boxsolid
Medical Travel (continued from page 5)
cine. The American health care system will reap substantial Liability insurance coverage for international care is now
benefits from medical travel, with savings that are suffi- available from companies such as Custom Assurance
cient to offset a major portion of the $1.5 trillion cost of (South Carolina) and Seven Corners (Indiana) – providing
providing universal access to coverage.
7
“peace of mind’ for both employers and patients.
Surgery costs represent one-third of the total annual medical Accreditation on the Rise: More than 300 public and private
spend of $2.3 trillion,
8
and yet – unlike pharmacy benefits or health care organizations in 39 countries have been accredit-
disease benefits – surgery expenditures are almost completely ed by the Joint Commission International (JCI),
13
which pro-
unmanaged, according to a study conducted by the vides accreditation for hospitals, ambulatory care facilities,
Dartmouth Institute for Health Policy and Clinical Practice.
9
clinical laboratories, care continuum services, medical trans-
port organizations, and primary care services, as well as certi-
“More spending and more utilization do not translate into fication for disease, or condition-specific care. Their stan-
improved life expectancy for those with chronic illness. The dards were developed by international health care experts and
differences in the use of discretionary surgery do not reflect dif- set uniform, achievable expectations.
ferences in patient preferences and informed patient choice.”
10
While some countries are adopting their own accrediting stan-
Surgery costs represent the largest untapped source of poten- dards, U.S. employers still generally regard JCI as the gold
tial health savings. Medical travel offers employees access to standard, though Trent and ISQUA are also well regarded.
high-quality, value-driven domestic and international COEs. By
providing employees with access to multiple networks, surgery Medical Travel Intermediaries: A medical travel service
cost and quality comparisons can easily be made among domes- provider should offer surgery education, turnkey member
tic COEs, international COEs, and local surgery choices. care, concierge services, and full data reporting (outcomes,
savings, claims) to assist in adoption and implementation.
“There are islands of excellence in the sea of high cost medi- It is equally important for companies to align with a med-
ocrity—hospitals and physician practices that are delivering ical travel service provider that can demonstrate genuine
high value health care that is less costly, more efficient, and health care experience and leadership, proven, HIPAA-
produces better health outcomes… These systems have fig- compliant operating systems, an emerging suite of vendors,
ured out how to improve the quality of the care they deliver and in-depth understanding of the health care continuum.
and simultaneously contain costs, without denying patients
needed, effective care. All Americans deserve to have access to It is critical to distinguish qualified service providers from
such superior health care, not just those who happen to live those operators that are little more than glorified travel
near these hospitals and physicians.”
11
agents. The provider should also perform basic services such
as coordinating the pre-travel communications for the client
Short Term Uptake: During 2009, many companies learned to the hospital and physician; arranging after-care needs;
more about the medical travel option and are now identifying tracking satisfaction and medical outcomes – with plan prices
medical travel service partners to facilitate its adoption.
Implementation in 2010 will document this trend, although
many corporations are still conducting due diligence. The
coming year will also provide a time for international
providers to optimize quality standards and outcomes report-
ing, as well as an increased reduction of costs.
Likewise, responsiveness to the medical travel option will
continue to grow among U.S. physicians, who will play a
critical role in the after-care of medical travel patients.
Arnold Milstein, the San Francisco-based chief physician
of Mercer Health & Benefits, reports that employers are
beginning to include in-hospital networks as an option for
accessing care outside the United States.
12
While most insurers do not yet include foreign providers in their
networks, they are beginning to actively consider it, and new
health insurance plans will follow the lead of Wellpoint, United
Group Programs, Aetna, and a number of TPAs in offering a
medical travel option. Likely adopters also include smaller,
regional health plans, PPOs, and stop-loss insurance carriers.
6• The Self-Insurer
©
/ January 2010
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