FEATURE As far as payers are concerned, a

surgery benefits program is different than traditional fee-for-service insur- ance, Stadler says. “Understanding the review process to accept patients and communicating with the patient’s ben- efit program in a timely manner is key to capturing more patients.” Understanding how the payments

work and what is covered by the bun- dled payment also is key to smooth processing, Stadler says. Develop- ing systems that support that pro- cess is important, so patients don’t receive bills for services that are cov- ered by their surgery benefits pay- ments. “Ensuring that staff understand the process and recognize the patients have different needs than a non-travel- ing patient will also help the ASC suc- ceed in this space.”

Challenges and Pitfalls Trends suggest that medical tourism could quickly become a more signifi- cant option for patients, Stine says. “It is important for ASCs to understand the changing marketplace and partici- pate in programs when available,” he says. “Medical tourism presents addi- tional logistical challenges that ASCs need to be prepared for. It is impor- tant to work through those challenges when the volume is relatively slow, so if the market does shift, they are pre- pared to manage these cases.” The first order of business is to have a logistical plan for how to manage a patient that travels from out of town, Stine says. ASCs need to think through where patients and their family or friends who accompany them will stay, how the patient will be transported and how they will be discharged back home. “This requires ASCs to really engage with their physician partners, including the anesthesia providers, to develop protocols to manage these patients,” he says. “This could require additional contracting by the ASCs with a physician’s practice, anesthe- sia group or other providers to outline

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.”

—Christopher D. Stine, Regent Surgical Health

how they will get reimbursed and what care will be expected to be provided.” Understanding the travel pro- gram process and having a key person involved in each step to ensure smooth processing and a great patient experi- ence will encourage other patients to use that ASC, Stadler suggests. “The best referral sources for travel pro- grams are happy patients who tell other coworkers what a great health care experience they had.” Consider how to adjust for the unique needs of potential employer clients, Connolly says. “While a large portion of the program’s success will be tied to providing a standard and predictable process, some flexibility will be necessary to attract and retain employer clients.”

As medical tourism becomes more

prevalent, ASCs will need to focus even more on increasing and preserv- ing referral sources and patient refer-

rals, he says. “This starts with knowing where your referrals are coming from and where your patients are employed.” In addition, having a robust quality program will help an ASC that is try- ing to grow beyond their local service area, Stadler says. “When individuals are traveling, they want more informa- tion about the quality and outcomes of the ASC, and it is our goal to provide them with that information.” The biggest pitfall surrounding qual- ity data is often circulating that infor- mation, Stine says. “To engage effec- tively with third parties that manage marketing, it requires specialized talent that may not currently exist at an ASC.” The other big pitfall is identifying patients. “Medical tourism is still a small market, and short of a national marketing campaign, it is difficult to try and reach potential patients and educate them about your ASC.”


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