All home health agencies (HHAs) may have different policies and processes in place, but they all have one goal: to maintain documentation compliance for quality patient care. 

To reach this goal, agencies must ensure that documentation remains accurate, compliant to the plan of care, and submitted in a timely manner. However, due to this complex and time-consuming process, HHAs are sometimes faced with a crucial decision when it comes to quality assurance (QA) for their documentation. 

Should they outsource this critical task to external providers or build an in-house team? 

Each option has its own set of pros and cons, and striking the right balance is paramount. In this blog, we’ll discuss some of the pros and cons of outsourcing home health documentation QA versus hiring in-house.

What are the pros and cons of outsourcing?

Here are the Pros:

• Guaranteed Expertise: Outsourcing allows you to tap into the expertise of specialized QA professionals who have experience in home health documentation. They may have in-depth knowledge of industry regulations, standards, and best practices. This protects HHAs from potential documentation-related problems. 

• Cost Efficient: Maintaining a team of QA specialists can be costly. There are expenses associated with hiring, training, and maintaining an in-house QA team, such as salaries, benefits, office space, and equipment. Partnering with third-party QA specialists can often be a more cost-effective option, especially if you have a small or medium-sized agency. 

• Scalability: Hiring an external QA team offers scalability and flexibility. You can easily scale up or down your QA requirements based on your needs. This is particularly beneficial during periods of fluctuating caseloads or when specific projects require additional resources.

• Time savings: By outsourcing, you can save time on the recruitment and training processes. The QA provider is responsible for ensuring their team is knowledgeable and up to date, allowing you to focus on core operations.

Although outsourcing has many pros, there are still some cons, like the ones listed below.

• Communication challenges: Working with an outsourced team might introduce communication challenges, especially if there are language barriers or time zone differences. Clear communication and efficient collaboration become crucial to ensuring accurate QA.

• Lack of control: Outsourcing means relinquishing direct control over the QA process. It requires trust in the capabilities and reliability of the outsourced provider to deliver high-quality results. 

• Confidentiality and security risks: Sharing sensitive patient information with an external party carries inherent risks. Home health documentation privacy and security are important. HHAs must make sure that they only work with trusted QA service providers.  

• Lack of organizational alignment: An outsourced team may not have the same level of understanding and alignment with your organization's specific goals, culture, and values. This can affect the overall quality and consistency of the QA process.

What are the pros and cons of hiring in-house?

These are the pros:

• Direct control and oversight: Having an in-house QA team gives you direct control over the entire QA process. You can closely monitor their work, provide immediate feedback, and implement changes as needed.

• Cultural alignment: In-house teams can be more aligned with your organization's culture, goals, and values. They have a better understanding of your unique requirements and can adapt their work accordingly.

• Immediate response: With an in-house team, you have the advantage of immediate availability. You can address urgent QA needs promptly without relying on external resources.

• Enhanced collaboration: Being physically present in the same location facilitates easier collaboration and communication among team members. It can promote a cohesive work environment and foster stronger relationships.

Just like with outsourcing, hiring an in-house QA team can have its cons.

• Higher costs: Hiring and maintaining an in-house QA team can be expensive. It involves costs such as salaries, benefits, training, office space, equipment, and ongoing professional development.

• Limited expertise: Depending on your organization's size, it might be challenging to find individuals with specialized expertise in home health documentation QA. This can limit the depth of knowledge and variety of perspectives within your team.

In addition, the management might not have the necessary skills, resources, time, or knowledge to offer the QA specialists the support they require.

• Limited scalability: In-house teams may face limitations when it comes to scaling up or down based on fluctuating caseloads. Hiring and training new team members to accommodate changes can be time-consuming and costly.

  Moreover, letting go of QA staff--your agency spent training and development resources on--when caseload is low, can be a daunting task, not to mention post-separation costs like COBRA or unemployment benefits.

• Recruitment and retention challenges: Finding and retaining skilled QA specialists can be a competitive and time-intensive process. It may require substantial effort to attract and keep talented individuals within your organization.

Making the Right Choice

Ultimately, the decision of whether to outsource or hire in-house depends on your agency’s specific needs and budget. If you are looking to save money and gain access to expertise, outsourcing may be a good option for you. However, if you need more control over the quality of the work , hiring in-house may be a better choice.

Here are some additional factors to consider when making your decision:

• The volume of documentation you need to have QA'd

• The complexity of your documentation

• The level of accuracy you need

• Your budget

• Your comfort level with outsourcing

We hope this helps!

If you are curious about outsourcing, QAnnovate offers a FREE trial to help you decide if our visit notes QA services are the perfect solution for you. Contact us today to learn more.