Healthcare leaders often frame the staffing question as “local vs. remote.” But the real operational decision should be:
Do we build practice management capabilities in-house, or do we buy them through a managed services model?
Location (onshore, nearshore, offshore) can matter—mainly for time zone coverage, communication, and continuity. But what usually determines performance is the operating model: who owns outcomes, how work is standardized, and how quality is measured.
What “managed services” means (and what it doesn’t)
Managed services is not just “outsourcing tasks.” In a true managed services model, the partner provides:
- Dedicated roles and capacity planning
- Standard operating procedures (SOPs) and training
- Quality assurance and reporting
- Clear ownership of defined outcomes (often via SLAs/KPIs)
This differs from staff augmentation, where you “rent capacity” and still carry most of the process design, training, and quality control burden internally.
Why in-house teams still matter
In-house teams provide proximity and context. They support high-touch work that is hard to standardize and benefits from in-person awareness—especially when it directly shapes the patient experience.
They also protect clinic culture. The way a front desk handles anxiety, confusion, or a sensitive question is part of care delivery, not just administration.
Direct oversight can feel easier when people are in the same building. That instinct makes sense. But growth can expose its limits.
The hidden weakness of the in-house-only model
As patient volume rises, in-house teams often become generalists by necessity. They juggle phones, front desk responsibilities, authorizations, referral coordination, and back-office work—often in the same hour.
That context switching is costly. It creates a common failure pattern: dilution of expertise.
When “everything is everyone’s job,” critical workflows lose focus:
- Credentialing and enrollment slows
- Scheduling rules drift and templates get messy
- Authorizations stall in the cracks
- Follow-ups and payer coordination become inconsistent
- Errors rise, and operations lag behind clinical demand
This isn’t a talent problem. It’s a system design problem.
What managed services does differently
A managed services model is designed for specialization and repeatability.
Instead of one team doing everything between interruptions, the work is organized into dedicated workstreams (credentialing, authorizations, scheduling optimization, billing support, payer follow-up, etc.). That structure supports a “center of excellence” effect: repeated reps, fewer handoffs, more consistent rules.
Just as importantly, managed services can add operational discipline:
- Clear queue design and escalation paths
- Standardized documentation and checklists
- QA routines and performance reviews
- Forecasting for peaks, absences, and growth
Many organizations also choose managed services because it scales faster. Adding capacity in a managed model can take weeks. Hiring locally can take months—and may restart the cycle if turnover rises.
The best answer for many organizations: a hybrid strategy
Many high-performing groups don’t choose “either/or.” They choose hybrid by design.
They keep in-house teams focused on patient-facing work and exceptions that require local judgment. Then they use managed services to run the administrative engine with dedicated capacity and measurable outcomes.
This shifts leadership’s job in a healthy way. Instead of constant firefighting, managers can focus on:
- Outcomes and KPIs
- Capacity planning
- Process improvement
- Service recovery and patient experience
The point is not replacement. The point is stabilization—reducing burnout, preventing operational drift, and building a practice that can grow without breaking.
What should stay in-house vs move to managed services?
Keep in-house:
- Face-to-face patient interactions and on-site coordination
- Sensitive conversations that shape trust and experience
- Workflow exceptions requiring local context
- Tasks tightly tied to clinic culture and daily “micro-decisions”
Move to managed services (often):
- Credentialing and payer enrollment
- Prior authorizations and structured documentation workflows
- Complex scheduling logistics and template management
- Payer follow-ups and administrative coordination
- Standardized back-office work with clear rules and measurable outputs
Call to action
If your operations feel stretched, don’t guess. Map your workflows, identify where interruptions create delays or errors, and define which outcomes matter most (access, compliance, revenue integrity, patient experience).
When care access, compliance, or revenue integrity is at stake, involve qualified healthcare operations professionals. A structured review can prevent costly operational drift—and help you choose the right in-house vs managed services mix.
Other interesting posts:
- https://us.medicosmos.org/administrative-overload-in-healthcare-where-efficiency-quietly-slips/
- https://us.medicosmos.org/how-nearshore-works-for-patient-coordination/
External links (outbound):
- MGMA – Management & Staff Compensation Data Report (2025): https://www.mgma.com/2025-management-staff-compensation
- U.S. Bureau of Labor Statistics (OEWS) – Medical Secretaries & Administrative Assistants (43-6013): https://www.bls.gov/oes/2023/may/oes436013.htm
- CAQH – 2023 CAQH Index Report (PDF): https://www.caqh.org/hubfs/43908627/drupal/2024-01/2023_CAQH_Index_Report.pdf
- Guidehouse + HFMA – 2024 Revenue Cycle Management Report (PDF): https://guidehouse.com/-/media/new-library/industries/health/documents/2024/2024-revenue-cycle-management-report-guidehouse.ashx
- HFMA – Evaluating the Performance of Outsourced Revenue Cycle Relationships (PDF): https://www.hfma.org/wp-content/uploads/2023/11/outsourcedrevenue-nov23-migl.pdf
Written and edited by MEDICOSMOS.
Editorial note: Prepared by Medicosmos’ operations team using internal playbooks and assisted drafting tools. Reviewed for accuracy and clarity before publication.
