I am working for a web design and development firm in India, and I completely
agree with trio in that people are usually good at either design or
programming.

Sometimes the communication cost is a lot higher, if you are communicating via
chat an email and the person on other end is not easily able to make you out.

But again any good company will tend to have people with good English skills,
who can communicate well over phone, so you could converse with them over
phone.

The best way around this is to hire a company with expert professionals and
proven track record in various fields rather than working with individuals.

Regards,

Steve Smith
steve[at]pixVista.com