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For India, US health care a sea of opportunity

Outsourcing firms in India brace themselves for onslaught of work following US health care reform.

Indian employees seated in their cubicles at a call center provide service support to international customers, in the southern city of Bangalore Wednesday March 17, 2004. Following U.S. health care reform, outsourcing firms in India are expecting mountains of work. (Sherwin Crasto/Reuters)

MUMBAI, India – U.S. healthcare reform gave 32 million new Americans insurance, the new U.S. president a feather for his cap and a good seven years' boon to the workload of India's $61 billion outsourcing industry.

India's Economic Times declared it the industry's "biggest bonanza yet" and "far bigger than the Y2K." While it's too early to know the extent of the boon, India's outsourcers — the call centers, the medical record transcribers, the software developers — are quietly gearing up for the increase in administrative work and technology development the health care legislation promises.

Finance and banking, telecommunications and manufacturing are the sectors that provide the lion's share of work to India's outsourcers. But healthcare — where now less than 5 percent of the industry's business comes from — is poised to be one of the fastest-growing, said Ameet Nivsarkar, vice president for global trade at NASSCOM, a trade body for India's information technology and business process outsourcers (BPOs). "Now the next $60 billion ... can't come from these sectors," he said. "So the industry is looking at health care as a promising new industry."

India's BPO and information technology exporting industry grew about 6 percent the fiscal year ending this March, according to NASSCOM, but is expected to more than double its growth — up to 15 percent — this year.

It's the classic outsourcing debate but with a newer, larger scale: Does the $940-billion bill, coming as unemployment persists at just under 10 percent, mean sending another round of jobs abroad?

Anything that is electronic in health care can be offshored — sent outside U.S. borders — and no state or federal regulations prohibit personal medical data from leaving the U.S. (Some insurers, however, choose to keep personal health data within U.S. borders.)

India's outsourcers get new health care work in two ways, by the initiative to computerize personal medical records included in last year's stimulus bill and by run-of-the-mill maintenance of health records both for the newly insured by the reform and the millions of others who already are but whose insurers will need to cut administrative costs.

That's where Firstsource Solutions, a Mumbai-based IT firm, sees an opening. Managing the new enrollments and claims, expanding member databases and revenue cycles that come with these 32 million "is very significant" for their business, its CEO Ananda Mukerji wrote in an email, adding that Firstsource has been watching the U.S. health care space since 2006.