million healthcare consumers have access to our teams of engagement specialists, care coordinators, RNs and other licensed healthcare professionals each year.