THIS WEEK IN U.S. DOMESTIC MEDICAL TRAVEL

Volume 1, Issue 11

Dear Colleagues,

Growing receptivity among employers to introduce a domestic medical travel benefit correlates to consumer/employee willingness to travel to other parts of the United States to access quality care with improved outcomes, and is coupled by increased demand for more cost-effective care that meets budget requirements.

The Journal of Tourism & Hospitality published an article I authored entitled, "U.S. Domestic Medical Tourism Delivers Sustainable Tourism for America's Cities and States," that further details the growth of U.S. domestic medical tourism, and its positive impact on the health, tourism and hospital industries nationwide. To read the article click here.

The interest in "Corporate Medical Travel" is clearly building.  Employee Benefit Adviser published an article, "A Place for Brokers in Medical Tourism," which includes input that I provided to the editor. To view the article, please visit: http://eba.benefitnews.com/.

There is one new leader in the healthcare space who merits a hearty welcome:  I would like to extend a sincere CONGRATULATIONS to healthcare analyst and commentator Brian R. Klepper, Ph.D. for his recent appointment as CEO of the National Business Coalition on Health (NBCH).

As a healthcare industry veteran, Dr. Klepper is very familiar with the medical travel market and the growing number of employers nationwide who are adopting a medical travel benefit. In this issue, Dr. Klepper will detail his thoughts on the employer role in this space, identify innovative ways to meet quality healthcare standards at affordable costs and emphasize the importance of outcome-based data.

Thank you for your interest in this exciting, growing market space. Please be in touch with your comments and editorial contributions, which can be sent directly to: editor@USDomesticMedicalTravel.com.


Laura Carabello
Editor and Publisher

SPOTLIGHT: Brian R. Klepper, Ph.D., CEO, National Business Coalition on Health

 

bklepper@NBCH.org
http://brianklepper.info/resume/
http://www.nbch.org/

 

About Brian R. Klepper, Ph.D.
Dr. Klepper is CEO of the National Business Coalition on Health (NBCH), representing 52 regional business health coalitions, 7,000 employer and union health benefits purchasers and more than 25 million people. NBCH is dedicated to leveraging purchasers collaborative strength to drive better health outcomes at lower cost.

A healthcare analyst, commentator and entrepreneur, Brian is also principal and chief development officer for WeCare TLC, LLC, a worksite primary care clinic and medical management firm based in Lake Mary, Florida.

Much of Brian's work has been focused on the mechanisms that underlie America's healthcare cost crisis and how institutionalized clinical and business practices have distorted care and cost patterns, driving unnecessary cost. His perspective favors patients, whose medical care often exposes them to needless physical risk, and purchasers, and whose healthcare costs are double those in other developed nations, creating a cascade of negative economic impacts.

Brian has also spearheaded policy initiatives that (partially) remedied major healthcare excesses. For example, his 2009 testimony to a U.S. Health and Human Services committee resulted in the revocation of the monopoly certification rights of the Certification Commission for Health Information Technology (CCHIT), a vendor-led, quasi-governmental agency that had blocked seamless healthcare data exchange, inhibiting care coordination. More recently, his campaign against the AMA's RVS Update Committee (RUC), which has systematically overvalued specialty care and undervalued primary care, led to mainstream media attention that has driven course corrections in medical services valuation.

Dr. Klepper is an in-demand speaker, a columnist for the physician site Medscape, and a regular contributor to the Health Affairs Blogthe Doctor Weighs InKevin MD and other expert healthcare blogs.

He is a reviewer for Health Affairs and The Journal of Ambulatory Care Management. With his wife, he also maintains Elaine's Journey, which details their struggle against primary peritoneal (ovarian) cancer.

Brian is an advisor to the Lundberg Institute and the Patient-Centered Primary Care Collaborative, which advocates for medical homes.

In his spare time, Brian is an offshore sailor.

About National Business Coalition on Health (NBCH)
The National Business Coalition on Health (NBCH) is a national, non-profit 501(c)6, membership organization of purchaser-led healthcare coalitions. NBCH and its members are dedicated to value-based purchasing of healthcare services through the collective action of public and private purchasers. NBCH seeks to accelerate the nation's progress towards safe, efficient, high-quality healthcare and the improved health status of the American population.

NBCH has a membership of 52 coalitions across the United States representing over 7,000 employers and approximately 25 million employees and their dependents. These business coalitions are composed of mostly mid- and large-sized employers in both the private and public sectors in a particular city, county, or region. NBCH member coalitions are committed to community health reform, including an improvement in the value of healthcare provided through employer-sponsored health plans and to the entire community.

NBCH provides expertise, resources, and a voice to its member coalitions across the country and represents each community coalition at the national level. As a "coalition of coalitions," NBCH spreads the tenets and practical applications of community health reform to areas where employers have yet to organize their purchasing power. For several years, NBCH has pursued national purchasing initiatives to offer turn-key healthcare products and services to community coalitions and their member employers. NBCH is dedicated to making the coalition movement the vehicle for meaningful change in the healthcare system throughout the United States.

U.S. Domestic Medical Travel (USDMT): First and foremost, congratulations on your recent appointment to serve as CEO of the National Business Coalition on Health (NBCH).

Brian Klepper (BK): Thank you!

Within a few weeks, I expect to gain an even greater understanding of the organization, and that is when I can fully begin to dive into my position.

The association is an incredible platform. There are 7,000 employers and 35 million people in the NBCH "community" - think of the market leverage you can get with that!

The healthcare industry has developed very specific mechanisms of excess in every sector, most of which are nearly invisible. On the entrepreneurial side of my career, I've tried to figure out what those mechanisms are.

But most people are aware of the national implications of these excesses. It's not just that healthcare costs double what it does in other developed countries, and that we know that half or more of all healthcare spending is wasted. We also know that four dollars out of every five in household income growth is now being absorbed by healthcare, which has left only one in five dollars for other critical needs, like education and infrastructure replacement. In other words, unrelenting healthcare cost is crowding out our ability to make other investments that are just as important for our country's future.

And then there's the fact that any business competing on an international stage must overcome a 9+ percent disadvantage on healthcare cost, just to be a level playing field with its competitors in Australia, Korea or Germany. That's an enormous barrier to success, and it's getting worse over time, eroding our global competitiveness.

These are serious national problems for business and the nation. My goal in this position is to make a long-lasting, positive impact on them.

USDMT: Let's start off by discussing your thoughts on major employers, such as Wal-Mart and Lowe's, playing an active role in the U.S. domestic medical travel space.

BK: I own an onsite clinic and management company, WeCare TLC, LLC, so I am very familiar with that market.

Aside from Lowe's, PepsiCo and Wal-Mart, the actual model where employers adopt a domestic medical travel benefit was engineered by a company named Health Design Plus.

EDITOR'S NOTE: Look for the inaugural issue of this newsletter which featured Ruth Coleman, CEO of Health Design Plus.

A medical travel benefit is especially attractive for employers dealing with high cost cases. Of course, employers first want to send employees to facilities that demonstrate high quality. Affordable costs are a significant added benefit.

As a healthcare purchaser, I prefer to see providers paid on a salary basis, rather than a percentage of what they order, so they have no financial stake in the care delivered. Domestic medical destination candidates should be able to show low nosocomial and post-surgical infection rates, and organizations should agree to set case rates. In other words, the employer should be given a set price for a surgery or procedure. Afterwards, if the patient needs additional treatment, the cost should be the responsibility of the provider.

Patients should have the option to travel with a spouse or companion, and be reassured that doctors inside the treating organization will work with doctors back home to transition the patient and work collaboratively if issues arise.

Of course, I would like to see all of the data afterwards.

Purchasers should be comfortable that the provider organization follows current evidence. That will ensure a higher probability of the right care, with fewer treatment do-overs.

Until now, healthcare organizations haven't had to improve the quality or cost of care, because local patients would seek treatment there by default. Now, plenty of treatment alternatives are emerging, which is putting pressure on these facilities to improve for the first time.

A domestic medical travel benefit creates a new dynamic for employers and further exemplifies the importance of looking out for patients and purchasers, rather than putting the financial aspects of healthcare organizations first.

USDMT: What is your take on the physician-owned surgi-centers that claim to deliver quality healthcare at 80 - 90 percent cost reduction?

BK: I want to see the data demonstrating that they're delivering equal or better quality care at lower cost.

There's an ambulatory surgery center organization in Kansas, I believe, that posts its rates. The organization is very competitive.

Employers and union purchasers need a lot more data in that and similar arenas so that they have a better idea what they are paying for.

USDMT: Do you think there is an opportunity for a medical travel benefit to capture the attention of smaller employers?

BK: Yes, I think it is coming.

I believe the healthcare reform law creates some unintended negative consequences. I strongly support its efforts to make healthcare more accessible and normally I would be predisposed to support the creation of the exchanges. But keep in mind that the healthcare industry has effectively captured and taken control of Congress and the regulatory process, and over decades they've demonstrated a willingness to take advantage of their position at the expense of the common good.

By creating a tremendous financial incentive for employers, smaller employers particularly, to place their employees onto the exchanges, the law removes the employer, as a purchaser, from involvement in healthcare. That will make it much more difficult to oppose the healthcare industry's excesses.

Businesses, large and small, need to collaborate to strengthen the marketplace and leverage the way that we buy together. That is the only way to bring healthcare back into balance.

USDMT: How can employers work together to drive down costs?

BK: For many years, I have been very focused on the tactics required to identify and disrupt healthcare's institutionalized mechanisms of excess.

I speak to employer audiences and describe exactly how the healthcare industry inflates cost, how the hospitals do it, how the health plans do it, how the drug and device companies do it, how the health IT companies do it. And then I provide concrete examples of how those mechanisms can be countered to improve quality and reduce cost. Many employers are astonished at the degree of excess and what it means for them, as well as what it means for the country's financial future.

USDMT: What do you see as the major challenge of leading the National Business Coalition on Health?

BK: One of the great mysteries of healthcare has been the unwillingness of employers, who pay for most of American healthcare, to mobilize and push back against the egregious practices of the healthcare industry.

Many business leaders can be ideological about healthcare, which makes them think about it very narrowly. But most of these individuals probably don't understand the gravity of what healthcare cost has done to the economy of the country, or understand that more than half of the money that purchasers pay provides no value.

Most also don't appreciate the extent of the healthcare industry's influence. In 2009, the year that the healthcare reform law was written, Congress accepted an unprecedented $1.2 billion in campaign contributions from the healthcare industry in exchange for influence over the shape of the law.

Only one group in America is potentially more influential than the healthcare industry - and that is everybody else. What's needed is for the business community to exert pressure - in the market and in policy - that requires the healthcare industry to be more transparent about its clinical and business practices. Only business is strong enough to achieve that, but if they do, it will save the country.

As a coalition of business health coalitions, NBCH is potentially the organization in the country that, at this moment, is most able to bring together and leverage the business community in ways that can address the healthcare industry's excesses. Of course there have to be local, market-based wins as well, but they're all part of the same process. The real task will be putting businesses' collective purchasing power to work in ways that can turn healthcare around and save the country.

 

NBCH Names Health Care Analyst and Commentator Brian Klepper New CEO

The National Business Coalition on Health (NBCH), representing 52 coalitions, 7,000 employers and 25 million employees and their families, is delighted to announce its selection of Brian Klepper, Ph.D., as CEO, effective March 10, 2014. Dr. Klepper is a healthcare analyst, commentator and entrepreneur who has focused on the mechanisms that underlie America's healthcare cost crisis. His perspectives favor patients, whose medical care often exposes them to needless physical risk, and purchasers, whose healthcare costs are double those in other developed nations, creating a cascade of negative economic impacts.

"We all know that healthcare is out of control, with many opaque practices that drive inappropriate care and cost, but much of American business has not yet confronted its gravity," said Klepper. "Unnecessary healthcare cost is displacing support of other critical needs, robbing American families of economic growth and hindering U.S. business' global competitiveness. The healthcare industry represents almost one dollar in five in the U.S. economy, and has tremendous control over both markets and policy.

"Only non-healthcare business is larger and more influential. NBCH represents a hugely powerful opportunity to leverage the health benefits purchasing power of employers and unions to make healthcare more accountable, higher quality, safer and more affordable. NBCH will work closely with business health coalitions and like-minded stakeholders around the country in ways that benefit patients, purchasers, the larger health system's sustainability and the nation."

Susan Szymanski, chair of NBCH's Board of Governors, agrees. "We are very excited that Brian will be at NBCH's helm. His clear focus and wide-ranging knowledge about healthcare clinical and business practice is the right mix of talents for NBCH at this time, as business leaders acknowledge that healthcare must be more meaningfully addressed. He'll work collaboratively with healthcare professionals and organizations, while encouraging change that can bring healthcare back into balance."

About the National Business Coalition on Health
NBCH is a national, non-profit, membership organization of purchaser-led business and health coalitions, representing over 7,000 employers and 25 million employees and their dependents across the United States. NBCH and its members are dedicated to value-based purchasing of healthcare services through the collective action of public and private purchasers. For additional information visit: www.nbch.org or follow us on Twitter: @nbch.

NOTE TO EDITORS:  For additional information, a high res photo of Dr. Klepper, or to schedule an interview, please contact Cary Conway at cconway@nbch.org, 972.731.9242.

U.S. Domestic Medical Tourism Delivers Sustainable Tourism for America's Cities and States
by Laura Carabello, executive editor and publisher, U.S. Domestic Medical Travel

Omicsgroup.org - Medical tourism is not a new concept, but what is new is the recognition of its emergence as a global medical business potentially challenging the dominance of healthcare markets in the developed world countries. Medical tourism - also known as medical travel - emerges as a new platform for international commerce, impacting healthcare delivery throughout the world [1]. Some of the factors which have contributed to the growth of the industry include increasing healthcare costs, long waiting periods in the developed world, low wage and competitive health markets in the developing world, availability of low cost transportation, and access to advanced information technologies [1].

The international medical tourism industry is now estimated to be worth $40 billion, with about seven million healthcare travelers seeking quality, affordable medical care that might not be available in their home countries [2]. Treatments and surgeries span everything from dental work to weight-loss procedures, orthopedic surgery and cancer treatments. The recent trend in medical travel can best be described as travel from developed countries, by the middle class, to a foreign country to avoid treatment delays, to access affordable, quality medical care or simply to have elective surgery combined with sight-seeing and other local tourism opportunities [3].

From an economic perspective, the phenomenon of medical tourism is regarded as a strategy for economic growth, with revenues from international patients translating into output, jobs and income [4]. Medical tourism follows the principals of sustainable tourism, aimed at improving the quality of life of everybody involved in the tourism sector. Countries throughout Central America now recognize the potential, as illustrated by Medical Tourism Guatemala which promotes on its website that, "... sustainable tourism favors a win-win situation: enhances the life experiences of the tourist and benefits the host people while respecting their cultural identity and their natural environment [5]."

Similar to other tourism ventures, there are many entrepreneurial opportunities associated with this emerging healthcare industry. Asian countries were among the first in the world to embrace the concept, and have enjoyed a competitive advantage because of the support and promotion by their governments. Medical and healthcare enterprises in countries such as India, Thailand, Singapore and Malaysia make ongoing investments in attracting tourists for this specialist market, with special emphasis on health and wellness destinations. As the costs of medical treatment and waiting times for accessing care gradually increase in western countries, the demands for medical services in developing countries are expected to increase. As a result, Asian countries specializing in attracting medical tourists create new entrepreneurial activity that can lead to a profitable and sustainable tourism industry in the region [6].

But the newest phenomenon in the medical tourism sector is the growth of U.S. domestic medical travel: inter-state to Centers of Excellence (COEs) throughout the country and inbound to the U.S. The United States is now one of the top three destinations worldwide for medical travel, and receives as many as 800,000 international patients seeking help with the most difficult health conditions [7]. This translates into good news for the tourism and hospitality industries since these sectors will benefit from the upward trend.

Growing receptivity among employers to introduce a domestic medical travel benefit correlates to consumer/employee willingness to travel to other parts of the United States to access quality care with improved outcomes, and is coupled by increased demand for more cost-effective care that meets budget requirements. Employers build in incentive programs to prompt workforce uptake of the benefit, including waiving co-pays and deductibles, and covering both patient and companion/caregiver travel expenses. One of the drivers is the documented track record of a COE to achieve better results for specific procedures, mitigating complications, re-do's, and readmissions - which can be very expensive in terms of hard costs, time lost from work, and the health of employees.

However, it may be challenging to calculate the precise size and scope of the domestic medical tourism marketplace since it is a relatively new trend and there is a paucity of reliable data from employers and other payers. About the only information comes from Lowe's, which introduced a program in 2010 to its 234,000 employees and 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 [8]. The program expanded to chronic pain management and spinal surgery in September 2012 [8].

Beyond Lowe's, there appears to be additional employer interest based upon ongoing announcements of the introduction and adoption of a domestic medical tourism program involving travel to another state or region within U.S. borders. Healthcare services have traditionally had a positive impact upon local tourism, and with the surge in domestic medical travel this is likely to grow. Upon review of the preferred COEs, the discussion of sustainable tourism in key cities throughout the United States becomes evident.

PepsiCo: Another Pioneer

PepsiCo, the world's second-largest food and beverage business, announced on December 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.

PepsiCo, which sponsors its own self-funded medical plans, will waive deductibles and coinsurance for those who elect to have their surgery at Johns Hopkins. The company will also cover the travel and lodging expenses to Baltimore for the patient and a companion. The payment methodology for these procedures is a bundled rate, an all-inclusive rate for hospital and physician charges and certain preoperative testing. This innovative reimbursement model provides payment for all the patient care over the course of a clinical episode instead of paying for each service on a fee-for-service basis.

To be eligible for the new program, the patient must be approved for surgery in advance and be healthy enough to travel. Other types of surgery may be made part of the program in the future.

Wal-Mart Announcement

Wal-Mart Stores announced October 12, 2012, that, as of Jan. 1, 2013, 1.1 million people covered under its employee health insurance would have access to heart and spine surgeries, and organ transplants at one of six health systems identified as "Centers of Excellence." Wal-Mart chose these health providers for their Center of Excellence program [9]:

  • Temple's Scott & White Memorial, Texas (cardiac surgeries, spine surgeries)
  • Mayo Clinic's three hospitals (organ transplants)
  • Cleveland Clinic, Ohio (cardiac surgeries)
  • Geisinger Medical Center, Pennsylvania (cardiac surgeries)
  • Mercy Hospital Springfield, Missouri (spine surgeries), the closest to Wal-Mart's corporate headquarters in Bentonville, Arkansas.
  • Virginia Mason Medical Center, Wash. (cardiac surgeries, spine surgeries)

HCR Manor Care

HCR ManorCare, a leading provider of short-term, post-hospital services and long-term care which has 60,000 employees, began offering fully covered cardiac surgery at Cleveland Clinic as of April 1, 2012. The HCR ManorCare Advanced Heart Care Program with Cleveland Clinic is a special program through the Company's medical plan that offers members state-of-the-art services focusing on complex heart procedures. This unique program allows those in need an opportunity to get quality care from the nation's leading heart care provider [8].

This program benefits any HCR ManorCare employee and his/her covered dependents enrolled in the MyCare Plan or MyHealth Plan medical plan option who meet clinical criteria for specific covered procedures. It focuses on certain complex cardiac procedures. These heart care procedures include inpatient heart surgeries and minimally invasive procedures. Upon return home, members use their own local physician(s).

Boeing Co. Introduces Benefit

As of October 1, 2012, Boeing Co., the world's largest aerospace company and leading manufacturer of commercial jetliners and defense, space and security systems, announced that it now offers approximately 83,000 of its non-union employees and retirees, and their eligible dependents, the opportunity to travel to the Cleveland Clinic for its cardiac care specialty program. The program covers comprehensive treatment for certain cardiac conditions, such as heart-valve replacements, coronary bypass procedures and other non-emergency cardiac procedures.

The program is available for U.S.-based non-union employees and non-Medicare-eligible retirees and their covered dependents enrolled in Boeing medical plans administered by Blue Cross and Blue Shield of Illinois, United Healthcare, Aetna and Cigna. While the program was initially open to non-union, Boeing would eventually like all employees to have access to this specialized care.

The aim of this specialty care benefit is to ensure that employees and their dependents have access to high-quality cardiac care from a leading medical facility with a proven track record of specialized cardiac care. Patients, who need certain cardiac procedures such as valve replacements and bypass surgery, have access to care for little or no out-of-pocket expense. The fixed-price, bundled-payment arrangement gives the self-insured company additional predictability because all expenses for a given procedure are wrapped into one payment. Patients can choose other medical centers but would likely pay more, in keeping with the provisions of their individual insurance plan.

Boeing and the Cleveland Clinic have a decades-long relationship, with the two working jointly to find innovative ways to deliver high value healthcare for Boeing's employees, retirees and families, including a program to manage healthcare for workers with chronic conditions. This program has significantly reduced hospital admissions, days of hospitalization and absenteeism, while also cutting direct costs of care by more than 20 percent [10].

Cleveland Health Line: Medical Travel Boosts Sustainable Tourism

With the Cleveland Clinic attracting the lion's share of domestic medical travel to date, the city of Cleveland is leveraging its world-class healthcare to reap the benefits of sustainable tourism. Euclid Avenue in Cleveland connects the two largest commercial districts in northeast Ohio: downtown Cleveland and University Circle, and in 1988, the city moved forward with bus rapid transit (BRT).

The resulting $200 million, 6.8-mile (11km) Euclid Corridor Transportation Project catalyzed a powerful transformation along the avenue. Since the BRT line opened in 2008, the corridor has attracted $5.8 billion in investment -- $3.3 billion for new construction and $2.5 billion for building rehab, together totaling more than 110 projects. Disproving naysayers and exceeding the expectations of supporters, the project has generated the economic growth that many thought could only be achieved with rail-and at a fraction of the cost.

By connecting downtown with University Circle, the BRT service contributes to the unification of Cleveland's top economic generators across the entire city. The Cleveland Clinic and University Hospitals of Cleveland-the city's two biggest employers-purchased naming rights to the BRT line in a 25-year, $6.25 million deal. Dubbing it the HealthLine ties the service to Cleveland's branding as a hub of medical care and research. By physically linking large hospitals, startups, convention space, and cultural amenities, the corridor is propelling Cleveland's evolution into a world-class destination for the healthcare and biotech industries [11].

The HealthLine has precipitated an economic development strategy not just for the corridor, but also for the city. The project has brought about the partnerships necessary for Cleveland to make a transition from an industrial economy to a knowledge-based economy, building on the strength of education, research, healthcare, and tourism. Euclid Avenue supports the ventures that comprise this new economy, as well as housing, retail businesses, restaurants, and entertainment venues. The corridor is vibrant with possibility as a place for people to live, work, and prosper, and serves as an example for similar cities in the United States and around the world [11].

Springfield, Missouri: Medical Mile District

The designated area surrounding the local medical facilities - including Mercy Hospital which now serves the Wal-Mart workforce - is known as the Medical Mile District. When patients travel to this area for care, the tie-in to tourism is evident: simply visit Arbor Suites Medical Mile, Springfield, Missouri, Sleep Inn Medical District, Springfield, Missouri, or Comfort Suites Medical District, Springfield, Missouri.

These hotels tout their location and close proximity to the prominent Medical Mile district, as well as the Bass Pro Shops, Wonders of Wildlife, Missouri State University, Drury University, the Springfield-Greene County Library and Ozark Technical Community College.

Excellent Healthcare Facilities Attract Business and Tourism

It is a logical conclusion that when employers direct their workforces to a healthcare COE, the city which houses these capabilities will benefit. Not only will the patient visit drive revenues to the hospital - which creates job opportunities and purchasing power for the institution - but the patient's companion/family member/caregiver will require services in the destination city.

  • Hotel and accommodations; casinos and medi-spas
  • Meals at local restaurants, other food purchases
  • Shopping
  • Visits to museums, local attractions or points of interest, entertainment venues, sports events
  • Airport and transportation services

Additionally, following the hospital stay, patients and companions may opt to remain in the city for a period of time before returning to their hometowns. An extended stay represents additional tourism revenues to the local economy and further stimulates job creation.

One employer who remains anonymous chooses to give employees an extra "spending allowance" to ease the decision to travel for care. The bottom line is: even after factoring in the travel expenses, the outcomes - and sometimes the lower cost of care - make the medical travel benefit a good decision for all. The impact on sustainable tourism is expected to be nothing short of profound.

References

  1. Connell J (2006) Medical tourism: Sea, sun, sand and y surgery. Tourism Management 27: 1093-1100.
  2. Jordan Robertson (2013) Top Travel Destinations for Medical Tourism; Bloomberg.
  3. Gray HH, Poland SC (2008) Medical tourism: crossing borders to access health care. Kennedy Inst Ethics J 18: 193-201.
  4. Bookman MZ, Bookman KR (2007) Medical Tourism in Developing Countries. New York: Palgrave MacMillan, PP. 245.
  5. Medical Tourism Guatemala 2013.
  6. Lee Christine (2006) Medical tourism, an innovative opportunity for entrepreneurs. Journal of Asia Entrepreneurship and Sand Sustainability 3: 1.
  7. Robertson Jordan
  8. Elliott Victor Stagg (2012) Wal-Mart gives major boost to domestic medical tourism movement.
  9. McKesson Reve News (2013) Wal-Mart Joins Domestic Medical Tourism Movement.
  10. Santilli John (2012) Boeing and Cleveland Clinic Finalize Employer Travel Deal
  11. Hellendrung Jason (2012) HealthLine Drives Growth in Cleveland, Urbanland.

To view the original article click here.


Let's Get a Medical Tourism Certificate! Is it Worth the Paper it's Printed On?
Written and published by IMTJ

A new industry is developing around the business of medical tourism. It's the certification business. You need an impressive sounding name, a website, a decent laser printer (and a good relationship with a certificate framing service!).

There's a plethora of "get rich quick" certifications which are appearing around medical tourism. They are quick and easy to obtain. Through a half or one day seminar or an online course, the certifier usually promises that you will attract more international patients, give your organization a competitive edge, increase the safety of patients and even reduce your organization's liability.

To continue reading click here.

World's Largest Self-Insurance/ART Event Coming to Phoenix!

The Self-Insurance Institute of America, (SIIA) today announced the program for its National Educational Conference & Expo, scheduled for October 5-7, 2014, at the J.W. Marriott Desert Ridge Resort & Spa in Phoenix. The event typically attracts more than 1,700 attendees from throughout the United States and from a growing number of countries around the world.

Detailed event information, including registration forms, can be accessed on-line at www.siia.org, or by calling 800/851-7789. Sign up today and take advantage of discounted early bird registration fees and secure your room at the host hotel. NOTE: This hotel is a SIIA member favorite and always sells out early, so please keep this in mind as you make your arrangements.

The program features more than 40 educational sessions designed to help employers and their business partners identify and maximize the value of self-insurance solutions.

We'll cover self-insured group health plans from every angle, including plan design and cost containment, financial risk transfer, broker involvement and healthcare reform compliance. Extra content has been incorporated this year that should be of specific interest to TPA executives and their key management teams. And you won't want to miss our panel discussion sessions featuring top thought leaders talking about the future of the self-insurance marketplace.

Another focus will be stop-loss captive programs (also known as employee benefit group captives). An increasing number of smaller and mid-sized employers have been considering self-insured group health plans and stop-loss captive programs can help facilitate this transition. SIIA has become the recognized industry leader in this fast-growing captive insurance market niche and the session speakers for this topic area will be many of the industry's top experts.

Also within the Alternative Risk Transfer track, additional sessions will focus on Enterprise Risk Captives, also known as 831(b) captives, which have become an increasingly popular self-insurance solution for many companies.

Given the rapidly involving business and regulatory environment for group workers' compensation self-insured funds (SIGs), we have incorporated a series of roundtable sessions where SIG leaders from around the country will provide a unique opportunity to share perspectives on how their organization should be positioning themselves for future success. These SIG-focused roundtables will be supplemented by additional timely sessions of interest to both groups and individual workers' compensation self-insurers.

Rounding out the program will be some sessions addressing key self-insured issues, including healthcare reform compliance requirements, for companies with global operations and/or workforces, giving the conference an added international flavor.

This top notch educational program will be supplemented with quality networking events, including an exhibit hall with more than 150 companies showcasing a wide variety of innovative products and services designed specifically for self-insured entities. If you are searching for a self-insurance business partner, they will be waiting for you at this event. For more information about exhibiting and sponsorship opportunities, please contact Justin Miller at 800/851-7789, or jmiller@siia.org.

Your can get a head start on your networking by participating in the conference golf tournament the morning of Sunday, October 5. And then cap things off with an incredible social event on the closing night of Tuesday, October 7, so be sure that you make your travel arrangements accordingly.

New to Self-Insurance/Alternative Risk Transfer? SIIA Welcomes You!....While the conference will be packed with industry experts and many advanced-level educational sessions, SIIA warmly welcomes those who are new to self-insurance/alternative risk transfer and want to learn the basics. To help you get started, we have scheduled "beginner" sessions immediately before Sunday night's welcome reception to help you more fully participate in the overall event. Additionally, for employers (non-industry service providers) considering self-insurance, you can take advantage of a highly discounted registration fee.

If self-insurance is important to you in any way, this is simply a must-attend event. We look forward to seeing you in Phoenix.

Register Now: www.siia.org/national

NC Medical Travel Joins Greensboro, North Carolina Chamber of Commerce
NC Medical Travel and Tours to Costa Rica joins the Greensboro Chamber of Commerce in April 2014. Services include coordinating travel arrangements and booking appointments for patients who travel to Unibe Hospital for medical, dental and surgical procedures. NC Medical Travel works with existing TPA's, benefit administrators, HR managers, and CEO's of self-funded companies to lower their employee healthcare costs by up to 65 percent.

DentaRica, LLC, is very pleased to announce that they have joined the Greensboro Chamber of Commerce in Greensboro, North Carolina, a metropolitan area near Clemmons, North Carolina, where their office is located in the Historic Broyhill Suites. They have joined as "NC Medical Travel to Costa Rica" to better explain who they are and what they do. Their websites are: ncmedicaltravel.com and www.dentarica.com. Although both websites function well, they are designed to meet different needs.

Membership in the Greensboro Chamber of Commerce adds credibility to the rather new DentaRica business, and the resources provided as part of membership are going to add many new networking opportunities for their business to grow. Along with their beautiful new office space, this is a measure designed to make their valued customers feel more comfortable about medical travel. 

Additionally, this is part of an effort they are making to reach out to small businesses, TPA's, benefits administrators, HR managers, and insurance agents to better inform them of NC Medical Travel's out-of-the-box solutions for employee healthcare benefits. With the new healthcare reform landscape, they know that their medical travel services won't work for all businesses or individuals. However, especially for certain medical needs not covered by insurance (or for plans that have high deductibles and co-pays), their services are meeting a substantial need. Weight loss surgery or procedures that insurance companies decide are not covered are almost always going to leave employers and their employees in a lurch.

Dental care is very often a source of unfilled needs (no pun intended). NC Medical Travel has partnered with Clinica Unibe in Costa Rica, and they are reaching out to help with practical, economical solutions. ProMed Certified, professional staff at NC Medical Travel can work directly with employers with few or many employees, and coordinate care for their employees, saving an average of 65 percent on surgical and preventative healthcare costs.  

One of the difficulties of any new business, or even an old one that is expanding, is convincing new customers that they are trustworthy and legitimate. DentaRica encourages smart shoppers. And unlike many businesses who try to 'trick' even a smart shopper with gimmicks and false advertising, their goal is to be the obvious best choice in value, quality, and service for medical travel to Costa Rica. 

Please visit the Chamber website at www.greensboro.org, and also www.clinicaunibe.net.  You may also visit us in the office in Clemmons, or at the ProMed International Medical Travel Summit at the Deauville Resort in Miami on May 6-8.

Media Contact

Company Name: NC Medical Travel
Contact Person: Kathryn Jordan
Phone: 336-608-5636
Address: 3540 Clemmons Rd 
City: Clemmons
State: NC
Country: United States
Website: www.ncmedicaltravel.com

To view the original article click here.

The Role of Urgent and Primary Care within Medical Tourism
by Christopher Timm, President Metro Immediate & Primary Care

Worldwide, medical tourism is a quickly growing industry as people are pursuing higher quality and more specialized healthcare outside of their own country. Many of these patients arrive to the U.S. after having researched and communicated with reputable specialists to pursue a path of wellness they can trust. While medical tourists frequently choose the U.S. for access to specific procedures like complex surgeries, specialized treatments for chronic diseases and other methods of focused care, immediate and urgent care practice managers across the nation might wonder: What role can our practice play to support this influx of medical tourists?

It is very common for medical tourists to travel to the U.S. in the company of family or friends and stay for an extended period of time. That said, while a family member is being treated for specialty care, the family and friends of the patient might encounter a health issue of their own during their stay. Should a friend or family member of a medical tourist fall ill to the flu or result in minor injury, what is the best and most cost-effective way for them to receive care while in the U.S.? Away from their primary care physician, access to their own country's healthcare services and out of their cultural comfort zone, a tourist's first instinct might be to visit the closest emergency room, but will this be the most cost-effective and fastest route to getting them back to health? Maybe not. Emergency services are expensive and the process can be cumbersome and frustrating.

Urgent care practices, such as Washington D.C.'s Metro Immediate and Primary Care, offer affordable self-pay options, shorter waiting room times than the ER, and quick access to equipment like X-rays. Visiting an urgent care practice in these cases is the logical and most convenient solution for this niche population of transients in need of non-emergency healthcare.

Urgent care practices, like Metro Immediate & Primary Care, utilize electronic health (or medical) records, improving the intercommunication and efficiency between physicians resulting in a more streamlined experience for the patient. With record-sharing now simplified with the use of this technology, experiencing medical care further and further away from home becomes less complicated for patients and their physicians.

Technology, interconnectivity and accessibility are the keys to success in the medical travel industry. This steady growth fosters a healthy competition between providers, making non-emergency healthcare services more affordable for the transient population. As medical travel to the U.S. continues to increase, urgent care practices should be taking the necessary steps to market the benefits of visiting their offices to those tourists visiting the U.S. and searching for non-emergency care.

Why Won't Medicare Pay for Medical Tourism?
by John R. Graham

Healthblog.ncpa.org - In a working paper published by the Mercatus Institute at George Mason University, Marc D. Joffe notes that Aetna, Blue Shield and HealthNet offer health insurance in California that gives beneficiaries access to Mexican providers. The U.S. insurers rent a provider network from a Mexican insurer.

The cost of healthcare in Mexico is 60 percent to 80 percent lower than in the United States. Therefore, cash-paying Americans travel to Mexico for many medical procedures. Joffe cites estimates of around half a million Americans visiting Mexico annually for medical care (although the number traveling only to fill prescriptions is not reported).

Joffe notes that 25,000 Americans living in Mexico in 2011 were receiving Social Security deposits. Unlike half a million other Americans who travel to Mexico for treatment, these retirees and their spouses return to the United States for treatment. The reason is that Medicare does not pay for their treatment out of country.

Joffe doesn't estimate how much money Medicare would save if it paid for their treatment in Mexico, but a back-of-the-envelope estimate is not hard to figure out. Let's just focus on inpatient hospital spending, which totaled $120 billion in 2012 (according the Medicare Payment Advisory Commission). This amounted to $3,263 per beneficiary. However, only 28.9 percent of beneficiaries required inpatient hospitalization in 2012. So, the cost per admitted patient was $11,291.

If Medicare could cut that cost by 60 percent, it would save $4,516 per patient. Scaling that to the American retirees in Mexico, it could amount to as much as $33 million.

Those savings amount to peanuts within the Medicare budget, and would only happen if every retiree took advantage of the option. But it's a start. And increasing numbers of Americans are planning to retire abroad, not only to Mexico, but Costa Rica and other low-cost countries.

It's a growing opportunity for Medicare savings. And the federal government wouldn't even have to establish provider networks: It could just ask Aetna, Blue Shield or HealthNet to share theirs.

To view the original article click here.

Health Costs Resume Their Rise
Reprinted with permission granted by the Pacific Research Institute

Pacificresearch.org - America's health cost crisis is no longer in remission.

Last week, the U.S. Commerce Department's Bureau of Economic Analysis (BEA) announced that healthcare spending had risen 9.9 percent in the first quarter of 2014 - the largest quarterly increase in more than 30 years.

The BEA's estimate comes on the heels of a report from the IMS Institute for Healthcare Informatics that attributed the jump in spending to increases in physician office visits, hospitalizations, and prescription-drug usage.

Worse, Obamacare will only exacerbate America's health cost crisis as it takes full effect this year.

Believe it or not, Americans have had some relief from high healthcare spending over the past few years. From 2009 to 2012, spending grew less than 4 percent a year, the lowest growth rate in 50 years.

The slowdown was largely due to the recession. Americans responded to stagnant wages and an uncertain economy by cutting back on medical expenses.

But with the economy picking up once again, health spending has returned to pre-recession levels. In January, it reached historically high levels as a share of GDP. And in February, health spending growth reached a seven-year high, according to the Altarum Institute.

Spending is going up because people are consuming more care. Doctor's office visits increased by 2.7 percent in 2013. Specialist visits rose 4.9 percent the same year.

To continue reading the article click here.


Report Urges Price Transparency Action
Tighten related healthcare reform regs, says Center for American Progress
by Ron Shinkman

Fiercehealthcare.com - Based on a new alert from the Center for American Progress, a recent article, "Report Urges Price Transparency Action,"f published by Fiercehealthcare.com, emphasizes the need for pricing transparency within the healthcare industry.

To view the original article in its entirety click here.

Help Save a Life and Support MatchingDonors
100 percent of all donations on MatchingDonors.com go to help people get organ transplants on MatchingDonors.com.

MatchingDonors is a 501c3 nonprofit organization and the nation's largest online living organ donor organization finding living organ donors for people needing organ transplants.  In conjunction with various health organizations throughout the United States we have created a very successful Public Service Announcement campaign to help people recognize that they can save lives by being a living organ donor, to encourage them to register as an altruistic living organ donor, and to make them realize they can help save the lives of people needing organ transplants by donating other things. This MatchingDonors Living Organ Donor Initiative program has already saved thousands of lives.

JOB OPPORTUNITIES
Do you know of any available job openings relative to the U.S. domestic medical travel industry? We encourage readers to submit any available, relevant job opportunities along with its descriptions and requirements for fellow readers and industry professionals to consider. All submissions are appreciated.

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U.S. Domestic Medical Travel™

About U.S. Domestic Medical Travel
U.S. Domestic Medical Travel, a sister publication to Medical Travel Today www.medicaltraveltoday.com, is a newsletter published by CPR Strategic Marketing Communications, an international marketing and public relations agency based near New York City that specializes in healthcare and life sciences. In the new era of health reforms, U.S. Domestic Medical Travel discusses the growth of domestic medical travel and its importance to hospitals, employers, insurers, health plans, government, TPAs, brokers and other intermediaries.

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Spotlight Interview

SPOTLIGHT: Brian R. Klepper, Ph.D., CEO, National Business Coalition on Health

News in Review

U.S. Domestic Medical Tourism Delivers Sustainable Tourism for Ameria's Cities and States

Let's Get a Medical Tourism Certificate! Is it Worth the Paper it's Printed On?

World's Largest Self-Insurance/ART Event Coming to Phoenix!

NC Medical Travel Joins Greensboro, North Carolina Chamber of Commerce

Why Won't Medicare Pay for Medical Tourism?

Health Costs Resume Their Rise

Report Urges Price Transparency Action

Help Save a Life and Support MatchingDonors