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FEATURE


their costs and have lower overhead, so they can provide services at a much lower price point than hospitals.” ASCs are in the rare position in the healthcare space to offer a signif- icant discount compared to hospitals without sacrificing quality, Stine says. “Most ASCs meet or exceed quality standards at hospitals. As we move to a more consumer-driven model of healthcare, ASCs have a great value proposition that should attract patients willing to travel or employers trying to drive employees on their group plans to higher quality, lower cost options.” More than half of all BridgeHealth


Medical Tourism in ASCs


Marketing to patients outside your community BY SAHELY MUKERJI


P


atient interest in medical tourism, a small but growing trend in the ASC setting, shows an uptick. “Patients [are] willing to travel short distances to receive care from a provider that has a contract for a bundled transparent rate for surgery,” says Christopher D. Stine, bundled payments & corporate compliance officer at Regent Surgical Health in Westchester, Illinois. “With the increase of high-deduct- ible health plans and out-of-pocket costs rising, patients with insurance can sometimes end up with expen- sive bills for surgery,” says Dan Con- nolly, vice president of payer relations & contracting at Pinnacle III in Lake- wood, Colorado. “Because the sur- gery costs less and quality is not com- promised, patients have been willing to travel a reasonable distance to the high-quality, cost-effective providers.”


Typically, in medical tourism, an


employer that self-funds its insur- ance plan contracts with a third party that, in turn, contracts with providers for bundled rates for specific proce- dures. The employer agrees to waive the employees’ copay and/or deduct- ible if the employee elects to see a pro- vider that the employer has contracted with, Stine says. “With companies like Walmart now paying for employees to travel to high-quality providers, it will be interesting to see if that becomes part of a larger trend,” he says. Medical travel to access higher


quality care at lower costs is a growing trend, agrees Mark Stadler, chief exec- utive officer of BridgeHealth in Den- ver, Colorado (see sidebar on page 20). “Many ASCs are uniquely positioned to take advantage of this, what we call, ‘surgery benefits’ trend,” he says. “ASCs have a better understanding of


18 ASC FOCUS OCTOBER 2019 | ascfocus.org


surgeries are now being performed in ASCs, Stadler says. “By participating in a surgery benefits program, ASCs could gain access to patients that are outside of their service area and work with companies that provide concierge ser- vices to the patients. As BridgeHealth likes to say, it is a win-win-win for the patient, the employer and the provider.”


Capitalizing on Available Opportunities To successfully access the medi- cal tourism market, the key is to be there early, Stine says. “Educating the physician partners in the ASC is the first step,” he says. “The market can quickly change, and the first high- quality group of providers willing to better engage with employers will be the ones who attract directed cases. It is highly foreseeable that if you aren’t the first one at the table, you may be shut out from the employers’ plans.” In addition, he advises ASCs to


strive to continually demonstrate the value they offer by consistently pro- viding and documenting the high-qual- ity, value-priced services they provide. “Understand your ASC’s costs and


develop rates that can be competitive in a surgery benefits environment,” Stadler says. Work with the surgery benefits companies to develop opera- tional flows that support the process.”


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