CategoryHealthcare

New Financial Services in US Healthcare

SSON speaks to Susir Kumar (MD & CEO, Intelenet) and Suresh Ramani (President – North America Sales & Operations, Intelenet) about outsourcing trends for the next year, acquisition of captive centers by BPO and how changes in the U.S. healthcare represent opportunities for Intelenet.

SSON: Let’s start with a look at BPO generally. We’re just seeing the back end of a global recession – how has this affected Intelenet over the past few months?

Susir Kumar: OK. A BPO is basically the back end of a company’s operations, so we handle their customers’ transactions. Through the recession period we have seen, for example, banks issuing a lesser number of credit cards; banks giving fewer mortgages; the new accounts that are being opened up have reduced. We are the back-end supporter of these clients of ours: the volumes coming in from these clients of ours have actually gone down, so if we were issuing 60,000 cards a month for a particular client it perhaps went down to as little as about 5,000. We became extremely concerned about issuing any further loans [while] people were just not willing to spend money or buy things, and all of that had a significant impact on the number of transactions and the number of calls coming in.

What we first saw in this initial phase of this whole recession was volume reduction, and a whole lot of companies being extremely concerned about whether they would survive through this phase of recession or not. So everyone started strategizing around how to survive. We had a set of companies which thought by taking certain actions they would survive, and then we had a set of companies which were pretty concerned about their survival. So in some companies we actually saw some drastic measures being taken, and now people were not expecting the traditional outsourcing deals. They were asking us “Tell us how you can accelerate the cost savings process? I know you can give us 50% reduction of costs after 18 months: is there a way that you can give us 30% right now?” So it was a completely new expectation that came in, and I think after the first six months of recession we saw a lot of companies coming out with the question, [so] we had to change our value proposition or our offers to clients and prospects… Then we started observing, over the next six months to about nine months, that these companies were making faster decisions: in the past it would take anything between six to 18 months to take a decision on outsourcing or offshoring, but during this phase we were seeing companies taking decisions as quick as maybe two or three months.

We noticed that clients who had outsourced just about 15% or 20%, were all talking to us about how they could increase the outsourcing/offshoring percentage, and get their costs down; so we also went after every company that had outsourced just a small component, and we told them that “yes, in this case you are saving $5 million a year, or $10 million a year; here is another opportunity where you can accelerate and increase the scope of offshoring and outsourcing, and you could save potentially double or triple the amount that you are currently saving.” The third thing that we saw was, [before the recession] people would not make an offshoring or outsourcing decision if the saving was, say, less than 40%. In the new environment we saw that even if we gave a value proposition of savings of 15%, people would make a decision. Three years back we would never go to a company if the value proposition was just a 15% saving.

I think right now we are in this phase – where from the bottom our clients have actually been growing about 5 to 10%, so we have already seen more cards being issued, more mortgages being given, more people traveling; in the travel segment that we handle, we are seeing a lot of demand coming up. And in the last six months most of the companies that have downsized their own labor force, are all believing that there is going to be some growth in the next six to 12 months. Albeit, these companies are not convinced that this growth is going to be sustainable; people are generally believe that 2012, is where they will see a growth equal to what they saw in 2007-2008. So the value proposition that we are offering to our clients is: ‘you guys have come out with a plan for next year that talks about 10% growth versus the bottom; rather than you building your own capacity and people why don’t you look at working with us, because you can turn on the tap or turn off the tap with us, whereas it’s more difficult for you guys to do it in your environment where it’s expensive and more regulated.’

SSON: Looking forward then, Susir, what now do you see as the biggest challenges facing outsourcing providers? And how are you positioning Intelenet to overcome these?

SK: Just to give you a summary: over the last, say, 18 months to 20 months, we’ve actually seen a reduction or a contraction of our existing business of around 10% to 15%. But there is new demand which is offsetting this shrinkage, and net-net we are still seeing a 10% growth. The good news is that people are making faster decisions and looking at outsourcing more. Because of these multiple reasons and the fact that we are giving them capacity as a value rather than just cost, there has been a growth in our existing-to-new business, to the extent of almost 25%, which after offsetting the 10%-15% shrinkage still accounts for 10% net growth. So that’s the bottom line of the whole thing.

People are also negotiating more. And people have actually tested the market in the last 18 to 24 months and trying to squeeze a little more out of service providers like us. When they came in through this phase of recession and asked us for a 5% or 10% discount, we gave it to them because these are long-term relationships, and we have to reciprocate in some form in their time of difficulty. Now this is becoming a new norm for pricing.

We have also learned in the last 18 months or 24 months to run the operations more efficiently. So what we have been telling the clients in the last 18 months is, “ok, you guys want a 10% discount, we’ll give you a 10% discount. But don’t dictate to me in terms of where the operations should be run from, what should be the span of control, what should be the kind of technology – you tell me what is the end result you want, in terms of efficiencies, in terms of turnaround times, in terms of accuracy, and let me decide how and from where to run the operations, and I’ll give you the 10% discount.” So what has happened in the last 18-24 months is we have been given the freedom to decide how to run and from where to run the operation.

Net-net, though we have reduced the price, we have been able to get the same margin as what we were getting in the past..

Another big challenge is that people are asking for more and more financially structured deals, rather than the regular outsourcing which is a per-FT price or a per-transaction price; it’s becoming a little more complex. They are asking us to fund the redundancy, they are asking us to fund the set-up costs; there are a few clients that are asking us to take an outcome-based pricing, and we’re taking more and more of that. I think from a risk perspective, we are now required to factor in if at all we have funded the redundancy – and if the contract is say over a period of 5 years, if it actually gets terminated before that, then we will not have to cover the entire funding of redundancy that we have done.

Companies are also coming and telling us, “guys, just take our operation lock stock and barrel, and you guys decide the onshore/offshore mix, etc: this is what we want as outcomes.” And what that means to us is investment; taking over the risk of pensions of these employees and costs associated with just aligning that new business that we buy out with our business, and so on and so forth. In the last six months we have done about five acquisitions of just the back-end operations of a company. And that always has the challenge of integration – and the risks.

SSON: That’s an interesting point: at the moment we’re seeing a lot of BPOs buying into shared services captives, for example Cognizant and UBS: is that something on your agenda for 2010?

SK: Yes they are, and actually, one of the advantages we have is we’re not a listed company, and being a part of Blackstone, we do have access to capital. When you acquire a back office of an existing company, what you need is capital, and an ability to take the impact on your P&Ls for the first six months or a year of buying out the company.

For example, if I were to buy the back office of an existing company, the company would expect a reduction of costs of, say, 20%. In the moment that you buy it and you start billing 20% less the next day, you’re actually incurring a loss in your books, because the cost structure and the way the operations are designed needs you to spend, for example, 100 and you’re only actually billing the client about 90. There’s a hole in your P&L. Only after about six months to one year you will start reducing your costs, you will start building efficiencies in the processes and so on and so forth, and you will be able to bring down your costs from 100 to, say, 80 or so – and because the client is paying 90, you start making a profit of 10. What this means to us is it will impact on our P&L accounts for a period of one year. But because we are not listed it really doesn’t matter to us; and the good thing is, normally when you do a transaction like this we ask them for a lock-in – to provide us a commitment of business for a period of time. And as I told you we did about five transactions in the last six months: all of those five transactions have come with a revenue commitment for a period of time. You will see us do more and more of these kinds of deals both onshore as well as offshore.

SSON: Who have you done transactions with over the last five months?

SK: We have done one transaction with one of the large banks, we are about to finish off a transaction in the UK. We bought two captives from travel companies, we bought one captive from a very large bank, we about to buy one very large captive from a transport company in the UK and we have also bought another company in the retail space, reasonably big: about 200-300 seats.

SSON: Moving on, Susir – let’s take a look at healthcare? We are running this a US healthcare series with Intelenet, can you give us some insight into the work you are doing directly in this space?

SK: There are two things. Firstly, Blackstone has about ten companies in the healthcare space in the US, either on the provider side and the payer side. Secondly, we are looking towards the regulatory changes that are taking place in the US: The new regulations will mean if a person in the US goes and applies for insurance, that person has to be given an insurance policy. Today they may just go and tell a customer that they will not give insurance coverage at all. The Obama administration is opening up insurance in that, earlier, insurance companies could only provide insurance for people in a particular jurisdiction – which could be a particular state, for example the state of Arizona. Now they have allowed these insurance players to give insurance policies across the United States.

So taking Arizona again for example – say there were four large insurance companies giving health insurance; all of a sudden now there are companies from New York that are issuing polices in Arizona, there are companies in Texas issuing policies in Arizona. The number of companies actually providing insurance cover has gone up by virtue of this new regulation. So in suammary, they cannot deny people coverage and the competition has actually gone up. By virtue of this we believe that both the insurance payers and insurance providers will have an implication on their cost and profitability.

A new code is also being prescribed. If you look at any medical diagnosis or procedure in the US or across the globe, it needs to be codified. For example if someone is diagnosed with four ailments, each of those needs to be coded; or if some surgery has been performed on a particular person then this again needs to be coded. This coding helps to keep medical records, and also helps to pay the insurance company and the hospitals – so insurance companies use this code to work out how much to pay for hospitals based on whatever ailments they have. Now this code is undergoing a change from what is called an ICD9 to an ICD10 which increases and changes the way things are codified.

So what does all of this mean to companies? Firstly, they will need to retrain their people in coding, they need to change the systems that they use for coding and, because the number of codes has gone up, they need to get more people into coding. The government will monitor payers and providers to make sure the coding is done properly. All of this will cause a huge impact on the healthcare companies in terms of costs and profitability so our value proposition at this point in time is that we can come in and help with codification. You don’t need to train people at your end, because we can either get these people onshore in the US or we can help you with an offshore solution. When you provide an offshore solution, the cost comes down – or it helps with the new issue we have in terms of competition and the universal access. As we have access to the ten companies in the Blackstone portfolio, we are already doing work for a few of them, we can just leverage this expertise and get across the whole market. So the reason we are focusing on the US is, one, to take advantage of the new situation, and two, to leverage the expertise we are already building by virtue of doing work for a few of these Blackstone portfolio companies, both on the payer and the provider side.

Suresh Ramani: I think if you were to draw a context of where US healthcare has been traditionally and where it is moving, I think there is cause for worry. If you look at the spend in 2008, they spent about $2.4 trillion on healthcare – which is about 17% of GDP – and of that $2.4 trillion, 80% of that went to 20% of the population of the US of the insured. That number today is going to double, within the next eight years the spend on healthcare will be about $4.5 trillion. So you can see the exponential growth and with all the reforms which Susir has talked about, such as universal access and going outside the state to insure, the risk appetite of all the providers is going to go up.

The other big piece is the unfunded mandates which are the conversions of ICD9 to ICD10 which as a program, I think, whether other countries have adopted, the US has to adopt, and that will be a regulation which has to come into effect by 2012. So, these are again costs that the providers and payers need to absorb.

Another big component to this is in terms of the reimbursements which will come down, because the Obama administration wants about $400 billion out of the spend to pay off the deficit. So if all this is going to happen, the payers have to focus on their operating costs if at all they are to survive – or there will have to be a story of consolidation or elimination out of the 1,800 payers in the American market.

There is also the issue of regulatory compliance. With all these changes, it is difficult to keep processes up to date; as a result healthcare insurance carriers are not meeting obligations to the state, to the federal government – and they are paying huge penalties. So Intelenet can step in here and fix these problems. The most important piece to that is not only do we consult but we actually implement process improvements. The other piece to this is that we get solutions which are both BPO and technology related so there is process optimization that we focus on and an enabler to that is outsourcing or offshoring. So clearly three things: regulatory compliance, driving down operational costs and improving quality, I think are our three pillars, if you will, of our service delivery.

SSON: Susir, you talked about the services that are being outsourced: processes and compliance etc, and you mentioned coding. What other services do you expect the healthcare industry in the US to outsource to you?

SK: There are two sets of people in this space: providers – basically hospitals and payers who are the insurance companies. On the providers’ side, there are also companies which provide medical equipment – so again another huge market. For example, the services we provide for hospitals are coding, billing services, contact center support, claiming monies from insurance companies – if somebody goes through a procedure then we need to ensure that the doctor writes it on a form and the form is scanned and it comes to us – we need the machine, we need to do the right coding, we need to send it to the insurance company to check that it is covered. If it is not covered by the insurance and it’s a deductible amount, we need to go after the insured. Then we need to raise a bill and say the payers challenge what we have invoiced, we negotiate and close those issues. Then there are complaints, and complaints management. On the payers side we receive invoices, we pay invoices, and we reconcile accounts.

SSON: Are you providing these services from onshore or are you providing from locations in India?

SK: There are clients who are asking us to do some piece of work onshore in our location, or in near-shore locations, or offshore. So, we are working with all of the models. We are offering clients both India and the Philippines. The Philippines has a lot of nurses who are either looking at going to the U.S. or who have returned back from the U.S. So that is a big pool that we are tapping into to say that “if you work with us in the healthcare space, it may be an added experience for you guys when you seek a job in the U.S”. Or for people who have come back from the US, when they already know the nuances and systems there, they can be readily employed in an environment such as the Philippines. We also have a site in Poland, again a good site from where we provide services in healthcare.

SSON: You are obviously looking very closely at the US healthcare space; do you foresee Intelenet possibly expanding into other countries?

SK: We have had a client from the UK for the past 8 years. But as there is a huge demand now from the US, we are all focused on the US. [But] we will be going beyond the US to other geographies. India itself is a huge market. The amount of people who are getting covered under insurance in India is huge; everybody now wants cover and there are a lot of healthcare companies, both on the provider and payer sides, coming into India. This is a completely new market for us.

SSON: So why do you think new customers – within the US or India further down the line – should sign with you as opposed to any of your competitors?

SK: I did mention to you that we have about ten companies in the Blackstone portfolio, all of whom we’re working with pretty closely – and the work that they give us covers almost the entire range of work that healthcare insurance companies look at outsourcing. Now these companies have not been used to offshoring and outsourcing as much as the financial services sector, and one big thing they will look for is, “are you guys really doing this, why I am looking at outsourcing?” And we are able to demonstrate an actual live case of the work they’re expecting to outsource. Also what we have done is significantly enhanced our management of healthcare, so we have of late recruited about half a dozen people who are some of the best-known people in the healthcare industry in the US; these are the guys who actually build applications for healthcare companies. We’re also leveraging, through the Blackstone portfolio, networking with people who are actually working in the companies, to see how they can work along with us, to build solutions for some of the companies in the U.S. We have a program where we can actually import people who are working with healthcare companies as part of the Intelenet team.

SSON: What other sectors do you think will provide you with the greatest scope for expansion over the next few years?

Suresh Ramani: I think there are some key areas that are going to grow in the US market. One is utilities and the second is government spends, but healthcare makes the biggest growth pie. Clearly speaking for us as an organization the US contributes about one third of our revenues. We’re equally distributed in the Indian market as well as the UK market. On an overall basis we see the banking industry again moving, not at an aggressive pace, but at a reasonable pace over the next 18-24 months; we can see some good traction in the marketplace. And we are very strong in the banking and financial services space. We have today close to about 8,000 people working in this market, and doing all the types of processing that you can think of doing for a bank. In short, if we had the money, we would be a bank ourselves!

Another area of growth for us is travel and hospitality. Susir started off pointing out that people are not travelling so much, but it’s a matter of time: when the economy starts looking up, there will be demand for travel as well as hotels. So that’s an area where we already have invested, both onshore and offshore and we have close to about 3,000 people in that space, so that’s again a focus area for us.

Telecoms is a focus for us especially in the Indian market; that’s a sunrise industry, with every month about 1 million customers being added in the Indian market space. Telecoms account for close to about 10% of our revenues today. And of course we are getting into new markets: Australia, we have a presence there, and we also do work for utility companies from Australia. The Middle East is again a good opportunity that we see for banking. And Europe of course with Poland coming in. We also have a center in Mauritius which caters for French opportunities. And all this will give us an identity of being a global player located in these markets who also can do work for these markets from low-cost destinations. So clearly we are moving away from a brand identity of an Indian-based BPO provider to a global BPO provider.

SSON: And is acquiring businesses in those locations a key priority for you?

Suresh Ramani: Absolutely. Like, in the US we already have two centers up and running with close to a thousand people; we have a partner signed in Australia. Susir talked about having a site in the UK now. So big markets, yes, certainly I think that’s a growth engine for us. We want to be present with a reasonable population in each of these countries.

SSON: Where would you like to see Intelenet in five years’ time?

SK: What we’re really trying to be is a one-stop shop for all the things associated with outsourcing and offshoring. There are companies who want multilingual solutions; there are companies who want multi-geography solutions; there are companies who want consultancy solutions; there are companies who want technology solutions; there are companies who want actual business process solutions, which might be either in terms of costs or in terms of efficiency; there are companies who want analytics. So everything which is a pain around the business process side, is what we want to really provide. That’s our focus; in the next five years that’s what we want to be: a company that can design, a company that can put in the relevant technology for implementing the design, and a company that can execute the business process. So we are looking at a one-stop shop for all the things associated with the business process.

SSON: Comparing yourself with other Indian BPOs such as Wipro or Tata – there’s plenty that have emerged out of India – how would you put yourself at the forefront, as an organization?

SK: If you look at Wipro and TCS – all the IT companies, all the large Indian IT companies, they are predominantly focused on IT and BPO is a sub-segment of it. If you look at the percentage of revenue that comes from BPO versus IT, BPO is a very small component. Compared with the IT companies, we are a focused BPO company – and I think that people who are seeking a large impact, like telecom companies or retail companies or banking companies, who have a lot of dependency on good operations to get in new business in new markets, they in the long term would rather work with a focused BPO company than an IT company that has got a subset of BPO, number one.

What we do is basically bolt on technologies which can build efficiencies into the processes that are outsourced or offshored – so we have scanning solutions, workflow solutions, ERM solutions, etc. Whereas the approach that an IT company takes is to build a solution. So that’s a difference between the two of us. There are instances where we lose deals to some of these IT companies; there are instances where we win deals against them. It depends how the buyer is looking at it: if they want more IT and less BPO they’ll go to companies like TCS or Wipro. If they’re looking at specialized BPO services, they come to us.

There’s also going to be competition from the Accentures and the IBMs of this world; but I think there are also issues with them in terms of cost, in terms of flexibility, in terms of speed, and that they’ve become too big, and we think very clearly we have an advantageous position against these guys because of the size and nimbleness and speed and the flexibility with which we can clear transactions. That’s where we have seen we have been able to win deals against these guys.

SSON: And do you consider yourselves competitive on price?

Suresh Ramani: Absolutely. We are best in class.

SSON: Of course you’re going to say that! Finally, I’d like to ask you: what is your definition of the perfect outsourcing relationship? And the perfect client?

SK: I think in terms of the services that we provide, everybody provides more or less a similar service. In the long term what really matters is the element of trust. And my definition of a true relationship between the company that is outsourcing and the company that is providing a service is that you can really live like a partner. So for example if you see the recession that we’ve had in the last 24 months, people have come and asked us for things which aren’t written in the contract. They’ve said, “we’ve actually given you a commitment of a minimum, a minimum commitment of so much: I can’t live up to the minimum for the following reasons.” Have we gone and sued them? Or have we really recognized that there has been a difficulty? I have not gone by the pure letter of the contract, but really responded like a true partner, and helped people through difficult times. And they have responded back, most of the companies to whom I gave discounts and to whom I let off a lot of conditions in the contract, have in the last three to six months come back and said “look, Susir, we’re looking at something new, and we really want to work with you; we don’t want to call for an RFP, we just want to stick with you guys because we trust you.”


Creating Printed Materials For Healthcare Marketing Professionals

Many times, marketing or advertising agencies have a broad range of clients. As a result, the marketing professionals that work for the company need to know how to extend their knowledge to accurately represent all types of brands and organizations. Because different marketing methods are employed depending on the type of client, it can sometimes be hard for a non-specialized marketing agency to accurately market and gain business for every organization or company they represent. For instance, one would go about marketing a non-profit differently than a restaurant, and also differently from a healthcare facility.

The healthcare field is one such field that needs to be marketed differently. For those looking to get the word out or re-brand their healthcare organization, it’s a good idea to turn to healthcare marketing professionals with vast experience in the field. With an organization that focuses specifically on healthcare marketing, clients can expect great results that successfully advertise their name to the public and ultimately increase their facility’s ROI.

Let Marketing Professionals Handle It

The hallmark of many healthcare facilities is printed materials including newsletters, magazines and collateral marketing materials. It can take a lot of time, money, and effort to create beautiful, error-free publications that are easy to read, appeal to a target audience, and are well designed. Those in the healthcare field, even in an administrative or managerial role, often don’t have the time, marketing know-how, or technical printing background to effectively market and brand an organization.

With an agency that specializes in healthcare marketing, clients can rest assured knowing that their healthcare facility will be advertised to the right people, the right way. Healthcare marketing professionals can help create and distribute content relevant to each specific healthcare field. Whether it is in the form of newsletters, in-house magazines, or physician publications, the content created by these marketing professionals will improve your relationship with your target audience.

Printing for Healthcare Marketing Clients

Healthcare marketing professionals may focus on healthcare, but the basis of their education is in effective marketing. Marketing agencies are made up of experienced writers who can promote healthcare organizations and successfully communicate their benefits and features to clients, doctors, and potential customers. Graphic and web designers can create beautiful, eye-catching newsletters, magazines, and web pages to go with the compelling text. And healthcare advertising professionals know how to properly prepare a document for print, and where to go for the most cost-effective yet professional print job.

Newsletters sent to clients or patients are a great way to let them know about upcoming specials, new services, a change of hours, or any other business news. In-house magazines can spread the word within the company about individual professional achievements, upcoming events, and more. Publications specifically for physicians can highlight new, innovative medical technology and methods, and employee publications can keep workers in the know, promoting company unity.

Hire healthcare marketing professionals to accurately portray your healthcare organization to the public. These professionals are able to create expertly printed materials with a polished voice that effectively communicates news to current and potential clients, other doctors, and competitors in the field.


The Perfect Storm in the Looming Healthcare Human Capital Crisis

Just as our country has endured an unprecedented economic crisis in the past 24 months, the United States will soon be in an unprecedented healthcare HUMAN CAPITAL crisis that will catch many off guard, just as the economic crisis of 2008 did for so many. There are several factors for this with Healthcare reform setting the stage for the “perfect storm” as the first of the “baby boomers” turns 65 in 2011. Just as government run Fannie and Freddie Mac helped fuel the economic crisis of 2008 – the current environment is ripe for a healthcare human capital crisis. It is no question that reform in healthcare is needed. What type of reform is the ultimate question. In their book, Redefining Health Care, the authors point out the following; “Health care is on a collision course with patient needs and economic reality. In today’s dysfunctional health care competition, players strive not to create value for patients but to capture more revenue, shift costs, and restrict services. To reform health care, we must reform the nature of competition itself.”

The Institute of Medicine in their 2008 report Retooling for an Aging America clearly leads the way when it comes to understanding the significant impact of the aging population which has not been seen before in our history. Here are the facts from the IOM report 2008.

1. Between now and 2030 the number of adults aged 65 or over will double. This dramatic shift will place unseen and accelerating demands on the US healthcare system. The sheer number of older patients will overwhelm the number of physicians and other healthcare professionals unless something is done.
2. Beginning in 2011 – the 1st wave of the baby boom generation will begin to turn 65 – the 78 million baby boomers will tip the population scale growing from 12 to 20% by 2030.
3. Older Americans will consume much more healthcare and this is not built into the $900 billion Healthcare reform estimate. The current 12% of older Americans currently accounts for 26% of all physician visits – by growing to 20% – older Americans will account for more than 50% of healthcare utilization just as these reforms start to take affect.

The recommendations laid out by the IOM report are essential in healthcare reform – but have not been addressed in the current healthcare model. Other demographic factors are at play, such as, the aging healthcare workforce. Leaders in healthcare human capital retention understand that we are in the “eye of the storm” with a false sense of security with the impending wave of baby boomers, the backlog of new grads, and the eventual retirement of veteran nurses. This is especially true in the competition for quality licensed healthcare professionals who drive the revenue and deliver the highest quality in patient care. The reality is that the demand for healthcare is going up and the supply of available licensed professionals is going down. This demand cycle will be good for professionals who will see significant growth in salaries and perks, but it will be a challenge for healthcare organizations wanting to attract and retain their people with the aging population and workforce – added with the new demands of Healthcare reform.

The “true cost” of the current healthcare reform can not be calculated – needless to say it will be a number that makes the Wall Street bailout seem insignificant. Healthcare reform is certainly needed – we are on a “collision course” with both the demographic and economic reality. The type and degree of reform needs to have all healthcare leaders involved in the debate as reform is being constructed like a makeshift life boat as the storm clouds appear on the horizon.


Healthcare Recruiting For Physical Therapy

Healthcare recruiting for physical therapy is gaining prominence as many studies have shown that there are shortages throughout the physical therapy profession as well in healthcare facilities that employ physical therapists. The structured healthcare recruiting services of dependable healthcare staffing solution providers enable medical care facilities to recruit qualified physical therapists.

Recruit Talented Physical Therapists

Several reputed healthcare staffing agencies in US offer competent recruitment services based on the requirements of healthcare employers. The recruiting agencies maintain regular contacts with the various healthcare facilities. They are therefore well informed about vacant job positions in these facilities.

To fill the physical therapy job positions existing in premium healthcare centers, these recruiting service providers make every effort to identify hardworking, dynamic and skilled candidates. The entire recruitment procedures including preliminary evaluation, candidate sourcing and interviewing are handled by skilled professionals. Moreover, they also help healthcare facilities to save the money, time and effort needed for putting out placement advertisements and conducting the recruiting process on their own.

Placement Services for Domestic and Foreign-trained Candidates

Healthcare recruiting agencies enable domestic and foreign trained physical therapy professionals to secure permanent, temporary, part-time, full-time, long-term, short-term or travel jobs in well-known healthcare facilities, and public and private organizations. These include rehabilitation clinics, hospitals, physician’s offices, acute care clinics, nursing homes, long term care centers, government organizations, home healthcare agencies and educational institutions.

Healthcare recruiting agencies provide physical therapists the opportunity to gain know-how and experience by placing them in challenging job environments. Successful candidates enjoy remuneration packages which include benefits like:

• 401(k) retirement savings plan
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• Additional state licensure

Locate Eminent Service Providers

Competent healthcare agencies make hiring easier and better. With the use of advanced technology, targeted searches and experienced recruitment team, they are well-equipped to provide healthcare facilities with qualified and experienced physical therapy professionals.


Healthcare Environmental Issues and Opportunities

The healthcare industry affects the lives of virtually everyone in the United States. According to the Centers for Medicare and Medicaid Services (CMS), healthcare expenditures will account for approximately 17% of the Gross Domestic Product this year. Many activities in the healthcare industry result in land, water or air pollution. Much of the waste is recyclable and consists of paper, cardboard, glass, plastic and metals. There are two other types of solid waste in healthcare: regulated medical waste and hazardous or chemical waste. Additionally, hospitals discharge large amounts of wastewater and release air emissions from their facility operations.

Oftentimes, hospital services are decentralized, departmentalized, or even managed by contracted services. There may be little or no centralization of efforts. There may be minimal regard, knowledge or control over minimizing waste or environmental impact. If healthcare organizations really want to decrease costs and reduce their carbon footprint, they must embrace sustainability with the full support of top management. They must pay close attention to what they purchase and what they discard.

There are many variables affecting healthcare waste minimization:

* The types of products and materials purchased

* The types of waste segregation systems

* The degree to which wastes are identified

* The locations of the waste generation

Healthcare wastes can be categorized as:

* Municipal

* Recycling (Pennsylvania Act 101, for example)

* Regulated medical waste (Bio-hazardous or Red Bag Waste)

* Hazardous waste (listed and characteristic waste, commingled waste, pressurized containers and ignitable gas, and universal waste)

* Universal Waste (Batteries, Fluorescent Bulbs, Electronics, Mercury-containing Equipment)

* Waste water, Storm Water and Air Emissions

Municipal Waste:

The United States healthcare industry generates 6,670 tons of waste per day, most of which is solid or municipal waste. Of this solid waste, more than half is composed of paper and cardboard. Hospitals with excellent recycling programs recycle over 40 percent of their total municipal waste.

Recycling:

Many states mandate commercial and residential recycling of a wide range of materials. For example, Pennsylvania Act 101 mandates recycling in Pennsylvania’s larger municipalities and requires counties to develop municipal waste management plans. The goals of the Act are to reduce Pennsylvania’s municipal waste generation; recycle at least 25% of waste generated; procure and use recycled and recyclable materials in state governmental agencies; and educate the public as to the benefits of recycling and waste reduction.

Municipalities must collect at least 3 of the following materials: clear glass; colored glass; plastics; aluminum; steel and bimetallic cans; high grade office paper; corrugated paper and newsprint. Commercial, municipal and institutional establishments are required to recycle aluminum, high-grade office paper and corrugated paper in addition to other materials chosen by the municipality. Leaf and composting are required to be separated from municipal waste. Businesses, including hospitals, are encouraged to help reduce waste by purchasing products that are durable, repairable, recycled, recyclable and/or have minimal packaging, and to find other uses for surplus goods instead of throwing them away.

Regulated Medical Waste:

Industry best practices for red bag waste are between one and three pounds of red bag waste per patient day, yet many hospitals still treat 25 to 30% percent of their total waste stream as infectious. Bio-hazardous waste includes sharps, pathological waste, blood and blood products, blood-soaked items, and non-regulated chemotherapy waste. Most patients in medical-surgical rooms generate little, if any, infectious waste, however, there may still be reluctance on the part of hospitals to “source-separate” the bio-hazardous waste at the patient’s bedside or at the place of treatment. Some healthcare organizations still consider all waste generated in a patient’s room as red bag waste even when the waste contains no visible blood. Hospitals may fear that they will be cited with a violation should an item of trash be discarded improperly.

Progress in pharmaceutical technology has reduced the need for surgical interventions. Changes in healthcare reimbursements have decreased the length of stay in hospitals and increased home care and outpatient healthcare. Healthcare products are being packaged more efficiently and the use of plastics instead of glass has lessened the weight of many products. Despite all these advances, the widespread purchase and use of “disposables” in healthcare has created large amounts of waste that cannot easily be recycled. Many “single-use” medical devices can be safely sterilized and reprocessed and used many times. This can save healthcare organizations significant dollars by minimizing their need to purchase single use items.

Hazardous Chemical Waste:

The healthcare industry generates only small quantities of hazardous chemicals relative to the amount of municipal solid waste or bio-hazardous waste. Hospitals that own research laboratories generate greater volumes and more diverse types of hazardous chemicals. Healthcare laboratories that perform diagnostic testing often use a large volume of a few chemicals such as xylene, alcohol and formalin in their processes. Some labs recycle and reuse chemicals to avoid the cost associated with hazardous waste disposal and repurchase of new materials. Other labs are equipped with chemical analyzer systems with reagent reservoirs that reduce the total amounts of chemicals used and waste generated.

Wastewater Discharge:

Most healthcare facilities discharge wastewater to Publicly Owned Treatment Works (POTW). Dischargers are classified as major based on an assessment of six characteristics: (1) toxic pollutant potential; (2) waste stream flow volume; (3) conventional pollutant loading; (4) public health impact; (5) water quality factors; and (6) proximity to nearby coastal waters.

Healthcare Wastewater Best Practices include:

* Limit the use of water discharged through conservation and reusing water wherever possible.

* Train employees to use water more efficiently.

* Post signs at all floor drains and sinks to discourage employees from using drains to dispose of oil, vehicle fluids, solvents, and paints.

* Use non-toxic floor cleaners or “Green Chemicals.”

* Consider capping off unused floor drains.

* Prevent any spills and drips from reaching the drain.

* Know where your floor drains discharge.

* Set up a preventive maintenance program for inspecting and cleaning floor drains, traps and oil/water separators.

Air Emissions:

Hospitals may generate air emissions from boilers, emergency generators, sterilization chemicals (ethylene oxide), air conditioning and refrigeration, paint booths, and laboratory fume hoods.

Boilers: Many hospitals operate industrial boilers, which generate criteria pollutants (NOx, SO2, particulates, CO) as well as hazardous air pollutants. NOx emissions from boilers are the most serious criteria air pollutant generated by the healthcare industry. Click here for information regarding EPA’s new HAP regulations for boilers.

Incinerator emissions: As a result of the Medical/Infectious Waste Incinerators HMIWI rule, most facilities no longer have on site-incinerators.

Healthcare Sustainability:

Through training, education, source-separation, environmental purchasing, energy conservation, recycling initiatives and waste minimization, a green initiative will have a major impact on reducing waste and pollution. Healthcare facilities should organize a multi-disciplinary team of healthcare professionals and establish a sustainability program if they haven’t already done so. A Green Team will reduce waste from healthcare operations while saving money. Paying attention to the little things pays big dividends. It is also an important component of any organization’s public relations and marketing arsenal.

How EES Can Help:

Environmental and Engineering Solutions, Inc. is the trusted source for environmental compliance for numerous hospitals. Our comprehensive services in sustainability, energy conservation and environmental, health and safety compliance make EES your best choice for sustainable development and cost savings.


Healthcare Assistant Jobs

Healthcare Assistant Job Duties
Job duties of healthcare assistants can vary greatly, as healthcare professionals who require the services or assistances are also quite varied. Assistants may work with any range of healthcare professionals, including everyone from doctors to nurses and radiologists or other technicians to midwives. In some cases, the job duties performed in healthcare assistant jobs may overlap with those of a nurse. The primary difference is that assistants may not administer medications or perform complex healthcare procedures.

Assistants in the medical industry are responsible for simple medical procedures and tasks, including the taking of blood samples, insertion of needles, measurement of patient vitals and the taking of patient histories. They are allowed to help professionals in emergencies and are also the primary contact for patients and patient’s families.

Pay Scale and Outlook
Assistants just entering the field can expect to earn on average £13,000 to £16,000 per year, though the exact salary will vary depending on the nature of the healthcare assistant jobs in question. With experience, a healthcare assistant’s salary may increase, but usually maxes out at about £18,000.

In spite of the limited salary scale of healthcare assistant positions, many who work in these roles remain in the career for the extent of their working lives. This is due in large part to the personal satisfaction that many assistants glean from their daily work.

Some decide to pursue employment in the professional career to which they have been an assistant. Many move on to study midwifery, nursing, and technician work.

Qualifications
Medical assistants are not required to have any sort of formal education or training, but must pass a criminal history check and must also pass a medical examination, due to the extent of close patient contact in their daily job duties. Most assistants are also preferred to hold a driving license.

If you are interested in this job role then you can earn a certification through the National Vocational Qualifications (NVQ) program, in either Healthcare or in Health and Social Care, will increase their career opportunities and potential salary earnings.

Previous experience in any care giving role is generally considered of benefit in securing a healthcare assistant role. Previous medical experience and volunteer work both make good CV additions when applying for a healthcare position.

Working Conditions
Healthcare assistant jobs are typically found in hospital settings and in home care. They may spend a great deal of time travelling between locations in order to perform their normal, everyday job duties.

Most assistants work on a shift schedule, and that schedule may include weekend and night hours. There are flexible schedules available in the field. There are also full-time and part-time positions to be found.

These positions are physically challenging, especially as the assistant is the primary party responsible for moving and lifting incapacitated patients, those who are seriously or terminally ill, and those who are unable to move on their own.

Employment Options
Healthcare assistant jobs are available with private and public hospitals, hospices, and residential care facilities. The National Health Service has a range of assistant positions from which to choose. Healthcare assistants may also work in nursing homes, for private agencies, or with homecare organizations.


What You Can Do to Reform Healthcare

Uproot U.S. Healthcare: To Reform U.S. Healthcare was written by someone who should know how to reform the system. Deane Waldman, MD MBA is both a practicing physician, as a pediatric cardiologist, and a speaker on healthcare reform.

In Uproot U.S. Healthcare, Waldman engages the reader in more of a conversation than a lecture and at the end of the book, you should come away with a clear understanding of what will really save our healthcare system.

You’ll discover that a cure for the currently sick system doesn’t lie in the hands of the political system or even a money fix – but in each and every one of us who can and do vote. Uproot U.S. Healthcare was written specifically to inform U.S. citizens about how to make their votes count to cure our ailing system.

With all the books, blogs and talking heads who shout out opinions about how to fix our healthcare system, Waldman’s book is a refreshing change. He has experienced the system first hand and has dealt with management and strategy issues within his own organization.

After experiencing the problems and seeing the results of a broken system, he realized that business knowledge and experience is a good way to understand the woes of the healthcare system and will also lead the way on how to eventually fix it.

Waldman wants the average U.S. citizen to understand that they simply can’t wait for Washington to do something – we have to pull together and do it ourselves. Eventually, we’ll all need the benefits of a healthcare system that really works, and the time is “now” to uproot the U.S. Healthcare system as it stands today and plant new, stronger roots.

Dr. Waldman devotes over half the pages in Uproot U.S. Healthcare to the “diagnosis” of the illness within our system before he actually addresses the “treatment.” This is a logical method and one that all doctors tend to take with their human patients.

One truth that Waldman brings out in his book is that if we don’t act now to fix the U.S. healthcare system, it won’t be available in the future. If the current trend of rising costs, costly errors, a shortage of nurses and doctors, people who don’t have and can’t afford health insurance and lawsuits are allowed to continue, we’ll never have a health care system that works.

The new roots of the healthcare system must be based on what the public wants – not what our misguided politicians want. Uproot U.S. Healthcare: To Reform U.S. Healthcare, by Deane Waldman, MD MBA, is an excellent and informative read and a real eye-opener to those who believe that the general public has no say about what happens to our healthcare system.


Healthcare IT Companies and Healthcare Reforms

Without much ado, technology companies try to adapt to change, usually more quickly than anyone else can think. In fact, after the change is proposed or enacted as a law, the initial news are about the implementation done by some big company or firm, and how others are following the suit.

Earlier this year, a very big change was proposed and enacted in the insurance industry. Healthcare reforms were implemented and brought tremendous amount of change in the healthcare sector. The main motive was to make sure that healthcare services are available to one and all within the range of affordable prices. Sure, a lot of entities had to face the brunt but the benefits of this change outweigh all the negativity that surrounds it.

Healthcare providers, health insurance companies, employers who provide healthcare benefits to their employees are some of the main entities that are affected positively or negatively by these reforms. At the same time, agents, brokers and smaller units facilitating the process of health insurance are also affected.

On the other hand, there are lots of opportunities and ideas that other firms can bank upon and create business. Software companies and service providing companies are vying hard to win customers-mostly on the B2B front of business.

Healthcare reforms poses real challenge and a test to the healthcare IT companies as whether they can adapt to the change within the given time-period or not. The methodology could be simple:

  1. Companies should know what type of change is required
  2. Companies should understand the change and ways to address it
  3. Companies should implement ways to adapt to change
  4. Companies should make sure the compliance to change is monitored and audited

It is not easy to adapt to change quickly but survival in the market demands swift action when a change is imposed on the business. Healthcare companies have been opposing the implementation of healthcare reforms, but there are many benefits that healthcare companies can accrue from these reforms.

It goes without saying that the short-term changes will have a negative impact on insurer profits. The requirements of the healthcare reforms demand that health insurance companies cannot sell policies with lifetime caps. At the same time, there will be reduction in government payments to Medicare Advantage plans.

The insurance costs are the main target that the healthcare reforms are trying to bring down. It is expected that if the insurance costs could decrease, more of the 23 million people who remain uninsured will be able to afford coverage. This would mean that the people will not buy health insurance only after they get sick.

The mandatory benefit package can cost more than the catastrophic plans, which will ensure that the insurance companies are not in loss. The healthcare reforms require that insurers provide a certain minimum level of benefits in the health insurance exchanges that individuals and small firms must use to buy coverage.

On the downside of these healthcare reforms, it is expected that the law will reduce about $200 billion in government payments to Medicare Advantage plans. Healthcare IT companies that are heavily involved in that market will have to bear the major brunt.

The challenge for healthcare IT companies is to analyze the situation and key areas where they need to change in order to make sure that their business does not suffer too much. Administrative costs need to be driven down in order to save on the profits, for, the premiums are going to slide down and reduce as the implementation goes in full-swing. With the creation of State insurance exchanges, the prices of health plans would become competitive. At the same time, technology compliance and implementation would require great amount of money to be spent.


Careers in Healthcare Management

Many of us associate a career in healthcare with nobility and helping others, treating doctors, nurses and other primary patient care providers with awe and admiration. But we forget that healthcare is also a business and like any other business, it needs efficient management and administration to survive. So, who are the people working tirelessly behind the scenes to make sure the delivery of healthcare is smooth at all times? These professionals are none other than health service managers or healthcare administrators trained and qualified to plan, direct, supervise, and coordinate the delivery of healthcare.

Healthcare management is an ideal career choice for individuals who want to take advantage of the growing job opportunities in this sector, but away from direct patient care. Interested? Then read on to find out more about the different healthcare management careers.

Educational Qualifications

The first thing you need to do for a healthcare management career is to get appropriate training. A health services manager is much like a manager in any other business unit who should have strong business and management skills as well as the ability to communicate effectively. A solid academic program definitely helps you acquire some of these skills. To work your way up the corporate ladder, a Bachelor of Science in Healthcare Administration degree would be a best suit for you. However, the standard credential for more senior positions in the field is a Master’s in Healthcare Administration degree.

Career Paths

Technological advancements and complex medical regulations have made the job of a healthcare administrator both exciting as well as challenging. As described earlier, healthcare managers are involved in planning and supervising the healthcare delivery system of a facility. Depending on its size, expertise and experience levels, they could lead an entire healthcare facility or be part of a team of health service managers working under a top administrator. Their day to day activities include management of finances, personnel, operations and admissions.

Other healthcare management careers that can be considered are clinical management and health information management. Clinical managers are trained and experienced in a particular clinical area, and are responsible for taking care of that respective department in the healthcare facility. To become a clinical manager, you need to have a degree in a related field. You can supplement your education and boost your career with a Master’s in Healthcare Administration degree.

Health information managers, on the other hand, maintain patient records in a secure manner in keeping with the federal government regulations. Health information managers need to have completed an undergraduate or graduate program in health information management.

Employment Opportunities

According to 2010-11 edition of the Department of Labor’s Occupation Outlook Handbook, the employment opportunities for healthcare managers should be good, and the profession is expected to witness a “faster than average” growth through 2018. The writing on the wall is bold and clear. This is the time to enter healthcare management careers. Undeniably, it’s a choice that requires considerable investment of time, money and effort. But equally irrefutable is the fact that you will soon see your investment turn into gold. Like a wise man once said – as you sow so shall you reap!


Healthcare Marketing

Overview Of The Healthcare Industry

The healthcare industry is quite a fragmented industry with many companies falling into the medical sector and other parallel sectors.

The mood in the industry currently is busy; due mainly to the fact that the population has boomed and resources are stretched. Healthcare funding is always in short supply and due to the current economic difficulties cutbacks are common.

Competition in the healthcare sector is high, and indeed is growing as more companies spring up.

Marketing In The Healthcare Industry

The healthcare industry is very active with its marketing using a wide range of marketing tools both for new business and also brand reinforcement.

Due to the growth and development of the healthcare market, specialist marketing companies have diversified and do concentrate on healthcare marketing. Many work exclusively with healthcare companies and use this as a USP to ensure they stand out as unique. Others have healthcare clients as part of their mixed portfolio of different industries they work in.

What Sort Of Marketing Tools Do Healthcare Companies Normally Use?

The industry tends to work in a specific way and as such do make use of certain marketing tools both for drawing in new business, but also communicating news.

The healthcare sector is unique and in many ways does not operate in the same way as other industry markets (such as retail, IT, recruitment etc.) as it is not as commercial.

Websites For Healthcare Companies

Websites are a big part of marketing for healthcare companies; giving up to date information about new products, services and any industry news.

Most healthcare businesses are quite web savvy and do make use of the internet as a form of communication. Their websites are normally quite basic HTML websites but quite a few do have flash websites to showcase their products in a creative and interactive way.

Internet Marketing also plays quite a big role in the marketing portfolio of healthcare businesses which links in to paid advertising and pay per click marketing.

PR For Healthcare Businesses

PR is a very effective marketing tool for healthcare companies. Used mainly for communicating business news and product launches it ties in well with any web advertising that is being done.

Crisis PR is something that is also used by many companies, as the industry does come under public scrutiny. Whether this is for protecting share prices, corporate espionage, or even problems that may occur within the business.

Telemarketing For Healthcare Companies

Inbound telemarketing is used by some healthcare companies, but the traditional B2B outbound calling is not really used within this industry.

This ties into what was mentioned earlier in this article, that the industry is not as commercial as other sectors that are more aggressive when it comes to their marketing and advertising.

Choosing A Marketing Company

Finding a marketing company that has healthcare marketing experience can be tricky due to the sheer number of marketing agencies around the UK. Something that could be time consuming both in terms of researching and selecting suitable agencies, but also in communicating with them.

Using a price comparison site can help save valuable time both in hunting down marketing companies with relevant industry experience; but also could save money in comparing costs – something that all businesses currently are looking for.


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