Thoughtworks does pretty well with it, out of Dallas/Chicago. The main downside is that you're paying at least one in-country employee per project the price of 4-5 local coders to move across the country once every 6 months to a year depending on project length and keep India's hours to be awake at the same time to communicate with the team. You save some on the coding, and the quality is there, but the overhead is high because you do need at least one or two people on site at Director's salaries plus living expenses.