Outsourcing and the Provision of Quality Health and Wellness Services

In its Framework for a Comprehensive College Health Program, ACHA asserts that “college health plays a critical role in the retention, progression, and graduation of students.” This role can be accomplished by offering comprehensive health care. The advantage of the convenience of on-campus health care and wellness services provided by professionals who understand the needs of students and the context of their care truly distinguishes a college health/wellness program from a community practice. As each institution of higher education is unique, building a comprehensive college health and wellness program requires the appropriate mix of health care and administrative services which meets the needs of the particular campus.

But as colleges and universities face increasing regulatory, programmatic, and financial pressures, a growing number of institutions are looking at alternative approaches to providing a comprehensive college health program, including the outsourcing of some or all services. According to the ACHA Guidelines Outsourcing of College Health Programs: Discussion Points, outsourcing is currently a controversial topic. This document, while not encouraging or discouraging the practice of outsourcing, delineates critical factors that must be addressed by both the college/university and the outside contractor when considering full or partial outsourcing of a college health program. This document can also provide guidance to institutions who are considering resuming management of an outsourced college health program.

Here are some critical issues to consider regarding outsourcing:

  • Community Resources: Look at the ability for the community to absorb the student patients. What is the wait time to establish with community providers, especially primary care, psychiatry, counseling, and women’s health.
  • Stakeholders: What is the level of stakeholder support for the health or wellness center, including students, faculty, senior administrators, and parents?
  • Budget: What is the funding model, and is it sustainable? Is the health center revenue-generating or in the red? Is there a surplus and reserve budget?
  • Operations: What are the scope of services and the efficiency of the delivery of those services? How is the operation staffed?
  • Collaborations: What are all of the collaborations the health center performs? What are the non-reimbursed services performed by the health center?
  • Organizational: Evaluate the organizational culture, patient satisfaction, quality of services, and leadership. Is the college health or wellness center accredited?
  • Review the incentive structure in the outsourcing contract very closely. What are the interests of the university compared to the interests of the outsourcing entity? What is financially (or otherwise) rewarded, and where will the priority be placed?

Resources

Outsourcing of College Health Programs: Discussion Points

This guidelines document from ACHA is designed to delineate critical factors that must be addressed by both the college/university and the outside contractor when considering full or partial outsourcing of a college health program. This document can also provide guidance to institutions who are considering resuming management of an outsourced college health program. The purpose of the guidelines is not to encourage or discourage colleges and universities to outsource some or all aspects of their health services.

Framework for a Comprehensive College Health Program

The ACHA Framework helps you develop a college health program that meets the needs of your students. The framework gives insight into creating a college health program that provides access to and/or coordination of health and wellness services and programs that address the unique stressors and needs of college students. It is adaptable to a wide range of campuses and college health programs; each institution can apply the elements, concepts, and services included in the document according to the institution’s resources, campus population, health needs, and existing community resources. This publication is intended to serve as a companion document to ACHA’s other publications, recommended practices and white papers, and position statements.

ACHA College Health and Wellness Consulting

ACHA offers a consulting service for organizations needing expert advice on their campus health or wellness services, including those considering outsourcing some or all other their services and those considering bringing services back in-house. For more information visit ACHA’s College Health and Wellness Consulting page or email consulting@acha.org.