Category Archives: Medical Tourism/Health Tourism

The retailer joins the ranks of companies sending employees to hospitals far from home in the name of less expensive and better care.

A small but growing number of U.S. corporations are offering their insured employees the option of undergoing certain procedures at highly ranked health systems across America at almost no out-of-pocket cost to them — travel included.

The companies believe sending heart and spine patients elsewhere would result in improved care for patients and lower costs for employers. Although companies are just getting started in pushing what is often called domestic medical tourism, analysts say it’s something doctors should keep an eye on. Physicians may find patients bypassing them on the way to health systems elsewhere. Others may be handling pre- and post-care for procedures performed hundreds or thousands of miles away.

“We’re going to see a lot more of this,” said Simon Hudson, PhD, director of the SC Center of Economic Excellence in Tourism and Economic Development at the University of South Carolina and an expert on medical tourism. “And if physicians cannot compete on price, then they are going to have to compete on quality and exceptional customer service if they are going to keep patients.”

These programs usually involve a large company negotiating a bundled rate from a health system for certain services. The procedures are then offered to employees who need them, with no co-pays or deductibles. Travel expenses for the patient and a caregiver are usually thrown in. Employees still have the option of receiving these services in their hometown, but co-pays and deductibles apply. For example:

• Wal-Mart Stores announced Oct. 12 that, as of Jan. 1, 2013, 1.1 million people covered under its employee health insurance will have access to heart and spine surgeries at one of six health systems identified as “Centers of Excellence.” The health systems are Cleveland Clinic; Geisinger Medical Center in Danville, Pa.; Mayo Clinic sites in Rochester, Minn., Scottsdale, Ariz., and Jacksonville, Fla.; Scott & White Memorial Hospital in Temple, Texas; Virginia Mason Medical Center in Seattle; and Mercy Hospital Springfield in Springfield, Mo. The latter hospital is the closest to Wal-Mart’s corporate headquarters in Bentonville, Ark.
• As of Oct. 1, Boeing Co. had a similar arrangement for heart surgery at Cleveland Clinic for the company’s 83,000 nonunion employees, dependents and retirees.
• PepsiCo announced Dec. 8, 2011, that the 250,000 employees covered by its health insurance plan could travel to Johns Hopkins Medicine in Baltimore for heart surgery and joint replacements with no out-of-pocket costs.
• Lowe’s Companies started offering fully covered cardiac surgery at Cleveland Clinic in 2010 for its 234,000 employees and many more dependents on its insurance plan. The program expanded to chronic pain management and spinal surgery in September 2012.
• HCR ManorCare, which has 60,000 employees, began offering fully covered cardiac surgery at Cleveland Clinic as of April 1.

Companies have released very little information about how many employees have traveled for care and how much money employers have saved. About the only information comes from Lowe’s, which reports that by the end of the first quarter of 2012, it had sent 50 employees and covered dependents to Cleveland Clinic for care. Although a small number, it exceeded expectations.

Health systems that have experience providing bundled payment arrangements say they are being approached by more companies looking for this kind of arrangement. The systems have said they are actively selling their services to national employers. Companies that have programs in place say they are looking for new procedures to make available and health systems to include.

“We’re looking to expand these programs to reduce our associates’ out-of-pocket medical costs and provide the highest quality of care,” said Randy Hargrove, a Wal-Mart spokesman. “And we plan to expand this program to include more procedures and providers.”

The shift to domestic medical tourism is in part because foreign medical tourism, which was talked about a few years ago as a means of controlling costs, never really took off. A report published Oct. 26, 2009, by the Deloitte Center for Health Solutions labeled the call for foreign medical tourism “tepid.” Sixty-nine percent in a survey of 3,000 patients included in the paper said they would not go outside the country for elective procedures.

“We have a perception that health care quality is much better here,” said Terry White, CEO of BridgeHealth Medical, a health care tourism company based in Denver. “Whether that is true or not is not the issue.”

Domestic medical tourism seems an easier sell. To some extent, there is comfort on the patients’ part in traveling for medical services. For instance, an issue brief published in September by the BlueCross BlueShield of Tennessee Health Institute found that 69.9% of 47,300 inpatient stays were not at facilities nearest to where the patient lived. In 43.4% of the cases, patients took a trip to larger facilities even though the services they needed were offered at their local hospitals. Some employees of the companies work in rural areas and traveled out of necessity, because the care they required wasn’t available nearby.

The health systems are devising ways to ensure that the primary care physician in the patient’s hometown is kept in the loop. For example, physicians with Geisinger Health System will have extensive discussions with a potential patient’s physician before accepting him or her for care. The communication will continue during the hospital stay and after the procedure.

“We want to make sure the handoff before the patient gets to us and after they leave is smooth and transparent,” said Alfred Casale, MD, Geisinger’s director of cardiac and thoracic surgery. “We will continue the interaction for as long as it takes, and we want to make sure the right patients are coming here.”

source: http://www.ama-assn.org / amednews.com / American Medical News / Home> Business / by Victoria Stagg Elliott, amednews staff / October 29th, 2012

Belize may soon become popular as the place for well-off North Americans to come to have elective surgery, dental work or other quality medical care at an affordable cost, if BELTRAIDE, Belize Tourism Board and the Ministry of Health have their way.

Medical tourism is a billion-dollar global industry, and some southeast countries, Thailand for example, receive a million medical tourism patients per year. Other Central American countries such as Costa Rica, Guatemala and Panama are also well-established in the medical tourism market, but Belize has a tremendous advantage in that it is the only English-speaking country in Central America and is positioned only a short flight away from gateway cities like Miami, Houston and New Orleans.

Mike Singh, the chief executive officer of the Ministry of Trade Investment Promotion and Private Sector Development, sees it as a tremendous opportunity for Belize. The industry would offer increased employment, not just for Belizean doctors and nurses, but also laboratory technicians, medical assistants, the staff of private clinics, hotels and spas, as well as tour operators and taxi drivers.

There would also be a transfer of technology as foreign specialists who would set up shop in Belize would also help to train local doctors in new procedures, techniques and treatments. The result would also be improved health care made available to Belizeans hear at home so they would no longer need to travel to Merida or Guatemala City for specialist treatment or surgery.

International consultant Massimo Manzi has been working with BELTRAIDE and the BTB to help establish the industry, and he explained that the aging population in the United States, Canada and Europe find that health care in their countries is expensive, even the welfare state cannot provide for all. National Health Insurance or Social Security often does not cover elective procedures, so patients in need of such treatment or surgery are seeking a more affordable alternative.

Qualified doctors in many countries outside North America and Europe offer high quality health care at low cost and this draws in the “medical tourist”. Dental clinics in Belize are already cashing in on offering high quality dental care to visitors from the U.S. and Canada at a fraction of the cost they would pay at home.

Belize unarguably already a very unique attractive destination, English-speaking which puts North Americans at ease, makes them feel more at home, and the bedside manner of our doctors and nurses is warmer and more compassionate and a far cry from the more impersonal treatment visitors may be accustomed to in hospitals at home.

What Belize needs to do is establish high quality standards in compliance with international standards for both the medical infrastructure – the hospital and clinics, and the personnel. Belize is in the process a preparing a bill for legislation that will establish regulations for the medical tourism industry.

Belize is now inviting foreign doctors, medical specialists and investors to establish hospitals and clinics in Belize to cater to medical tourists, the industry will also benefit local practitioners who will have opportunity for medical fellowships abroad to improve their skills.

Dr. Peter Allen, the chief executive officer of the Ministry of Health, sees the industry as a huge opportunity for Belize, with the government of Belize and his ministry working simply as the catalysts to provide the conducive environment for the private sector to prosper. Any investment is not without risks; therefore, a proper regulatory framework must be established to minimize such risks.

Belizean neurosurgeon Dr. Joel Cervantes, president of the Belize medical and Dental Association, says he is committed and on board and happy to be moving our country forward with this new industry.  He noted that getting everyone up to speed with the needs of medical tourists will also require additional training for anyone working in the industry, so that even taxi drivers and tour operators would be trained in first aid and cardio-pulmonary resuscitation (CPR).

He sees the industry as lowering health care costs for Belizeans. Belize is a small market, so many private hospitals and clinics might not want to invest in certain expensive equipment, like a CAT-scan or a laporoscopy apparatus because they treat too few patients for the investment to be cost-effective, but the equation would rapidly change if they were treating thousands of patients requiring such equipment.

Another sector of the industry is the health spa, for example the Maruba Jungle Resort and Spa, where visitors would come to feel better. Medical tourists seek privacy and seclusion where they may recover and recuperate from surgery or other treatment and Belize’s hotel sector is totally congruent with this requirement. Most of Belize’s hotels and inns are 10-12 rooms, private and secluded, off the beaten path, exactly what medical patients want.

The BTB, BELTRAIDE and the health ministry want North Americans to become aware that Belize is place they can come to feel better, even live longer, and the doctors catering to medical tourists are totally in tune with this concept.

source: http://www.reporter.bz / Home> General / October 19th, 2012