The result is that you have a void of talent in the developer pool.You sometimes end up having very poor project managers that were very good developers.Please know that I appreciate most of the Indian people I work with every day and I value there efforts greatly.With about a 12 hour difference with MST (Mountain Standard Time) it is very difficult to find moments to speak.
The more advanced your project/tasks the more difficult it will be to succeed.
I believe it is possible to succeed in outsourcing to India and ultimately this might put your business in a very good place.
I ask my Indian friends to forgive me for stereotyping their great culture, sometimes in a simplistic\caricaturistic way, but in order to help the US readers of this article a bit of stereotyping might be more effective.
In other words, for a basic website design these points will be easier to overcome and maybe some not even an issue.
But as your projects get more complex these points will be more difficult to overcome and if you are not extremely careful any of these issues might cost you your projects and maybe even your business.