“We tried offshoring revenue cycle. It didn’t work.”
It’s not uncommon to hear this from providers across healthcare disciplines. But did the model fail — or did the visibility fail? If you can’t see performance in real time, distance amplifies risk.
Before offshoring — or after a failed attempt — three things need to be true.
1. You need real-time operational visibility that is easy to access.
You need a window into where your revenue is, who is working on it, what escalations are occurring, etc. You need this separate and distinct from the RCM outcomes (it doesn’t pay to muddy the metrics waters), which we’ll mention in a second. You don’t need endless summary reports passing back and forth, often trailing the action and missing the chance to meaningfully intervene.
2. You need revenue outcome metrics, not activity metrics.
At Tally we focus primarily on three key metrics: write-off rate, AR days, and overall collection rates. There are other metrics, of course, but when metrics have no hierarchy, more datapoints make things less clear.
3. You need defined escalation paths.
Modern revenue cycle isn’t onshore versus offshore. It’s machines, offshore teams, onshore oversight, and your internal staff — each with a clear role. Automation should triage and draft. Offshore teams should execute defined workflows. Onshore leaders should weigh in to accelerate performance and quality. Your internal team should intervene only when escalation thresholds are triggered.
4. Frame the right economic question.
It’s not “how much cheaper is the labour cost?” –the right question is the margin one: “does this model increase our net collections while maintaining the control and managing the risks?” If you focus primarily on the former question, you will underinvest in governance, and stumble into an ugly surprise: margin drag. If offshore RCM failed, it’s often because it was treated as a procurement exercise instead of a financial operating model.
Offshoring fails when there is no instrumentation, no outcome-oriented metrics, and no clarity around ownership. Offshoring when these things are missing feels like a tremendous vendor management burden.
If offshore didn’t work the first time, it’s time to rebuild the operating model with visibility and escalation discipline first.
