As per a joint ASSOCHAM-EY study, players engaged in business process outsourcing (BPO) in healthcare sector in India are facing tough competition from their Filipino counterparts.The Philippines and other low-cost locations are emerging as a big challenge to the Indian BPO industry, including the healthcare vertical.The study highlighted that competition from leading healthcare BPO companies in the US is a big challenge for the Indian vendors. Most of them being specialists in the healthcare sectors helps them to avail gamut of services as compared to the Indian vendors.To provide outsourcing services to overseas vendors, the Indian vendors need to comply with international standards of security and privacy as this can result in business being lost.Some other problems being faced by the industry is the fact that global/local service providers with IT and BPO offer integrated solutions, including big data and high investment.Rising salary levels, inflationary pressure on overall cost of infrastructure, fluctuating exchange rates and infrastructural challenges such as power, broadband connectivity are other challenges that the Indian BPO industry is faced with, according to the ASSOCHAM-EY study.The study also highlights destination for payer and provider outsourcing in India. Payer market in India is estimated around USD 700-900 million with top BPO and IT vendors. India is estimated to have a considerable share in payer outsourcing market as a destination and is also a leading destination in this segment along with the US and Philippines.Difficulty in expansion beyond the US is another challenge for the domestic payer market. As per the study, “Indian BPO vendors have not been able to penetrate European and other developed markets for insurance outsourcing business due to stricter regulatory norms and data privacy laws.”However, lack of expertise on global medical standards, laws and policies related to healthcare benefits, inadequate skills for documentation and medical record management are other challenges faced by the industry in India.Besides, preference for skilled doctors, competition from hospital management companies and concern on benefits of outsourcing are the other challenges being faced by the Indian players.