Self-Insurer_January_2010

that include surgery/procedure costs, The schedule below demonstrates typ- from the other end of the spectrum –
airfare, lodging, transfers, 24/7 ical case allowances in the United medical travel will see a greater
concierge service, savings potential, States. Medical case fees are inclusive American presence of international
and accredited hospitals. of anesthesiology, consumables, and companies seeking to create a higher
other inclusion specific to providers. profile in the United States and to
More Serious Procedures: The most sig- Travel and food/accommodation costs help facilitate seamless adoption and
nificant trend that will continue into outside of hospital stays are additional. implementation. There will also be a
2010 is the increase in patients travel- Conservatively, these have been mod- number of insurance products materi-
ing abroad for serious surgeries and eled at $2,000 and $3,000 respectively. alizing, offering employer, health
procedures, including orthopedics and plan, and individual coverage options.
joint replacement, cardiac, in vitro fer- Do-It Yourself Health Care: An increasing
tilization, and bariatrics, as well as pro- number of patients bypass their primary In 2009, the industry grew steadily –
cedures not available in the United care physician in search of reliable, first- with high expectations for a surge in
States such as stem cell transplants. hand information about medical travel 2010. Clearly, U.S. employers, third
via the Internet and through social net- party administrators, insurance com-
According to the Online Journalism work sites – a trend that will further panies, stop-loss companies and oth-
Review, surgeons in India are offering erode the competiveness of the U.S. ers are reaching a tipping point and
cutting-edge medical care at a fraction health care system, which on its current will begin rolling out meaningful med-
of what it costs elsewhere in the world. path may be going the way of the auto ical travel programs that will give
One heart hospital in particular charges industry.xvi This grass-roots swell of employers and employees the chance
$2,000, on average, for open-heart sur- interest will serve to further induce to save money without compromising
gery, compared with hospitals in the employers and insurance companies to, quality health care.
United States that are paid between at the very least, implement medical
$20,000 and $100,000, depending on travel pilot programs. In the meantime, medical travel qual-
the complexity of the surgery.
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ity will continue to be better defined;
2010: A Critical Year new business models will emerge;
The approach has transformed As market pressures and economic insurers, legislators, and employers
health care in India through a simple slow-down continue, the medical trav- will go on exploring pilots and pro-
premise that works in other indus- el field has become more compact and grams; health care providers will
tries: economies of scale. By driving more competitive – with top providers become increasingly involved in coor-
huge volumes, even for complex pro- displacing less competitive compa- dinating care; and more consumers
cedures like heart surgery, the hospi- nies. Mergers and acquisitions are will begin to benefit from the medical
tal manages to cut the costs of health being fueled by venture capital organ- travel option.
care dramatically.
15
izations that recognize opportunities
in this field. At the same time – and
(see page 8)
Procedure Typical Case* Typical Domestic Typical International
Travel Contracted Rates Typical Travel Contracted Rates
U.S. U.S. Costa Rica India
CABG w/o cath $60,000 - $100,000 $32,000 - $36,000 $25,000 $8,500
CABG w/cath w/comp $70,000 - $110,000 $47,000 - $53,000 $25,000 $8,500
Hip Arthroplasty $45,000 - $50,000 $20,000 - $25,000 $13,400 $8,000
Knee Arthroplasty $43,000 - $50,000 $19,000 - $23,000 $12,400 $7,000
Bilateral Knee Arthroplasty $65,000 - $80,000 $32,000 - $35,000 $21,200 $14,000
Shoulder Arthroplasty $40,000 - $50,000 $20,000 - $24,000 $10,100 $8,500
ACL Repair $20,000 - $25,000 $10,000 - $14,000 $4,800 $6,500
Laminectomy $20,000 - $25,000 $10,000 - $14,000 Price N/A $7,000
Gastric sleeve
or Gastric bypass $35,000 - $50,000 $20,000 - $25,000 $9,800 - $12,900 $9,800
(sleeve)
Gastric banding $25,000 - $40,000 $13,000 - $18,000 $9,800 - $10,300 $7,500
*What a sponsor pays after preferred provider organization (PPO) discount.
SOURCE: BridgeHealth Medical; 2009.
The Self-Insurer
©
/ January 2010 • 7
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