THIS WEEK IN U.S. DOMESTIC MEDICAL TRAVEL

Volume 1, Issue 8

Dear Colleagues,

I am honored to report that this newsletter and my experiences - nearly 15 years ago - with U.S. domestic medical travel have been featured in the February 2014 issue of Delta Sky Magazine! The medical travel piece entitled, "Paying Less for the Best," written by Kevin Featherly, focuses on the growing domestic medical travel industry and the nation's push for high quality, low cost healthcare options. To read more about my personal experience with domestic medical tourism and where the industry is headed, view the original article here.

We continue to report on healthcare reform nationwide and its impact on the medical travel industry. Consumers now face with higher deductible insurance plans, along with the harsh reality of healthcare expenses.

By exposing the actual cost of treatment and how consumers are being charged, Scott Decker, president, HealthSparq, discusses the company's role in developing the appropriate tools and solutions that consumers need to become empowered shoppers of healthcare services -- provider by provider, specialty by specialty, location by location.

I am also pleased to announce that I will moderate a panel discussion on medical travel, "ALL ABOARD! U.S. Centers of Excellence Banking on Employer and Payer Uptake of Domestic Medical Travel Benefits," during the Institute of HealthCare Consumerism's (IHC) 5th Annual IHC FORUM & Expo Conference, on Thursday, May 8, 2014, between 3 p.m. - 4 p.m., in Atlanta, Ga. It will be a great meeting and an opportunity to showcase your offerings in medical travel. http://www.theihccforum.com/2014-ihc-forum-and-expo/

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: Scott Decker, President, HealthSparq

Scott Decker, President
http://www.healthsparq.com/

About Scott Decker
As HealthSparq's president, Scott leads the company's mission to develop the tools and solutions that consumers need to become empowered shoppers of healthcare services.

Prior to HealthSparq, Scott spent five years at NextGen Healthcare, a leading developer and provider of electronic health records and financial systems. As president, he oversaw day-to-day operations for three years. He also managed the development and implementation of strategic business plans to promote the company's future growth. As senior vice president, Scott managed the company's marketing and strategic planning, community connectivity and the hospital sector.

Before his tenure at NextGen, Scott founded and served as chairman of the board of directors and CEO of Healthvision, Inc., a pioneer in the health information exchange (HIE) market. While there, he built and deployed one of the first Software-as-a-Service (SaaS)-based infrastructures in the healthcare industry.

Scott served as the vice president of development for VHA's health information technologies business unit previous to Healthvision, Inc. There he helped develop one of the nation's first Intranets: VHAseCURE.net. Scott began his career at IBM Corporation, where he held a variety of sales, marketing and business development positions within the global health industry business unit.

A regular speaker at healthcare and financial conferences throughout the United States, Scott leverages his 23 years of professional and management experience in healthcare information technology to provide a unique perspective on the emerging world of health information technology.

Scott graduated summa cum laude from Trinity University in San Antonio, Texas, where he earned a bachelor's degree in computer science. He has been honored twice as a finalist for the Ernst & Young Entrepreneur of the Year. In his spare time, he is an active triathlete and eight-time finisher of the Ironman Triathlon.

About HealthSparq
HealthSparq™ develops healthcare transparency software solutions for health plans and employers to offer to their members and employees. We are part of- and backed financially by-the Cambia Health Solutions family of companies, which brings nearly a century of experience in developing and providing health solutions to consumers.

HealthSparq's integrated healthcare transparency solutions for information sharing and decision-making work by leveraging claims-based treatment timelines, costs and treatment data linked together with consumer reviews and community discussions. The result turns patients into informed healthcare shoppers, allowing them to seek out better care, make smarter choices and save money. Our customers consist of 15 health insurance plans that cover 30 million members across 20 U.S. states.

Our SaaS platform delivers critical cost and quality information to consumers via their health plan and employer websites, saving patients and insurers money and time. These integrated applications, which have been in use by members of a large regional health insurance plan since 2006, empower patients and provide strategic advantage to health plans.

U.S. Domestic Medical Travel (USDMT): Share with our readers some background on your career and your company.

Scott Decker (SD): Beginning with the company, Healthsparq is a wholly owned subsidiary of Cambia Health Solutions, which technically consists of two components: One piece of the company is a regulated insurance business-a Blue Cross Blue Shield plan in the Northwest-and the other half is an investment arm that makes investments in companies that aim to transform healthcare into a consumer friendly and economically sustainable model.

We purchased intellectual property, hired a number of employees, and have gradually been growing and developing the company. We now have 15 health plans across the country that each utilize our transparency platform to essentially light up cost and quality information in their local markets.

USDMT: Let's start with the pricing transparency. How willingly did these health plans adopt that kind of transparency?

SD: The health plans have every incentive to bring more transparency to cost information -- it is a friendly initiative for health plans and their members.

Little resistance is shown by health plans to bring this kind of information to market. If there is any resistance, it is generally on the side of the provider that isn't accustomed to working in a market that's economically transparent.

For a long time, consumers have not paid attention to what medical treatment has been costing. But all of that has changed as we see more individuals coming into higher deductible plans.

USDMT: Are the health plans pressuring the providers and the hospitals to offer transparency? Is that your role?

SD: We take years of claims data and run it through an analytics engine. By doing that, we see what treatments are costing and how they are being charged -- provider by provider, specialty by specialty, location by location.

When one of our clients requests information, assuming we can get our hands on the data to power our analytics, we are good to go… whether the providers like it or not.

USDMT: So will the health plan be telling its members that they can have treatment performed at one facility for $5,000 or have it done across the street for $10,000?

SD: Exactly.

Patients become aware of what actual procedures will cost, as well as how these procedures will impact them at a personal level-out of pocket expenses-and allow them to formulate a decision.

I would just like to add this: Employer clients of the plan are thrilled about healthcare transparency. In a lot of cases we have the opportunity to work with a health plan and provide a more customized solution for their specific employee base.

USDMT: Would that be for surgical procedures only, or is it for MRI's and outpatient treatment?

SD: Anything a claim would be submitted for we can use to populate our healthcare transparency tools.

USDMT: After you have this transparency in place, can you then trend changes in consumer behavior regarding the choice of location?

SD: Yes, we can.

As a provider of online shopping tools for healthcare, there are competitive pressures in the market we haven't seen before, and we continue to study this trend.

In fact, HealthSparq has initial data from one of our health plan customers in the Pacific Northwest that demonstrates when consumers have the tools and information they need to shop for healthcare, costs go down.

In our research study we examined the cost savings generated when consumers used HealthSparq's Treatment Cost Estimator tool to shop for healthcare services online prior to treatment.  This tool provides detailed out-of-pocket estimates and cost comparisons for common treatments, visits and services from pre-treatment to post-treatment.

Our researchers compared the choices made by those who used cost tools to shop for treatments around specific treatment conditions versus those who did not use cost tools. We reviewed medical claims for the conditions, controlling for gender, age, state, member benefit level and more… and what we learned was astounding.

The study revealed a potential of $49 million in cost savings that could've been achieved if all health plan members had shopped for healthcare using the cost tool during the study period.

What our study demonstrates is that once patients have the right information and tools available to them, they do shop for healthcare services, and many of them choose lower cost options.

USDMT: Do you find that the consumer needs other forms of education or information to make a decision?

SD: Absolutely.

Patients aren't always just looking for the lowest cost, but are equally in search of quality.

Our company provides patients with an online resource to view everything from certifications and accreditations, outcome studies, and personal patient reviews of facilities and other reports to assist them in making better healthcare decisions. We also offer an online community to support the emotional part of the decision-making process, where members can consult with each other and with experts.

USDMT: How do you report outcomes? Who benchmarks the data and does the consumer understand that data when it comes to quality and outcomes?

SD: We are very effective with the cost half of the process.

On the quality side, we've taken an approach that allows our clients to specifically choose what type of quality information they want to provide.

USDMT: Considering our publication is geared towards domestic medical travel, would the individuals who have access to your tools and information be able to make a choice between a hospital that is down the street versus one that is 10 states away? Or is it just with the providers in your immediate area?

SD: We are providing this as a direct-to-consumer offering, which is driven by what our clients want to provide to their members and/or employees.

We have clients who are aware that when undergoing a search on cost, the opportunity to participate in a tele-video conference with the physician -- as opposed to going to see the physician -- is always available. The client can very easily do the same thing on a medical tourism time opportunity.

USDMT: How does your solution compare to others that are also in this market?

SD: What really differentiates us from others in the market is that we use a model that works with the health plans at its core.

With our sophisticated claims based analytics model we are able to partner with the actual member, define the out-of-pocket expenses, and give a very specific answer to each consumer based on their coverage.

The more generic transparency companies currently in the market are working with broad-brush data around our region. They hit obstacles because they don't have the specific data to reassure the consumer on his or her choice or the opportunity to take different actions.

USDMT: Tell me how you got interested in this line of work.

SD: I've been in healthcare Information technology for 25 years, and prior to this I was on the provider side of electronic health records with physicians.

Individuals that have been in healthcare for a long time have a bit of a vested interest in repairing issues that have been frustrating for a long time. When this opportunity was presented to me, it seemed like a fantastic way to change the game and bring consumerism to healthcare, which it has proven to be.

There is just so much going on right now on this front that I think we are going to see major changes in U.S. healthcare within the next five years.

USDMT: Consumerism is so poised to appeal to the American public. Are Americans ready to embrace having all of this information, or do you think they were happier when people made decisions for them?

SD:Personally, I don't think that Americans are happier. It is a lot easier for somebody else to worry about all of the information involved in the cost and quality of care, and it is hard for the American public to understand these changes.

USDMT: Exactly. The health plans give you the most expensive option and people say I want that because it's the Mercedes vs. the Chevy. In the long run, does it really matter? Is the cost really the differential or is it the quality?

SD: I think it is a combination.

As I said, there is absolutely no correlation in most markets between cost and quality. What the consumer will ultimately be driven towards is the highest quality they can receive at low to mid cost.

Groundbreaking Study Unveiled at AHIP Institute Offers Health Insurers New Insights into the Post Reform Environment

HealthSparq President Reveals Under-Utilization of Cost and Quality Comparison Tools

HealthSparq, a trusted provider of healthcare transparency solutions to many of the nation's largest regional health plans and employers, unveiled a first-of-its-kind benchmark study at the America's Health Insurance Plans (AHIP) Institute 2013 conference demonstrating the under-utilization of transparency tools by health plans nationwide. Additionally, HealthSparq president, Scott Decker, offered feedback to health plans about how they can be more competitive in a reform environment.

According to a recent Robert Wood Johnson Foundation focus group survey, consumers are interested in basing healthcare decisions on comparison data; however. A recent HealthSparq study, however, found that a majority of insurers are offering only basic provider search tools, and not essential healthcare cost and quality information to members. This presentation comes on the heels of a recent AHIP Board of Directors statement that listed "Tackling Barriers to Transparency" as one of three key strategies.

"In the midst of healthcare reform, and change happening in the healthcare marketplace, costs continue to be unsustainable for employers and individuals," said Decker. "The marketplace is responding slowly as consumers demand more information to comparison shop for healthcare. Insurers and employers have the power to provide that information to individuals. Our organization helps them bring that power directly to their members and employees."

The survey was commissioned by HealthSparq and conducted by the Cicero Group, an independent market research firm. The study found that among health plans, transparency is expected to emerge as a point of greater organizational focus, and interest in third-party tools to provide enhanced transparency for consumers is anticipated to grow. This finding is validated by a recent study by research and advisory firm Aite Group indicating that the healthcare transparency industry is expected to grow to $3 billion by 2016.

"More than two-thirds of health plan executives and managers agree it's important to equip members with the tools they need to make informed healthcare decisions," said Cicero Group CEO Randy Shumway. "However, with varying levels of awareness of availability of different transparency tools, there is clear room for increased understanding of the full scope of what transparency is and can entail."

The statistical significance of the survey calculated to a confidence level of 95 percent.

To download a summary report of the study, visit HealthSparq's website.

Coincident with the release of this study, HealthSparq has also released a new White Paper at AHIP Institute that describes the close relationship between healthcare reform and transparency. To download the paper, visit HealthSparq's website.

About HealthSparq
HealthSparq develops healthcare transparency solutions for health plans and self-insured employers. The HealthSparq platform leverages data from a variety of sources, including health insurance claims, linked together with community reviews and discussions to empower consumers to make informed decisions via online shopping for healthcare. HealthSparq is part of the Cambia Health Solutions family of companies and is located in Portland, Ore. To learn more about HealthSparq, visit www.HealthSparq.com and follow @HealthSparq on Twitter. To request a HealthSparq demo, please send an email to info@HealthSparq.com or call 855-SPARQ-IT (855-772-7748).

Media Contact
Christine Lynch
208.333.7839, Christine.Lynch@CambiaHealth.com


Laura Carabello Moderates IHC Medical Travel Panel Discussion
Institute of HealthCare Consumerism's (IHC) 5th Annual IHC FORUM & Expo Conference, Thursday, 3 p.m. - 4 p.m., May 8, 2014, Atlanta, GA

Laura Carabello, founder and principal, CPR, and publisher of Medical Travel Today and U.S. Domestic Medical Travel™, will moderate a panel discussion on medical travel - "ALL ABOARD! U.S. Centers of Excellence Banking on Employer and Payer Uptake of Domestic Medical Travel Benefits" - during the Institute of HealthCare Consumerism's (IHC) 5th Annual IHC FORUM & Expo Conference, Thursday, 3 p.m. - 4 p.m., May 8, 2014, Atlanta, Ga.

"The fast-growth phenomenon of U.S. domestic medical travel -- inter-state to Centers of Excellence (COEs) throughout the country, inbound to the U.S., and outbound to destinations worldwide - is capturing the attention of employers, payers, third party administrators, insurance companies and other intermediaries throughout the world," Carabello says. "With the growth of HSAs as well as self-funding, a domestic medical travel benefit is now gaining traction among small, medium and large employer groups."

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. As a result, and in the new era of health reforms, Americans are witnessing:

  • Rapid adoption of domestic medical tourism: travel to another state or region within U.S. borders
  • Employer receptivity to introducing a medical travel benefit
  • Consumer willingness to travel to other parts of the United States to access quality care with improved outcomes
  • Increased demand for more cost-effective care that meets budget requirements

"There is growing interest among U.S. hospitals, providers and Centers of Excellence to attract foreign patients," Carabello adds. "Physician-owned ambulatory surgi-centers are participating in this growth trend, as well. International patients are often cash-paying customers and originate from countries where there are significant financial resources but limited healthcare infrastructure or access to quality diagnostics or care."

This session will examine the top volume procedures for medical travel, track the growth of the industry, evaluate the positioning of provider organizations and COEs, and review initiatives by some of the nation's largest employers to introduce domestic medical travel programs. With the implementation of healthcare exchanges, and amid mounting challenges for balancing quality and cost-savings, this discussion will help conference attendees to evaluate their participation in a medical travel program.

Big Name, Expensive Hospitals Don't Necessarily Provide Best Care
by Zack Budryk

Fiercehealthcare.com - Hospitals' reputations and prices have little bearing on their care quality, according to a new study published in Health Affairs.

For the study, researchers analyzed almost 25,000 insurance claims from current and retired autoworkers in 10 metropolitan areas: Cleveland, Detroit, Indianapolis, Kansas City, St. Louis, Flint, Mich., Warren, Mich., Toledo, Ohio, Youngstown, Ohio and Buffalo, N.Y. The workers visited 110 hospitals, divided into three categories:

  • Thirty "low-price" hospitals, where prices were at least 10 percent below average;
  • Fifty "medium-price" hospitals, which were not defined in the study; and
  • Thirty "high-price" hospitals, where prices were 10 percent or more above average.

To view the original article in its entirety click here.

Study Finds Telehealth Expands Access to Health Care
by Antoinette Alexander

Drug Store News - As the interest in telemedicine programs continues to grow, a recent Rand Corp. study found that people who are younger, more affluent and do not have established healthcare relationships are more likely to use a telemedicine program that allows patients to get medical help for acute ailments - including prescriptions - by talking to a doctor over the telephone.

Patients who used the service suffered from a wide assortment of acute medical problems, such as respiratory illnesses and skin problems, and researchers indicated that they found little evidence of misdiagnosis or treatment failure among those who used the service.

The findings, published in the February edition of the journal Health Affairs, are from the first assessment of a telemedicine program offered to a large, diverse group of patients across the United States.

"Telemedicine services such as the one we studied that directly links physicians and patients via telephone or Internet have the potential to expand access to care and lower costs," Lori Uscher-Pines, lead author of the study and a policy researcher at Rand, a nonprofit research organization, stated.

"However, little is known about how these services are being used and whether they provide good quality care. Our study provides a first step to better understand this growing health care trend."

Uscher-Pines and co-author Ateev Mehrotra studied 3,701 patient "visits" provided from April 2012 to February 2013 by Teladoc, a provider of telemedicine services. Teladoc connects patients to providers for specialty visits or connects providers to other providers for consults for in-hospital care. Patients who used Teladoc were compared to peers who visited hospital emergency departments or a doctor's office for a similar problem.

Among patients studied, the most common problems for a Teladoc visit were acute respiratory conditions, urinary tract infections and skin problems, which accounted for more than half the cases. Other frequent reasons for Teladoc visits were abdominal pain, back and joint problems, viral illnesses, eye problems and ear infections.

Teladoc users were slightly more likely to be women and live in more affluent areas. In addition, more than a third of Teladoc visits occurred on weekends or holidays.

"The people who are attracted to this type of telemedicine may be a more technologically savvy group that has less time to obtain medical care through traditional settings," Mehrotra, a Rand researcher and an associate professor at the Harvard Medical School, said.

Across the leading conditions, visits to Teladoc were less likely than visits to the emergency department or a physician office to result in a follow-up visit for a similar condition, according to researchers. Rand researchers have indicated that the finding suggests that health problems were most likely adequately addressed during the Teladoc visits. However, researchers caution that more research is necessary to further assess the quality and safety of telemedicine services.

Support for the study was provided by the California HealthCare Foundation.

To view the original article click here.

Saudi Aramco and Johns Hopkins Medicine Launch Healthcare Joint Venture
Joint venture to build a sustainable healthcare center of excellence and strengthen healthcare services in the Kingdom of Saudi Arabia

Saudi Aramco, a fully integrated global energy and chemicals enterprise, and Johns Hopkins Medicine, a leading U.S. academic health system with extensive experience in elevating care delivery worldwide, today inaugurated a first-of-its-kind healthcare joint venture in Dhahran, Saudi Arabia. The new company, Johns Hopkins Aramco Healthcare Company, will begin operations on Feb. 1, 2014. Saudi Aramco and Johns Hopkins Medicine each have an indirect ownership interest in the Saudi-registered company. The healthcare joint venture will bring together Saudi Aramco's long established healthcare delivery system and its approximately 350,000 beneficiaries and the world-renowned clinical, education and research expertise of Johns Hopkins Medicine.

Johns Hopkins Aramco Healthcare will deliver high-quality healthcare to Saudi Aramco's employees and their families. The partnership will enable growth and diversify and strengthen the provision of medical services in the kingdom.

"This partnership will result in a comprehensive transformation to further enhance our healthcare standards, and marks the beginning of a new level of care with new lines of treatment, new and enhanced specialties and subspecialties. It will also enable new forays into research and medical education, as well as create opportunities for education and training of medical staff," said Abdulaziz F. Al-Khayyal, senior vice president of Industrial Relations at Saudi Aramco.

Johns Hopkins Aramco Healthcare is expected to fuel clinical innovation, serve as a model in the provision of healthcare and contribute to the development of the healthcare industry in alignment with Saudi Aramco's commitment to enabling growth, opportunities and diversification within the kingdom's economy.

For more than 80 years, Saudi Aramco has established a strong, comprehensive healthcare system that delivers on the company's commitment to provide quality healthcare to its employees and healthcare beneficiaries. The company has been instrumental in building one of the first hospitals in Saudi Arabia.

On a broader time scale, Johns Hopkins Aramco Healthcare will seek to improve population health through scientific innovation, clinical care, and training of clinicians, nurses and healthcare professionals - the very principles that have defined Johns Hopkins Medicine throughout its 124-year history.

"Together, we will be greater than the sum of our parts, because this joint venture combines Saudi Aramco's existing health system with the transformative science, clinical care and education that Johns Hopkins is known for," said Paul B. Rothman, M.D., dean of the medical faculty and CEO of Johns Hopkins Medicine. "Johns Hopkins Aramco Healthcare will become an incubator for clinical and scientific progress, and address some of the region's most pressing health challenges, including cardiovascular disease, diabetes and other chronic conditions, which are on the rise worldwide."

"It is a privilege for us to collaborate with Saudi Aramco to carry forth its commitment to improving the health of its employees," says Steven J. Thompson, CEO of Johns Hopkins Medicine International. "Doing so will be mile one on a long journey to enhance the well-being of the entire community, and represents a next-generation approach to global collaborative healthcare."

Media Contacts

Ekaterina Pesheva
Johns Hopkins Medicine
Office: +1-410-502-9433
Mobile: +1-410-926-6780
epeshev1@jhmi.edu

Sarah Palmer
Johns Hopkins Aramco Healthcare
Office: +966-13-877-8853
Mobile: +966-533-087-774
Healthcare.JV@aramco.com

About Johns Hopkins Aramco Healthcare
Johns Hopkins Aramco Healthcare Company (JHAH) is the result of a joint venture between Saudi Aramco, a fully-integrated global energy and petrochemicals enterprise, and Johns Hopkins Medicine, one of the world's leading academic health systems. This healthcare organization is designed to drive and enhance the well-being of the community in an environment of growth and learning, by providing innovative, integrated and patient-centered care to Saudi Aramco's employees and healthcare beneficiaries.

Since 1933, Saudi Aramco had delivered a high standard of medical care to its employees and their families through its own medical services organization. In 2013, Saudi Aramco partnered with Johns Hopkins Medicine to carve out and expand the capabilities of its medical services through Johns Hopkins Aramco Healthcare, drawing upon the vast expertise of The Johns Hopkins University and The Johns Hopkins Hospital and Health System to provide clinical program development, research, training, safety and quality, and healthcare administration expertise.

Over the coming years, this global collaboration will contribute significantly to health and well-being in the Kingdom of Saudi Arabia. Johns Hopkins Aramco Healthcare will evolve into a center of excellence that provides enhanced specialty and subspecialty services, new lines of treatment, research and education that address some of the most significant healthcare challenges in the region.

About Saudi Aramco
Owned by the Saudi Arabian Government, Saudi Aramco is a fully integrated, global petroleum enterprise and a world leader in exploration and producing, refining, distribution, marketing and petrochemicals manufacturing. In addition to its headquarters in Dhahran, Saudi Arabia, Saudi Aramco, through its affiliates, has joint ventures and subsidiary offices in China, Japan, India, the Netherlands, the Republic of Korea, Singapore, the United Arab Emirates, the United Kingdom and the United States. For more information, visit www.saudiaramco.com

About Johns Hopkins Medicine (JHM)
Headquartered in Baltimore, M.D., JHM is a $6.7 billion integrated global health enterprise and one of the leading academic healthcare systems in the United States. JHM unites physicians and scientists of the Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System. JHM's vision, "Together, we will deliver the promise of medicine," is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. Diverse and inclusive, JHM educates medical students, scientists, healthcare professionals and the public; conducts biomedical research; and provides patient-centered medicine to prevent, diagnose and treat human illness. JHM operates six academic and community hospitals, four suburban healthcare and surgery centers, and more than 35 Johns Hopkins Community Physicians sites. The Johns Hopkins Hospital, opened in 1889, was ranked number one in the nation for 21 years in a row by U.S. News & World Report. For more information about Johns Hopkins Medicine, its research, education and clinical programs, and for the latest health, science and research news, visit www.hopkinsmedicine.org.

About Johns Hopkins Medicine International (JHI)
Johns Hopkins Medicine International (JHI) facilitates the global expansion of the Johns Hopkins Medicine mission: to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. JHI provides personalized, culturally appropriate care for patients traveling to Johns Hopkins from outside Maryland and the United States, and for local patients with limited English proficiency. JHI also leverages Johns Hopkins' extensive knowledge base in medicine, nursing, public health, medical education, research and healthcare administration to improve health and healthcare delivery through sustainable, high-impact collaborations throughout the world.

How Employers Are Cutting Their Costs through Domestic Medical Tourism
by Dr. Prem Jagyasi

Due to higher costs of healthcare in the United States, millions of patients become medical tourists every year. They travel to different foreign countries in order to receive medical treatments through elective procedures and surgeries.

American employers who are observing a significant increase in employee medical premiums are facing the same issue. That is why some employers have come up with an innovative model of reducing these costs for their companies: domestic medical tourism. Under this model, employers have tied up with premier healthcare institutions and facilities within the country.

Insurance companies, who are negotiating prices with specialty facilities to reduce their costs, are following similar, highly lucrative and beneficial model. Employees are sent to high-quality healthcare facilities within the United States when they require undergoing important surgeries or elective procedures.

As employee patients are traveling domestically, there are fewer complications arising post surgeries, and they seem to be more satisfied with their treatments. However, employers opting for domestic medical tourism must make sure they contract with high-quality facilities and the right kind of healthcare services.

To view the original article in its entirety click here.

 

Medical Travel: New Opportunities for Agents
by David Boucher



I recently reported that most Americans who seek surgical destinations overseas do so for reasons of safety, service and savings, while most Canadians travel internationally for medical care to avoid long waiting times.    

Some of the spike in health-related travel is due to the emergence of top-notch wellness services that both prevent and heal. Part of the increasing demand is due also to aging populations in developed countries who have both the time and money to travel for their health.

But there's another factor, one that the popular media predicted back in 2007. American employers increasingly are turning to medical travel as a way to mitigate the growing costs of employee benefits, as these have been increasing by 15 - 25 percent, year over year over year. 

Multinationals sign on
Over the past couple of years, several large marquis employers, including Lowe's, Wal-Mart and PepsiCo, began directing employees and dependents to a limited number of domestic hospitals located outside their home areas.  

This development is a signal that the safest and most affordable surgical care might not be at an employee's local hospital.

And these are not Mom and Pop companies. Together Lowe's, Wal-Mart and PepsiCo employ more than 1.5 million people. 

Today, an increasing number of U.S. employers feel comfortable having their employees consider treatment at hospitals overseas, as well. 

Kevin's new knee
For a specific example, direct your attention to the Facebook page "Kevin's New Knee" where Kevin explains why he decided to travel abroad for a total knee replacement and describes the experience.

When Kevin learned that his employer's benefit plan would waive his more than $4,000 personal out-of-pocket financial responsibility, he was all-ears about the idea of leaving the country for his surgery. 

Kevin decided on Ramsey-Sime Darby Medical Center in Kuala Lumpur, Malaysia, for his care. A travel agency was engaged to coordinate his air travel plans, and off he went. His Facebook page chronicles the rest.

So the media's prediction that Americans would begin traveling abroad for surgery - with their employer's assistance - has become reality. And it will occur with increasing frequency as patient wait times in the United States lengthen, one of the effects from the Affordable Care Act that I expect to see. 

Travel agents, take note
The opportunities for travel agencies in this market abound. 

Historically, most medical travel facilitators are neither licensed nor experienced travel agents, so most contract with existing travel arrangers.

For example, a company like Companion Global Healthcare might vet international hospitals, and we'll work directly with the consumer to assist in their destination selection. 

But we refer the consumer to a travel agent for their travel arrangements.

Medical travelers need agents
Most will need air travel, and well over 90 percent of our medical travelers have a companion accompany them, so for agents that's twice the opportunity.  

Hotel bookings are involved in nearly 100 percent of cases, as almost all discharged patients remain for at least a week in the destination where they undergo surgery or treatment.  

And it is very common for travelers to want day excursions. 

Companion Global recommends that patients consider such excursions before their care, while their companions might want to plan at least half-day outings after the patient is a couple of days post-surgery.

So 2014 offers exciting times for travel agents in the medical travel arena. Happy contrails. The sky's the limit!

David Boucher is president and chief operating officer of Companion Global Healthcare, a medical travel facilitation and HR benefits consultancy. Companion Global Healthcare is a partner to Well-Being Travel, a sister company to Travel Market Report.

To view the original article click here.


2014 Edition Now Shipping: AHA Hospital Statistics®

The 2014 edition of AHA Hospital Statistics® began shipping on Jan. 22, 2014. The data in AHA Hospital Statistics™ comes from AHA Annual Surveys of Hospitals and U.S. Census Bureau population data.

AHA Hospital Statistics™ provides the ability to analyze and compare U.S. community hospital trends in utilization, personnel and finances. It includes:

  • Five year trends for utilization, personnel and finances for 2008-2012 by total U.S., bed size, U.S. Census division, and state
  • Facilities and services by U.S. Census division and state for 2012
  • Community health indicators by U.S.  Census division and metropolitan statistics area with 2012 Fiscal Year hospital data
  • U. S. Community hospitals wall chart (poster)

The version with the Excel tables on CD allows users to combine the data with other data sets, hone in on particular statistics, and create charts and graphs. With it, users can:

  • Create charts and graphs from eight Microsoft® Excel tables of aggregated hospital data about utilization, personnel, finance, beds, admissions, inpatient and outpatient visits data;
  • Benchmark facilities of similar size and location for hospital data comparison and analysis;
  • Gather industry intelligence to pinpoint emerging trends such as physician models, insurance products, and managed care contracts;
  • Examine hospital data in utilization, finances, and staffing to identify opportunities and areas of potential growth;
  • Incorporate other data sets such as census data, geographic information or company data, to focus healthcare market research on specific areas of interest.

With the 2014 edition of AHA Hospital Statistics™, users can take a deep look at the healthcare industry and current trends. For more information, call 800-242-2626.

About Health Forum
Health Forum is a strategic business enterprise of the American Hospital Association, creatively partnering to develop and deliver essential information and innovative services to help healthcare leaders achieve organizational performance excellence and sustainability.

About the American Hospital Association
The AHA is a not-for-profit association of healthcare provider organizations and individuals that are committed to the improvement of health in their communities. The AHA is the national advocate for its members, which includes nearly 5,000 member hospitals, health systems and other healthcare organizations, and 43,000 individual members. Founded in 1898, the AHA provides education for healthcare leaders, and is a source of information on healthcare issues and trends.

For information contact:
Peggy Neuzil
AHA Press/American Hospital Association
312-261-4903
pneuzil@aha.org

WellCare Appoints Kenneth A. Burdick as President, National Health Plans

WellCare Health Plans, Inc. (NYSE: WCG) announced today that Kenneth A. Burdick has been named the company's president, National Health Plans. Burdick will have profit and loss responsibility for all of the company's health plans and product lines. He will be a member of WellCare's senior management team and will report to Dave Gallitano, chairman of the board and CEO.

"Ken's significant leadership experience in managed healthcare will be a great asset to WellCare as the company expands and grows," said Gallitano. "His success leading both commercial and public sector businesses, as well as his regional and national management experience, will enable him to be a strong and strategic leader driving our performance and profitability across the country."

Burdick spent 14 years as an executive with UnitedHealth Group, rising through positions of increasing responsibility. Early in his career at UnitedHealth, he was senior vice president, National Underwriting, and CEO of the central Texas business. He was later named CEO of UnitedHealthcare of Arizona, a position he held for three years. He then served as president, UnitedHealthcare's Public Sector, and was CEO of the company's Southwest region. Burdick was named CEO of UnitedHealthcare Group's commercial business for two years before being named CEO of Secure Horizons. In 2010, Burdick joined Coventry Health Care as CEO of the Medicaid Division and CEO of MHNet, a behavioral health business unit. Most recently, he was president and CEO of Blue Cross and Blue Shield of Minnesota.

Burdick holds a bachelor's degree in American Studies from Amherst College and a law degree from University of Connecticut School of Law. 

"I'm looking forward to joining the WellCare team, and contributing to the company's efforts to help members lead better and healthier lives," said Burdick.

About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored healthcare programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind, and disabled, as well as prescription drug plans. The company serves approximately 2.8 million members nationwide as of Sept. 30, 2013. For more information about WellCare, please visit the company's website at www.wellcare.com

CONTACTS:
Investor Relations
Gregg Haddad
813-206-3916
gregg.haddad@wellcare.com

Media Relations
Crystal Warwell Walker
813-206-2697
crystal.walker@wellcare.com

 

Reading the Pulse of America's Healthcare System
Experienced medical director checks vitals of U.S. healthcare

A hot button issue, the U.S. healthcare system and the recent changes have been both praised and critiqued by media, politicians and medical experts across the country.  

With all the reforms and amendments, technical jargon and political emotion surrounding this topic, it's almost impossible for average citizens, those without extensive medical or legal background, to understand the critical issues of healthcare reform.

Earl W. Ferguson, MD, PhD, is very aware of these issues and aims to educate the public while also providing sound, rational solutions for current healthcare reform. Rather than criticize either party for problems with the implementation of the Accountable Care Act, Ferguson explores the problems with our current healthcare system and the ACA with clear facts, without regard for political associations. 

More importantly he offers plausible solutions that can be implemented, if the American public understands the facts regarding healthcare and holds our elected leaders accountable for implementing the rational solutions that are required to meet our healthcare needs.

"I believe in open exchange of information on quality and costs of healthcare to allow patients and provider to make optimal decisions about patient care," Ferguson said.

As a cardiologist, preventive medicine specialist, biomedical scientist and healthcare executive, Ferguson offers extensive insights from his experience in these fields.  Even with his vast list of credentials, Ferguson writes to inform and help the average reader and bring them to a level playing field with those who already have a comprehensive understanding of the subject.

His book propels the conversation that Americans need to have about the current state of healthcare and government. He makes this conversation possible by laying a foundation of mutual understanding-one that can be referenced by any political view as factual.

Ferguson looks to guide Americans through the realities of government and into a more hopeful, unified future.

"American Healthcare Reform"
By: Earl W. Ferguson, MD, PhD
ISBN: 978-1-4918-4315-4
Available at Amazon, Barnes and Noble and AuthorHouse online bookstores.

About the author
After graduating from the University of Texas Medical Branch with MD and PhD degrees, Dr. Earl Ferguson completed his training in at Duke University Medical Center.  He was on the faculty of the Uniformed Services University of the Health Sciences and a senior executive managing hospitals, medical centers and healthcare systems, as well as Director, Aerospace Medicine and Occupational Health for NASA.  Ferguson currently works in a remote, rural hospital developing and implementing telemedicine and other health information technology applications.   

 

Hospital Safety Improves for Heart Patients, Study Finds
But no drop seen in 'adverse events' for surgical or pneumonia patients
by Serena Gordon

HealthDay News - Efforts to reduce "adverse events" that occur in the hospital appear to be taking hold for patients who've had a heart attack or those being treated for congestive heart failure, according to new research.

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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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2014 Edition Now Shipping: AHA Hospital Statistics®

WellCare Appoints Kenneth A. Burdick as President, National Health Plans

Reading the Pulse of America's Healthcare System

Hospital Safety Improves for Heart Patients, Study Finds