Volume 1, Issue 10

Dear Colleagues,

Low-cost healthcare in the Dominican Republic (DR) makes this location an attractive destination for patients worldwide to access cosmetic procedures. But with the Centers for Disease Control and Prevention (CDC) reporting on March 7, 2014, that a total of 19 non-tuberculous mycobacterium wound infections cases were identified in patients from five different U.S. states who traveled to the DR for cosmetic procedures, many U.S. citizens are thinking twice about this option.  This infection, commonly caused by contaminated medical equipment, must be treated with extensive antibiotic treatment, and in some cases, risky corrective surgeries. To read the full CDC study click here.

Shortly after the CDC released this alert, ABC News followed up with an article exposing the death of a 28-year old female after she had undergone a cosmetic procedure in the DR. The clinic in this instance, Vista del Jardin Medical Center, has since been temporarily closed due to the presence of bacteria and violations of bio-sanitary regulations. To read the ABC News article click here.

Although the booming medical travel industry, both domestic and international, offers prospective patients the opportunity for high quality care at affordable costs, the primary concern for all patients must be safety, quality and proper physician/hospital accreditations anywhere in the world. 

Even in the United States, there are risks:  An analysis of government data on hospital safety, including how likely patients are to die of avoidable surgical complications, shows that hospitals vary markedly on these measures and that patients are at higher risk in some nationally-known facilities than at tiny hospitals little known outside their rural communities.  The safety ratings of 2,591 hospitals, released by Consumer Reports magazine, come at a time when the estimated number of Americans killed by hospital errors is soaring.  The U.S. Department of Health and Human Services (HHS) inspector general cites a 2013 study that estimated such deaths at a minimum of 210,000 annually and as many as 440,000. http://www.reuters.com/article/2014/03/27/us-hospitals-ratings-idUSBREA2Q0NC20140327

These statistics -- both domestic and international -- are alarming, and good reasons for U.S. employers to keep their eyes wide open. 

In this issue, I am pleased to spotlight esteemed entrepreneur and healthcare expert, Mitch Rothschild, CEO, Vitals. Rothschild will detail his company, its ability to help consumers make informed healthcare decisions based on quality, cost and accessibility, as well as the importance of pricing transparency in this market.

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.  Panelists will include: Ruth Coleman, CEO, Health Design Plus, Jason Jones, vice president, Human Capital Practice, Willis Insurance Services of California, Inc., Jennifer Albers, director, Mercy Medical Destinations, Spine Center, Pain Management, and Headache Management, Trisha M. Frick-Hoff, MS, RN, assistant director, Managed Care Contracting Office of Managed Care Johns Hopkins HealthCare LLC, Anne Meisner, president and CEO, Southeastern Regional Medical Center, Cancer Treatment Centers of America (CTCA). 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: Mitch Rothschild, CEO, Vitals



About Mitch Rothschild
Mitch brings two decades of entrepreneurial experience to his role as co-founder, chief perfectionist and CEO of Vitals. Prompted by personal medical experience that could have turned out badly, Mitch helped found Vitals. He designs and oversees the direction of the company and promulgates the Vitals message.

Prior to Vitals, Mitch founded RaspberryRed Marketing, NetWorks, Tuff Rhino, Awards.com, RUSS CandyBears and Time Warner Viewer's Edge. He has also been involved in the rapid growth of Popcorn Indiana, Blue Moon Mexican Cafe and IT'SUGAR.

Mitch earned an M.B.A. with honors from Columbia University and an M.A. (Phi Beta Kappa, Summa Cum Laude) from Queens College.

About Vitals
Vitals turns information into knowledge to help patients make better health decisions. We believe that when patients are able to find the right doctor or health facility, it leads to trusted relationships, improved care and better overall health.

U.S. Domestic Medical Travel (USDMT): Tell us about Vitals.

Mitch Rothschild (MR): At Vitals, we help individuals make informed decisions about which healthcare providers to choose -- based upon quality, cost and access.

We amass and standardize dozens of metrics on doctors, including quality data, outcomes, procedure volumes, special expertise, patient's feedback, awards, etc. If a particular doctor or facility has a bad reputation or inadequate certifications, Vitals will make patients aware of that issue, as well.

In terms of healthcare expenses, there has, historically, been no clarity when it comes to pricing transparency.

At Vitals, we work with over 20 different health plans and have one of the nation's only out-of-pocket cost estimator tools that allows prospective patients to familiarize themselves with their out-of-pocket costs, before a procedure takes place.

Lastly, regarding access, we help individuals find the highest quality care with doctors who have the availability to see them.

USDMT: How do you differ from Castlight Health and other companies that promote transparency?

MR: We are similar to Castlight Health and have a great relationship with them.

Both companies have the same goal, which is to help individuals make smart medical decisions. The main difference between Castlight Health and Vitals is that we are in the health plan market, and Castlight Health works in the employer market.

The primary focus of Vitals is to save patients money while helping them access optimal quality care.

We operate two different businesses: one is a direct-to-consumer site where we get 12 million individuals visitors a month who visit the site, research information and read/leave ratings. Behind the scenes, we also power a white label Cost Transparency solution for 25 health plans.

USDMT: Is Vitals involved in the international market?

MR: We strictly work within the U.S. domestic market. If patients are traveling to the U.S. and are seeking healthcare information, they can look on the Vitals website and access a clear understanding of which providers are highly recommended.

USDMT: Do individuals understand outcome statistics, or are they more interested in patient satisfaction rates?

MR: We operate in the world of the Internet...and people want to access "the best," usually, without much hard work. Vitals tries to surface the best providers, using a complex algorithm of 20+ quality measures. Having said that, the number one thing that consumers care about are the patient ratings and reviews of their doctors.

When prospective patients perform a search, our algorithms work behind the scenes to rank doctors based on quality, cost, bedside manner, language, etc.

Our patients really value this tool, and regard it as a trusted resource.

USDMT: Does the cost of healthcare tend to act as an incentive to patients or more of a deterrent?

MR: Currently, in the U.S. cost can be completely unknown when visiting a provider. Everyone has been through the experience of opening a bill from a doctor and not knowing whether to expect the bill to be $20 or $400.

Right now, our main priority is to provide cost transparency and clarity before people choose a provider.
When dealing with an insured individual, the range of cost can vary dramatically, based on the type of facility doing the procedure, and whether the provider is "in network."

Generally speaking, when it comes to the choice of buying health insurance, cost is by far the first factor considered. Individuals are more apt to sign up for the worst insurance coverage because it comes at a lower cost, which is why the bronze and silver healthcare plans are doing so well in the Exchanges.

USDMT: If the less expensive models aren't necessarily going to attract insured individuals, what about the self-funded groups?

MR: The self-funded groups, which are the employers, have a big motivation to keep costs contained. A percentage of employers will operate by giving their employees medical incentives to choose the lowest cost / highest quality care. Which is why Transparency Tools like Vitals are growing fast.

For example, if it has been determined that two different doctors provide comparable quality, but one physician charges $1,000 less, the employer may give $100-$200 back to the patient just to choose the less expensive provider.

USDMT: If patients have the opportunity to travel to another part of the U.S. for care, do you think that option has merit?

MR: Absolutely, especially in terms of more complicated surgical procedures, fairly intense traumatic brain injuries, cancer treatment and other life-challenging surgeries.

For example, there are significantly different overall quality scores between the doctor population in Florida vs. Massachusetts. There is a much higher percentage of providers that receive America's Top Doctor awards coming from Massachusetts.

What we are seeing now is a major increase in the number of hospitals who want to partner with Vitals and build their brand nationwide. These facilities, especially larger ones, are willing to spend substantial amounts of money to convince prospective patients that their organization is the best place to seek treatment.

USDMT: Do you think mid-sized institutions have an equally fair opportunity to grab market share?

MR: Certainly when it comes to staying within a local market, our cost and quality tools are helping create a more rational market place.

In the world of marketing, there's a concept known as "better, faster, cheaper," and physicians and facilities, that want to attract patient volume in the long-term, need to be - at least -- one of those three to be an industry leader. The issue has been that in the absence of information, individuals didn't have the knowledge to know the leaders.

Now that the information is being exposed, the local organizations that are better, faster, cheaper are going to be able to gain market share.

There's four different types of doctors: primary care, specialists, surgeons and hospital-based doctors.
I believe the care that individuals are willing to travel for lies mostly within the surgical realm, which is approximately 15 percent of doctors and procedures. When a condition is life threatening, people will certainly travel.

At Vitals, we have a radius search, and the radius search for primary care is almost always narrower than for a specialist. A lot of decisions for certain providers, such as a pediatrician or OB/GYN, are based primarily on convenience.

One key data point we provide at Vitals is special expertise. It helps patients make sure their doctor specializes in their particular need. For example, we have taken every publication that every doctor has written in a peer review journal over the last ten years and analyzed publication key words covering more than 2,200 conditions and treatments. Through this process, we have identified which doctors are thought leaders in each of those categories.

If a patient has Stage IV melanoma, for example, this individual is going to want to go to America's leading expert, and now that data is knowable.

USDMT: Do you think there's an opportunity for our ailing workers compensation system to benefit from medical travel - domestic or international?

MR: I would have to do more research before I can answer that confidently, but I will share a relative statistic that I am familiar with.

Vitals develops infographics to shed light on areas of medical care. One we recently published showed that 60 percent of all bankruptcies in the U.S. stem from the inability to pay for medical care. Of that 60 percent, 70 percent of those individuals do have health insurance. So, having health insurance is only one part of the equation; knowing what is covered before you go is equally important.

As cost is becoming more transparent, patients are realizing that a certain procedure may cost $57,000 in the U.S., but for equal quality they can receive the same procedure in Singapore for as little as $6,000.
This is exactly what I believe will allow the medical travel industry to flourish.

USDMT: What would your challenge be to the hospitals to position themselves for optimal quality, cost and access?

MR: We see a market in a disruptive state, meaning the employers, insurers and government are all pushing to make information more transparent - which is going to have a negative effect on high-cost providers.

Six years ago when Vitals was founded, we began asking patients to rate doctors. And, initially the doctors that received poor ratings were outraged.

After a while, these same physicians began to recognize the bad ratings as a wakeup call to perform better, which is exactly what was necessary in the first place.

The same adaptation seems likely for providers whose costs are currently too high, relative to the market.

USDMT: Is there anything else that you would like to share with our readers?

MR: Vitals was initially founded after working with a concierge medical practice out of Chicago that requested the development of a database including all local physicians. After building the database, we realized this developmental process was really an entirely separate business.

I think it is quite important for individuals to be aware of the true benefits coverage of their health insurance plans. For example, is the plan national or regional? Are travel benefits available?

Our eyes tend to glaze over when we read insurance plan benefit information. But, it's worth the effort to really understand your coverage.

If patients have a national network, they will receive extended coverage throughout the U.S. But some local plans may only provide coverage in certain areas. This limits a patient's ability to access the best care anywhere in the country.

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.

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...that has been at the forefront of the healthcare consumerism mega-trend as we witness one of the most monumental shifts in our industry's history.

Wondering what specifically you will take away from the 2014 IHC FORUM & Expo? Read our Attendee Takeaways.
IHC FORUM's 2014 Theme:
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2014 IHC FORUM & Expo, May 7-9
Cobb Galleria Centre, Atlanta, GA

"HealthCare Consumerism:
The Solution for HealthCare Reform"


Produced by: The Institute for HealthCare Consumerism
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Domestic Medical Travel: Quality Care, Controlled Costs
by Laura Carabello, Founder and Principal, CPR, Publisher of Medical Travel Today and U.S. Domestic Medical Travel

Theihcc.com-A growing number of U.S. employers have adopted domestic medical travel programs, encouraging employees to travel to Centers of Excellence (COEs) for elective surgical procedures. 

Patients save money and companies are able to negotiate bundled, fixed-rate prices that are generally 20 to 50 percent - or more - below the rates charged through traditional insurance plans. The COEs range from high-profile hospitals and health systems to physician-owned surgi-centers specializing in specific procedures such as orthopedic and cardiac care.

Interest in domestic medical travel comes in response to rising health insurance premiums, lack of transparency and increased awareness of how varied medical costs and quality vary dramatically between hospitals and across regions. 

Recent domestic medical travel programs include:

  • Wal-Mart has partnered with six U.S. healthcare organizations to expand its COE program in 2013 to certain heart and spine surgeries in addition to transplants at Mayo Clinic.
  • In 2012, Boeing began offering its 83,000 non-union employees, retirees and their dependents the option to travel to the Cleveland Clinic for complex heart procedures or surgery.
  • PepsiCo domestic employees and their dependents - almost 250,000 people - have had the option since 2011 to seek treatment at Johns Hopkins Medicine for cardiac and complex joint replacement surgeries. PepsiCo negotiated a bundled, all-inclusive rate for hospital and physician charges and certain pre-operative testing.

The growing interest in domestic medical travel among employers and payers is likely to see an uptick as more companies follow in the steps of the retail giants.

Benefit to Employees

Employees who travel to COEs experience lower costs and better quality of care. Frequently, they are enticed by employers who waive co-pays and deductible, offer cash incentives and cover the full cost of travel for the patient and caregiver. Medical travel within the United States is a much easier sell than travel abroad, especially for patients who have never traveled to another country and feel uncomfortable about unfamiliar settings while recovering from surgery. 

For patients who don't want to fly, regional options can be arranged. Based on patient volume, complication and infection rates, a surgeon is chosen who can perform the procedure and help negotiate a bundled rate at a facility he or she is contracted with - all within driving distance for the patient.

Patients also benefit when a physician at a COE suggests an alternative to surgery. Rather than being guided solely by their physician, patients find they have more choices. Studies show that when patients engage with highly specific, detailed information about their diagnosis, prognosis and treatment options, they make informed medical decisions that lead to healthier and more personally satisfying outcomes. Given the ability to understand their options and actively participate in surgical decisions, consumers can play a significant role in directing their surgery.

Influence of the Affordable Care Act

The Affordable Care Act (ACA) has triggered a significant shift toward cost-containment and patient-centric care, and employers now put enormous stock in preventive health care programs and options that offer quality, transparency and value. 

The ACA waives pre-existing conditions restrictions by insurance companies and makes insurance premiums the same for healthy and chronically ill individuals. With this aspect of reform driving insurance costs up dramatically, it will increase the appeal of domestic medical travel as a way to curb costs for employers and insurers.

And as Americans become more engaged and educated health care consumers in the new reform environment, domestic medical travel will become more acceptable. 

Role of the Employer

The key difference between domestic medical travel and medical travel overseas is that employers and employees appear to prefer the concept of domestic travel. Individuals like staying within U.S. borders where they say they feel safer and more comfortable dealing with English-speaking physicians. The pioneer employers understood the cost-savings of domestic medical travel and recognized the opportunity to keep employees healthy and productive, while maintaining control over quality of medical outcomes. Toward that end, they demanded safety, security and quality of treatment.

As more employers adopt domestic medical travel, they will be motivated more by cost control, while moving toward paying for quality care - rather than simply paying per service. 
With this in mind, domestic medical travel offers a way to curb the cost of unnecessary surgery. Utilizing robust health data, employers can identify plan members who are on the path to major surgery and will benefit from providing education about the surgery, and the utilization of quality provider options, such as COEs. 

This strategy can reduce financial risk for employer organizations of all sizes. A relationship with a COE empowers employers to anticipate costs and take action, which is important given that surgical costs represent the largest component of U.S. health care spend by far.

Opportunities and Challenges

Insurers pose a potential roadblock to the adoption of domestic medical travel. When Lowe's asked its benefit administrator to develop ways for workers to determine the best hospitals for cost and quality, the insurer dragged its feet for years, and Lowe's ended up doing the research. 

As baby boomers age, the number of knee, hip, spine and heart-related surgeries are rising. Surgery costs account for 30 percent or more of employers' total health care spend. These complex, high-cost surgeries, while infrequent, consume disproportionately high resources.

In the case of Lowe's, one employee had three complex heart procedures while hospitalized under the new program. Lowe's asked a benefit firm to calculate the cost of those procedures if they were done under the company's standard insurance plan. The benefit firm estimated $531,000. Under the agreement with the Cleveland Clinic, Lowe's paid $469,000.

With the implementation of private insurance exchanges, the growth of health savings accounts or flex benefits plans and the surge in self-insurance for companies of all sizes, the domestic medical travel trend will continue to build, as employers introduce incentives, including waiving co-pays and deductibles to prompt utilization. 

Opportunities for expanding domestic medical travel care to include a wider range of conditions exists as well, particularly for conditions that are difficult to manage, such as diabetes, where it is a precursor for other serious conditions. 

Looking Ahead

For employers and payers, domestic medical travel provides an opportunity to control rampant health care costs - and play a role in accelerating health care reform. After years of operating outside of market forces, U.S. health care organizations are being held accountable and must become competitive to survive.

The full impact of the ACA has yet to play out. When employer plans are no longer able to impose annual or lifetime dollar limits on Essential Health Benefits (EHBs), self-insured employers will be looking for new solutions. Expect to see a greater push by benefit plan designers and HR to focus on educating employees about the advantages of domestic medical travel - and for positive word-of-mouth to push acceptance even further. 

Many companies have watched the big retailers begin offering domestic medical travel to COEs and have waited to see results. Soon, they will begin to explore how they too can curb costs by offering employees a proven benefit strategy in the spirit of health reform.  

To view the original article click here.

Shortest Average Wait Time for Doctors in Major Cities Increased One Minute Year Over Year
Wisconsin Tops List as State With Shortest Wait; Seattle Leads Major U.S Cities, in Vitals' Annual Report of Physician Wait Times

Everyone is busy these days, so a long wait at the doctor's office can be frustrating. In fact, 10 percent of people said that long wait times would be enough reason to find a new doctor.

But accessing care in America's largest cities is getting tougher. According to the Vitals Index annual report analyzing U.S. trends in patient care, the shortest wait time in the top 50 cities increased by a full minute, compared to last year.

In 2013, Denver had the shortest wait at 15 minutes, 15 seconds. This year, Seattle earned the top spot with 16 minutes, 15 seconds. For the third year in a row, the longest wait time was reported in El Paso at 29 minutes, 20 seconds, an increase of 41 seconds, compared to last year.

Top 10 Cities with the Shortest Average Wait Times

Seattle, WA

16 minutes, 15 seconds

Milwaukee, WI

16 minutes, 17 seconds

Denver, CO

16 minutes, 25 seconds

Minneapolis, MN

16 minutes, 42 seconds

Portland, OR

17 minutes, 05 seconds

Omaha, NE

17 minutes, 23 seconds

Charlotte, NC

17 minutes, 26 seconds

Austin, TX

17 minutes, 32 seconds

San Diego, CA

17 minutes, 43 seconds

Raleigh, NC

17 minutes, 48 seconds

Among the top U.S. cities, Vitals also found significant increases in 2014. Detroit had a 3 minute, 32 second gain over last year's wait time. Memphis added 2 minutes, 20 seconds to their wait times for 2014. A couple of cities did better, though. Fresno patients had 1 minute, 47 seconds shaved off their wait this year compared to last. Charlotte residents waited 1 minute, 12 seconds less for their appointments in 2014.

The bright spot in the report is that nationwide, the time spent in doctor waiting rooms dropped this year - but only by one second. The national average physician wait time is 20 minutes, 16 seconds for 2014.
Alternative care centers, like urgent care facilities and retail clinics, have taken some of the pressure off traditional doctors.

"While Americans have more options for their routine care, there are also 30 million more Americans entering the healthcare system under the Affordable Care Act," said Mitch Rothschild, CEO, Vitals. "We are going to continue to feel a strain on the system, especially in our most populated cities and urban areas. As people seek quality doctors, wait time will impact a patient's perception, and ultimately their relationship with their physician."

For states, Wisconsin led the nation with the shortest wait time at 15 minutes, 32 seconds. The remaining top five states with shortest physician wait times include New Hampshire, Maine, Vermont and Washington. Mississippi repeated for a third year as the state with the longest wait, with an average wait time of 24 minutes, 45 seconds - an increase of 20 seconds over last year. Rounding out the bottom five with the longest physician wait times are Alabama, Tennessee, West Virginia and Louisiana.

Top 5 States with the Shortest Average Wait Times


15 minutes, 32 seconds

New Hampshire

15 minutes, 40 seconds


16 minutes, 7 seconds


16 minutes, 25 seconds


16 minutes, 39 seconds

Bottom 5 States with the Longest Average Wait Times


23 minutes, 04 seconds

West Virginia

23 minutes, 10 seconds


23 minutes, 11 seconds


24 minutes, 18 seconds


24 minutes, 45 seconds

For its fifth annual Physician Wait Time Report, Vitals analyzed patient-reported wait times from its database of over 870,000 physicians. The Vitals Index is designed to provide transparency at all levels of healthcare to enable consumers to make smarter decisions.

About Vitals
Vitals believes that technology makes better health possible. We are a leader in providing online tools and actionable data that enable healthcare consumers to make more informed decisions about the cost and quality of their medical care. Through health plans, hospitals and our leading consumer websites, Vitals helps more than 150 million people each year access information for better, more affordable care. The Vitals Index is an ongoing report about the state of doctor-patient relationships based on proprietary data and surveys.

North Dakota is Number One and West Virginia is Number 50 in Annual Gallup-Healthways State Well-Being Rankings
Well-Being Is a Key Metric for Governments, Communities and Businesses Looking to Lower Healthcare Costs and Improve Performance

For the sixth consecutive year, global well-being improvement leader Healthways (NASDAQ: HWAY) and world-leading management consulting firm Gallup have released their analysis of the state of well-being across the United States. North Dakota and West Virginia bookended the list, with top and bottom rankings, respectively. The analysis is based on data from the Gallup-Healthways Well-Being Index®, a definitive measure and empiric database of real-time changes in well-being throughout the world. More than 178,000 interviews nationwide fueled the 2013 analysis, which examined Americans' perceptions on topics such as physical and emotional health, healthy behaviors, work environment, social and community factors, financial security, and access to necessities such as food, shelter and healthcare, to create a composite well-being rank for each state.

Comparatively speaking, the difference between states is not as notable as the fact that so much room for improvement still exists, even for the top states.

The ten states with the highest well-being in the nation are:
North Dakota
South Dakota

Certain states stand out for specific well-being achievements, as reported by their residents. Colorado, for example, is always at or near the best in the nation for the lowest obesity rate. Utah has the lowest smoking rate. Massachusetts residents have had the greatest access to health insurance in all six years that the rankings have occurred. New Jersey has the lowest levels of depression, and people in Vermont eat more produce than people in any other state.

"States that score high in well-being have achieved success in creating environments where people can live their best lives, something that goes far beyond physical wellness and traditional health risk factors," explained Dan Witters, research director of the Gallup-Healthways Well-Being Index. "Individuals in these states are motivated to achieve their goals, enjoy what they do each day, feel safe and financially secure, have pride in their communities, and have the supportive relationships and good health they need to get things done each day. We not only commend the top finishers but recognize Colorado, Hawaii, Iowa, Minnesota, Montana, Nebraska and Vermont for achieving the distinction of being in the top 10 for two years in a row."

Understanding the Value of Well-Being
According to James E. Pope, M.D., senior vice president and chief science officer at Healthways, both measuring and improving well-being are becoming increasingly important to governments, communities, healthcare organizations and employers.

"Achieving high levels of well-being is a strategic imperative for all types of organizations because it unlocks economic value on so many levels. In short, healthier people cost less and perform better," Dr. Pope stated. "Our partnership with Gallup helps us continue to advance the science of well-being and create a definitive measure of well-being for individuals and across populations. Measuring well-being ultimately helps organizations systematically improve well-being because measurement helps organizations establish a baseline, determine where they should invest resources and then identify the impact of those investments."

Research shows a strong link between well-being, healthcare costs and engagement in the workplace. Each point in well-being improvement equates to a statistically significant percent decrease in the likelihood of hospital admission and emergency room visits and in the likelihood of incurring healthcare costs.

For a community, the achievement of higher well-being for its citizens yields competitive advantage for economic development and job creation. For employers, it means greater productivity and better health in the workforce and dependent families, resulting in better business performance. For individuals, it simply means living well, longer.

"Comparatively speaking, the difference between states is not as notable as the fact that so much room for improvement still exists, even for the top states," said Ben R. Leedle, Jr., president and chief executive officer of Healthways. "Steady improvement in well-being is indeed possible even where well-being is already strong, as Montana, Vermont, Nebraska and Iowa have shown these last several years. Consumers have made the connection between lifestyles and behaviors, and between quality of life and longevity. Strong leadership and proven solutions that identify opportunities, break down barriers and encourage sustained consumer engagement in well-being improvement activities are the key to community, organizational and individual transformation."

Working Together to Improve the Health of Populations and Individuals
In 2008, Gallup and Healthways initiated a 25-year partnership merging decades of clinical research and development expertise, health leadership and behavioral economics research to track and understand the key factors that drive well-being. Together, the organizations have built the world's largest data set on well-being to support their mutual goals of helping governments, communities and businesses better understand and improve the health of both populations and individuals.

Launched that same year, the Well-Being Index provides unmatched, in-depth insight into the well-being of populations. Gallup conducts 500 telephone interviews a day with Americans to gather their perceptions of well-being, for a resulting sample that represents an estimated 95 percent of all U.S. households. In 2013, Gallup and Healthways extended the reach of the Well-Being Index beyond the United States. Global leaders now have the ability to benchmark the well-being of their country against the results of roughly 140 countries around the world.

To access the "State of American Well-Being: 2013 State Rankings and Analysis," report visit http://info.healthways.com/wbi2013. The full "State of American Well-Being: 2013 State, Community and Congressional District Analysis" will be available online in April at http://info.healthways.com/wbi2013.

About Gallup
Gallup delivers forward-thinking research, analytics, and advice to help leaders solve their most pressing problems. Combining more than 75 years of experience with its global reach, Gallup knows more about the attitudes and behaviors of the world's constituents, employees, and customers than any other organization. Gallup consultants help private and public sector organizations boost organic growth through measurement tools, strategic advice, and education. Gallup's 2,000 professionals deliver services at client organizations, through the Web, and in nearly 40 offices around the world.

About Healthways
Healthways (NASDAQ: HWAY) is the largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant's health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 45 million people on four continents. Learn more at www.healthways.com.

Bruce Middlebrooks, 615-614-4463


Lauren Kannry, 202-715-3050

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.

U.S. Medical Tourism To Dominican Republic Could Increase With High-Tech Clinic
by Dr. Marc Siegel

Latino.foxnews.com - This week the Metropolitan Hospital of Santiago (HOMS), Dominican Republic, opened the first robotic surgery institute in the Caribbean. Named after Dr. David Samadi, pioneer in robotic prostate surgery and member of the Fox News Medical A Team, the institute is sure to draw patients from throughout the continent.

Close to a million Americans a year now seek healthcare outside the U.S. Medical tourism is increasingly popular in the Caribbean for its high quality, cost savings of up to 75 percent, and of course, the unbeatable beautiful surroundings. 

The Dominican Republic has long been a tourist destination known for its inexpensive plastic surgery and dental procedures. Now you can add the state-of-the-art Da Vinci robot, featuring precision robotic arms that allow surgeons to perform delicate procedures. Recovery with this kind of surgery is remarkable - you can get in and out of the hospital in a day.

Dominican Republic President Danilo Medina attended the opening of the new facility along with Dr. Raphael Sanchez Espanol, CEO of HOMS hospital and a renowned surgeon.

"You're going to change the lives of many, many people out there and be part of the first robotic institute in the Caribbean," said Dr. Samadi. "This is a huge blessing. For us to be part of this -- we're very proud."

The institute will include treatment of prostate, kidney, gynecologic and surgical cases. Doctors operating in the Dominican Republic will now be able to use techniques developed by Dr. Samadi, who became the country's first to treat prostate cancer as well as other delicate surgeries in a safer, more effective manner, with minimal blood loss.

"Big decisions have transformed into small decisions," said Dr. Sanchez Espanol. "I like to say, with less trauma. The less trauma facilitates an amazing recovery."

"This is a huge step in this country and it's going to bring a lot of patients from the entire Caribbean to this hospital," Dr. Samadi said.

And beyond the Caribbean. With more and more regulations and restrictions coming our way on American soil, many Americans may look elsewhere for their surgeries and the new David Samadi Robotic Institute could be another option.

To view the original article click here

First Stop Health Receives $2.2 Million in Additional Angel Financing

Telehealth and advocacy service First Stop Health announced it has received $2.2 million in additional angel financing.

"First Stop Health is serving members across the country with telehealth and patient advocacy services," said First Stop Health CEO and co-founder Patrick Spain. "The latest investment will be used to scale our efforts to sell our services to employers. All employees and employers benefit from quick, convenient and affordable access to more than 350 physicians 24/7/365. However, self-insured companies can benefit immediately by realizing savings in the first month of implementation."

Because reductions in claims fall right to the bottom lines for self-insured companies, First Stop Health's telehealth service can typically save up to three times its cost, Spain said. The company creates customized employee engagement programs for each employer. "Unlike traditional telehealth companies that have low single-digit employee participation rates, First Stop Health targets participation rates of 20 percent or more in the first year," Spain added.

Since its launch of the telehealth and advocacy service for employers last year, First Stop Health has established a client base of employers spanning a variety of industries, including technology, media, transportation, oil field services, law and nonprofit organizations.

Driven by the urgent need for cost containment and physician shortages, the U.S. market for telehealth is expected to grow eightfold from $240 million to $2 billion in the next five years, according to the consulting firm IHS.

About First Stop Health
First Stop Health (www.fshealth.com) is a quick, convenient and affordable telehealth and advocacy service available to employers and to consumers. It offers immediate, 24/7/365 phone and email access to more than 350 U.S.-based physicians. First Stop Health members can also get help from expert patient advocates with negotiating medical bills and navigating serious illnesses. In addition, members can use a confidential, secure dashboard to access recordings of calls with First Stop Health physicians; store and share any medical records; and quickly locate nearby physicians, drugstore clinics, urgent care centers and emergency rooms. Adding First Stop Health to employee benefits can reduce employers' health care costs while improving employee health, productivity and satisfaction. Connect with First Stop Health on Facebook and follow First Stop Health on Twitter: @firststophealth.

Media Contact:
Jani Spede

If You Like Your Scam, You Can Keep It: the Attack on Out-of-Network Doctors
by G. Keith Smith, M.D.

A patient who wanted to have a procedure at our facility asked us to file insurance. We discovered that if she had her surgery at our facility rather than at an "in network" hospital, her deductible would have been $3,000 instead of $1,500, her copay would have been 50 percent of the charge rather than 20 percent, and she had to agree to a 25 percent penalty for coming to the Surgery Center of Oklahoma rather than one of the hospitals in the network. Never mind that the hospital would receive multiples of our fee from the insurance company, the patient's copay at the hospital was more than our entire charge.

This insurance company (a huge national company) made it clear when they came to Oklahoma that they were not interested in contracting with any facilities that were not hospitals or affiliated with hospitals. Because of this, our facility is out of network. In order to steer patients to in-network facilities, insurance companies financially punish patients for wandering outside.

These networks were ostensibly devised to control cost and to guide patients to quality care. They have done the opposite, as you can see by comparing what you were charged for your medical care or insurance premiums 10 years ago with what you are charged now. Fewer and fewer good physicians with busy practices have remained in these networks as these organizations cut their fees every year.

Cutting the physician fees introduced a soft form of rationing that was central to the profitability of the carrier-PPO concept, as preposterously low payment to a physician for a service resulted in little of that service being rendered.

You may well ask, "If profitability is what drove these carrier/PPO's, why would they want to pay more at a hospital? This doesn't make any sense."

It doesn't make sense until you understand that the giant hospital bills gave the PPOs an opportunity to profit from their repricing scam, charging for the extent to which they are successful in "discounting" these inflated bills.

The out-of-network penalties didn't work well at first because our acceptable profit margin was so low that even what the PPOs and carriers considered giant penalties weren't sufficient to put us in the red. The carriers started to punish patients more and more aggressively, but our prices were so low that we could work with patients individually, making sure that their cost for working with us out of network was less than if they stayed in their network at the more expensive hospitals.

While these punishments were limited by statute, the carriers found ways around them that no insurance commissioner felt like challenging. Most of the funding for state insurance commissions comes from fees paid by insurance carriers, not taxpayers, and as the proverb says, "Whose bread I eat, his song I must sing."
Carriers finally hit on a solution to stop the leakage. They made the "in" and "out" of network deductibles separate, so they didn't cross-apply. That meant that if you had met your $1,500 deductible at an in-network facility and you chose to go out of network for other care, you started at zero. Your $1,500 did not apply toward the new and separate $3,000 deductible.

This solution worked. The number of these carriers' patients we saw at our facility plummeted. Their hospital pals rewarded the carriers by giving better rates for certain hospital services, so the carriers could now much more effectively loot the employer groups with their repricing fees. Everyone but patients and their employers won.

Increasingly aware that something was wrong, managers of employer health plans had become more skeptical when their insurance broker rambled on about the spiraling cost of care and the next year's 10 percent premium increase. All the employer groups needed to see the scam clearly was for someone to post prices online.

The tables are turning now. Employer groups (self-funded plans) are carving out more and more medical services from carrier/PPO groups, and are directly contracting with facilities like ours. As prices fall and quality soars, all patients will benefit, even those who are not beneficiaries of these employer plans.
I believe that the corporate hospitals and carriers have known for some time that their scam was unsustainable, and consequently may have turned to their cronies in D.C. Maybe they were told, behind closed doors, "If you like your scam, you can keep it."

Author / Contributor bio:  Dr. G. Keith Smith is a board-certified anesthesiologist in private practice since 1990.  In 1997, he co-founded The Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City, Okla., owned by 40 of the top physicians and surgeons in central Oklahoma.  Dr. Smith serves as the medical director, CEO and managing partner while maintaining an active anesthesia practice. 
In 2009, Dr. Smith launched a website displaying all-inclusive pricing for various surgical procedures, a move that has gained him and the facility, national and even international attention.  Many Canadians and uninsured Americans have been treated at his facility, taking advantage of the low and transparent pricing available. 

Operation of this free market medical practice, arguably the only one of its kind in the U.S., has gained the endorsement of policymakers and legislators nationally.  More and more self-funded insurance plans are taking advantage of Dr. Smith's pricing model, resulting in significant savings to their employee health plans.   His hope is for as many facilities as possible to adopt a transparent pricing model, a move he believes will lower costs for all and improve quality of care.

Dr. Smith resides in Oklahoma City, Okla.

Tallwave Commercialization Fund I Invests Over $500,000 in High Tide Lean Business Competitions and Select Participating Companies
Health Options Worldwide, Inspire Living, Inc., and Performance 3D Receive Early Stage Seed Funds to Commercialize Their Businesses and Attract Follow-On Investment

Tallwave Commercialization Fund I today announced that it has deployed $500,000 in capital in two Tallwave High Tide business competitions and three early-stage ventures that have emerged from the latest High Tide program.

The Tallwave Commercialization Fund I (Fund) is an Arizona-based venture capital fund specializing in Seed investments in early-stage technology and media companies. The Fund is managed by Tallwave Capital.

"We are looking to invest early, and work with these promising ventures to commercialize their businesses and attract follow-on investment," said Greg Lehmann, Principal, Tallwave Capital. "The High Tide program is an ideal source for bringing validated and fundable startups to the Fund for consideration."

In addition to investing in the recently completed High Tide for Healthcare IT program and the current High Tide for Healthcare and Ed Tech competition, the Fund has provided early stage seed investment to three of the most recent competition's finalists, including winner Health Options Worldwide.

The three companies are:

Health Options Worldwide, Somerset, N.J., uses behavioral psychology to increase employee engagement with health plans and reduce reactive care spend. 

Inspire Living, Fairfax, V.A., provides a respiratory monitoring device with a unique algorithm that allows for early detection of child pneumonia. 

Performance 3D, Scottsdale, A.Z., provides 3D motion capture and analysis technology that improves fitness performance and reduces the risk of injury. 

"As we progressed through the High Tide for Healthcare IT competition we learned invaluable lean business and design principles and forged relationships with an entire ecosystem of advisors, subject matter experts and potential investors," said David Goldstein, president, Health Options Worldwide. "The seed funding we've received from the Tallwave Commercialization Fund will help us get to market faster, and we're much better prepared to leverage the funding efficiently and effectively."

About Tallwave Capital
Tallwave Capital is an early-stage venture firm focused on making investments SaaS, e-commerce and digital media and marketing companies across a variety of verticals including Healthcare IT, EdTech, AdTech, and Mobile among others. Headquartered in Scottsdale, AZ, Tallwave Capital invests in companies across the country.

Additional information about Tallwave is available at www.tallwave.com.

Linda Capcara
Cell: 480-229-7090


Why Medical Tourism for Workers' Comp is an Idea Whose Time Has Come
by Richard Krasner

There are some people in the workers' comp world whose mission it is to keep the status quo going for the benefit of plaintiff lawyers, defense lawyers, doctors, hospitals and workers' comp services providers, as well as for the state legislators and regulators of workers' comp systems in all 50 states who write the laws and oversee that the rules and regulations are adhered to.

They like to argue that the claimant's lawyers would object, but it is the very lawyers, both plaintiff and defense, that have made workers' comp claims so expensive and so dysfunctional. Then there are the myriad service providers who claim to be able to lower costs, but only add more expenses to the claims. Add to that what the physicians charge, what hospitals charge and by the end of the claim, the medical costs have outstripped the indemnity payments to the claimant. There is something wrong with that.

And because these people are invested with keeping the status quo, they feel it is their right to shoot down any idea that would change the status quo. One such individual has called my idea to implement medical tourism into workers' compensation a "ridiculous idea" and "a non-starter."

Yet, I have been published in several medical tourism blogs and newsletters published in this country and elsewhere, and have been singled out as one of the "many smart, loud, and committed folks talking and writing about what needs to happen [to improve workers' comp] and why" by a well-respected fellow blogger in the managed care/workers' comp arena. This blogger also told me that I am "far in front of the crowd" on this issue, and I wrote a post with that very title.

And, I have been invited to speak at a medical tourism summit in Mexico in November because of my writing on the subject of medical tourism and workers' comp. So obviously, my idea is not as far-fetched or ridiculous as some would have you believe.

What most of these individuals do not know is that cross-border healthcare is already happening. And it's been happening for years, as I've written in my post, Cross-border Workers' Compensation a Reality in California, and I also wrote about a company in North Carolina that is paying for their employees to go to India or Costa Rica, mainly for work-related back injuries.

They are under the delusion that workers' compensation, unlike other industries, is somehow immune to the forces of globalization, and that by doing the same things over and over again, to lower costs, and to get better quality outcomes, they are going to get different results. You know what that is called, right?

What most of these people are afraid of is that these innovative and new ideas will actually work to help bring down costs and provide better quality outcomes for workers' comp claims. They know that if employers and insurers actually save money by sending injured workers to places like Costa Rica, Mexico and other Latin American countries where they speak the same language as the claimant and have the same or nearly the same culture as the one the injured worker came from originally, that other injured workers will do the same.

And that would mean that the American surgeons and hospitals that charge thousands of dollars for surgeries common to workers comp could lose market share. Well, isn't that what capitalism is all about? Getting the same good or service at the same or better quality, but at a lower price? Why should workers' comp be any different than buying a car in another state where the price of the car is lower than what is available at a nearby dealer?

But there is another reason why these people do not like the idea of medical tourism in workers' compensation. It's called "American exceptionalism." It is a meme carried over from our colonial past whereby the original settlers believed that America was a shining city on a hill, and therefore anything Americans do is the best. Well if that is true, then why is America's healthcare system so bad? I wrote an article not that long ago called "We're No. 1!", NOT! - Why the US Health Care System is Not the Best in the World and Why Implementing Medical Tourism into Workers' Comp Could Improve Outcomes that proves that we don't have the best healthcare system in the world.

But what's more, these people actually believe that non-Americans cannot be as good as Americans, as if being from another country somehow means that they are less qualified or less skilled, even when the physicians are trained in the U.S. or in Western Europe. Have any of these people ever seen how many foreign-born doctors are working in our hospitals? Where do you think they go once they stop working in this country?

Yet again, these people believe that it is okay to subject injured workers to this broken, dysfunctional system, and insist that if we only do this, or do that, or try something else that has no chance of lowering costs to a reasonable level, they will get different outcomes. Saying that you can negotiate lower costs or use a fee schedule to bring down costs, when even that negotiated cost or fee schedule cost is higher than what is available outside the US, is not a real solution to high-cost medical care. It only makes matters worse. What good is getting surgical costs down to $25,000 from $30,000, when the same surgery can be less than $20,000, with airfare and accommodations for two people in a first-class medical tourism facility?

I know there are barriers and obstacles to implementing medical tourism into workers' comp. I wrote a White Paper on it, and have written many times that it won't be easy, nor is it a "pipe dream." They even say that it can't happen under the current workers' comp statutes. I know, that is why I said they have to change the statutes to do so. And they also said that no judge would order medical tourism. No judge has to order this, it has to be done before it goes before a judge, but since they mentioned it, I will say that the District Court of Appeal in Florida has ruled that a worker can return to their home country for care under Florida law (see AMS Staff Leasing v Arreola).

But somehow, medical tourism for workers' compensation is harder to do than flying in the air, or going into space and walking on the moon. Tell that to the millions of people around the world who fly in airplanes every single day. Tell that to the men and women, from many countries, not just our American astronauts and Russian cosmonauts who have flown in space, and tell that to the men who have walked on the moon. Is medical tourism in workers' comp harder and more difficult than those achievements? Hardly. The only thing that stops us is our lack of imagination and lack of will.

I leave it to others to figure out how to get employers, insurers, lawyers, doctors, and most of all, employees to choose medical tourism as an option for medical care. It's not for everyone, but for those who do chose it, it could be better than the sub-standard care they are getting now in our broken and dysfunctional healthcare system. And they just might find that the world is really truly getting smaller and that borders are no longer the barriers they once were for all kinds of goods and services.

The world is globalizing. Healthcare is globalizing, and workers' comp medical care must and will globalize. If not, it will fail as a system to provide the best care possible at the lowest cost possible. There is nothing anyone in the workers' comp industry can do to stop globalization, so you might as well get on-board with it and stop fighting it. You'll feel better when you do.

To view the original article click here.

Global Spa & Wellness Summit Unveils 2014 Theme "Fast Forward"
Futurist speaker Dr. Kjell A. Nordström to keynote event; Moroccan Agency for Tourism Development named as Titanium Sponsor

The Global Spa & Wellness Summit (GSWS) today unveiled its futurist theme - Fast Forward - for its 8th annual event taking place September 10-12, 2014, at the Four Seasons Resort Marrakech, Morocco. The event, which is considered the world's most prestigious gathering of business, government and academic leaders in the wellness, travel and spa industries, is expected to attract a record number of attendees. The 2nd annual Global Wellness Tourism Congress (GWTC) will take place concurrently on September 10.

"This year, the Summit is hitting the Fast Forward button," said Susie Ellis, GSWS Chairman and CEO.  "Our agenda and keynote speakers will be focused on looking closely and creatively at the future of spa and wellness, from new technologies that will transform our businesses and the way wellness gets delivered to the future of design, exploring the latest in brain science and its implications, the next wave in retailing, and presenting crucial, new research that will illuminate and shape our industry's future path."
Dr. Kjell A. Nordström, a Swedish economist, futurist thought-leader and renowned co-author of Funky Business, is the Summit's first announced keynote speaker in what will be a prestigious, high-profile line up of future-focused thinkers. His provocative presentation will analyze a future global world marked by seismic shifts in demographic and consumer realities.

"The future is urban and female. The influence of countries and men is fading away - prepare yourselves for Amazonia," says Nordström.

About Dr. Kjell A. Nordström
Dr. Kjell A. Nordström holds a doctoral degree in International Business from the Stockholm School of Economics. His research and consulting focus is on the areas of corporate strategy, multinational corporations and globalization.

He has published three books (co-authored with Jonas Ridderstråle) and numerous articles on the internationalization process of firms. His books (Funky BusinessKaraoke CapitalismFunky Business Forever) have been featured on CNN and CNBC and appeared in FortuneFast CompanyTime MagazineFinancial TimesParis Match, etc. Funky Business was an international bestseller and was translated into 32 languages. Funky Business Forever (2008), his long awaited update takes a look back on the latter half of the millennium's first decade, and provides evolved thinking and commentary in a way that is truly "funky" and down to business.

Titanium Sponsor - Moroccan Agency for Tourism Development
The host country sponsor of the 2014 event, the Moroccan Agency for Tourism Development (SMIT), has also committed to the Summit's highest level of sponsorship - Titanium. This generous support is in addition to SMIT's responsibilities as the co-organizer of the Global Wellness Tourism Congress.
"Interestingly, Morocco ranks among the top 10 nations worldwide for wellness tourism growth through 2017 and is expected to have an annual growth rate of 14.7 percent, 60-plus percent faster than the global average," said Ellis. "SMIT has proven itself incredibly forward thinking when it comes to realizing the potential of wellness tourism and attracting investment, making them a perfect partner for the 2nd annual GWTC."

"We are proud to welcome the 8th annual Global Spa & Wellness Summit (GSWS) to Marrakech, Morocco. This event embodies our commitment to promote Morocco as a worldwide recognized wellness destination," said Imad Barrakad, CEO, Moroccan Agency for Tourism Development. "As host sponsor and co-organizer, we look forward to bringing the leaders in spa and wellness together and introducing them to Morocco's unique spa heritage - including Moroccan Hammams and our increasingly popular export, Argan oil.

To register to become a delegate to the GSWS, click here. For more information, visit http://www.gsws.org or email Alexandra Plessier at Alexandra@gsws.org. For sponsorship information, contact Executive Vice President Sallie Fraenkel at sallie@gsws.org.

About the Summit: The Global Spa & Wellness Summit (GSWS) is an international organization representing senior executives and leaders from over 40 countries, joined by a common interest to drive economic development and understanding of the spa and wellness industries. Delegates from diverse sectors, including hospitality, tourism, health and wellness, beauty, finance, medical, real estate, manufacturing and technology, attend the organization's annual Summit, which is held in a different host country each year. After just seven years, the GSWS is now considered the leading global research and educational resource for the $1.9 trillion spa and wellness industry. For more information, visit www.gsws.org.

About SMIT: A key player in planning and tourism development in Morocco, the SMIT is committed to develop and implement innovative concepts to produce the best results and to meet the expectations of all its partners. In addition to its contribution to the conception of the Strategic Vision 2020, the SMIT is a major player in setting of the execution of tourism development projects.

Since its creation, the SMIT has actively worked to carry out different missions, including: conception and the development of the tourism product as defined by the national strategy; the identification of potential sites for targeted developers and operators; engineering studies and the investment advisory; promotion of investment opportunities; and enhancement of private initiative and public-private partnership. Then SMIT philosophy is based on the capitalization of its key success factors in each business area explored and each project developed. Aiming to make Morocco the 20th most important tourist destinations in the world by 2020, the SMIT is the initiator of innovative projects and is a key player in the field of engineering and tourism development through its public and private partnerships.

Medical Tourism Gets Domesticated
Once seen as the Next Wave, Patients are Forgoing International Options for Care Closer to Home
by Steve Jacob

D CEO - Hannaford, a 9,000-employee supermarket chain in the Northeast, wanted its work force to get low-cost knee and hip replacements in Singapore. In January 2008, the company offered to waive deductibles and co-payments and pay for transportation costs for joint-surgery patients and spouses. One year later, not one employee had used the benefit.

To continue reading click here.

DrforCash.com Connects Medical Tourists and U.S. Doctors with Site Launch
DrforCash.com helps increase the foreign patient base of busy medical practitioners accepting cash payments with an all-in-one user toolbox

Doctor For Cash, LLC, a company with an interest in enhancing American Medical Tourism, has launched a new website which has been designed to give the U.S. market share in the gigantic worldwide medical tourism industry a kick in the pants. DrforCash.com provides American doctors with the means to directly advertise their practices to prospective foreign patients.

To read the original article click here.

Consumer Reports Ranks Top 10 Safest U.S. Hospitals
Publication Considers Readmission, Mortality Rates, Hospital-Acquired Infections When Tallying Scores
by Zack Budryk

Fiercehealthcare.com - A recent article, "Consumer Reports Rank Top 10 Safest U.S. Hospitals," published by Fiercehealthcare.com, recounts the top 10 safest and least safe hospitals nationwide, according to rankings from Consumer Reports.

Based on the standings, the safest hospital in the U.S. is Miles Memorial Hospital in Damariscotta, Maine, with a score of 78 out of 100, and the least safe is Bolivar Medical Center in Cleveland, Miss., with a score of 11 out of 100.

To view the original article in its entirety click here.

Hospitals' Use of Locum Tenens Physicians up in 2013
by Heather Punke

Beckershospitalreview.com-Nearly all (90 percent) of hospitals and other healthcare facilities reported using locum tenens physicians at some point in 2013, up from 73.6 percent in 2012, according to a survey conducted by Staff Care, a national temporary healthcare staffing firm.

Becker's Hospital Review is the original producer/publisher of this content.

To view the original article click here.

Surgery Center of Oklahoma Accepting Bitcoin for Billing
by Ellie Rizzo

Beckershospitalreview.com- Oklahoma City-based Surgery Center of Oklahoma has announced it will accept the cryptocurrency Bitcoin as a legitimate method of payment, according to The Global Dispatch.

Becker's Hospital Review is the original producer/publisher of this content.

To view the original article click here.

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Printable Version

Copyright © 2014
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.

For advertising inquiries, please email us at advertising@usdomesticmedicaltravel.com

Spotlight Interview

SPOTLIGHT: Mitch Rothschild, CEO, Vitals

News in Review

Laura Carabello Moderates IHC Medical Travel Panel Discussion

Domestic Medical Travel: Quality Care, Controlled Costs

Shortest Average Wait Time for Doctors in Major Cities Increased One Minute Year Over Year

The Role of Urgent and Primary Care within Medical Tourism

First Stop Health Receives $2.2 Million in Additional Angel Financing

If You Like Your Scam, You Can Keep It: the Attack on Out-of-Network Doctors

Why Medical Tourism for Workers' Comp is an Idea Whose Time Has Come

Global Spa & Wellness Summit Unveils 2014 Theme "Fast Forward"

Medical Tourism Gets Domesticated

DrforCash.com Connects Medical Tourists and U.S. Doctors with Site Launch

Consumer Reports Ranks Top 10 Safest U.S. Hospitals

Hospitals' Use of Locum Tenens Physicians up in 2013

Surgery Center of Oklahoma Accepting Bitcoin for Billing


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