Where should you outsource your contact center?
Here’s how each option breaks down across 7 factors:
Domestic (U.S.-Based)
Cost: Highest by far
Scalability: Limited talent pool
Attrition: Most stable workforce
Accent: Zero friction for patients
Time zones: Perfect alignment
Data security: Same jurisdiction, simplest to manage
Travel: You can be on-site fast if something goes wrong
Nearshore (LATAM / Caribbean)
Cost: Moderate
Scalability: Growing talent pool
Attrition: More stable than offshore
Accent: Generally well-understood by U.S. patients
Time zones: 1-3 hours, real-time collaboration still works
Data security: Fewer legal regimes, easier to audit
Travel: 3-6 hours, you can actually visit regularly
Offshore (Typically India / Philippines)
Cost: Lowest by a wide margin
Scalability: Largest talent pool by far
Attrition: Highest, 30-45% annually on average
Accent: Strongest accents, but software solutions exist
Time zones: 8-12 hour difference, can be managed with night shifts
Data security: Most complex, tightest governance required
Travel: 15+ hours, oversight structure matters more here
The right answer depends on what you’re optimizing for.
What factor matters most to your operation?
I’m Mark Danielson, and I help healthcare leaders reduce support costs while improving patient satisfaction.
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