Volume 1, Issue 16

Dear Colleagues,

As we continue to hear about a rapid spread of the deadly Ebola virus throughout Africa, and now its infiltration into the United States, individuals worldwide are expressing great concern about their health and safety.

To take a brief survey about the threat of contracting Ebola and the decision to pursue a medical travel option, please click here.

To help enhance quality measures and ethical practice guidelines, Tom Emerick and Rick Chelko, co-founders, Edison Health, are presenting consumers with an innovative model that offers patients care from clinics that excel in diagnosing complex health problems.

Edison Health co-founders suggest it is essential for hospitals and Centers of Excellence to employ physicians who can collaborate on surgical decisions and diagnoses, which is not always the case. To help halt money-driven medicine, Edison Health has a screening process in place where facilities must be willing to rehabilitate their models and avoid the performance of unnecessary surgeries.

With the growing interest in medical/surgical travel options, we'd like to hear from your provider organization - ACO, health/hospital system, free standing surgi-center, community hospital - about why you believe that your facility or organization is a Center of Excellence that can serve the needs of employers and payers throughout the United States.

What distinguishes your service offering in terms of cost, patient experience and satisfaction, outcomes, or other quality indicators? Send us your descriptor, including photos or charts, and we will evaluate for publication in this newsletter.

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


Tom Emerick, President, Emerick Consulting LLC and Co-founder, Edison Health
Rick Chelko, President and Founder, The Chelko Consulting Group and Co-founder, Edison Health


About Tom Emerick
Prior to starting his consulting career, Tom was vice president, Global Benefits Design for Wal-Mart Stores, Inc. where he designed and managed benefits for over 1.1 million associates in the U.S. In 2009, Tom was named by Heathspottr as one of the top 100 innovators in healthcare in the U.S. for his work on medical ethics. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever.

Tom Emerick is the coauthor of "Cracking Health Costs: How to Cut Your Company's Health Costs and Provide Employees Better Care." To learn more or to buy a copy of this book online click here.

Rick Chelko, President and Founder, The Chelko Consulting Group

About Rick Chelko
The Chelko Consulting Group is a boutique health and welfare benefits consulting firm headquartered in Cleveland, Ohio.  Previously, Rick served as a principal and Regional Practice leader for Ernst & Young LLP.  He is recognized as an industry expert in the areas of healthcare consumerism, benefits design and management, and health promotion. Rick also serves as the national co-president of WEB (the Worldwide Employee Benefits Network).

Through EdisonHealth, members of contracting health plans can gain access to heart, valve, spine, and transplant care at some of the highest-performing clinics and health systems in the United States.  The EdisonHealth Network contracts with first-rate hospitals and clinics, and then extends the exclusive benefits of these contracts to participating employers and health plans along with a suite of care coordination, claims payment, performance reporting and related services. www.edisonhealth.net

USDMT: How is Edison Health and its business model different from others in the market?

Rick Chelko (RC): A new way of domestic medical travel was introduced when Wal-Mart announced its plans to work with Centers of Excellence (COE) in the U.S. Now, individuals nationwide are interested in cloning a version of what Wal-Mart is doing with these COEs.

I was continually receiving calls from third party administrators, small and medium size employers, and other aggregators inquiring about how to obtain access into a Wal-Mart-like COE plan.

It is challenging for clinics to do business with somebody that has 10,000 lives -- it is entirely too much work and too many legal battles.

It is our goal to make this kind of a program accessible to the masses who want this approach.

Tom Emerick (TE):  Our business model appeals to different markets.  Our approach appeals to companies that desire access to elite, high-profile clinics.

There are benefit managers today, especially big companies, that aren't willing to send employees for care that offers only the deepest discounts, but will send them to facilities with the best quality.

The clinics I've worked with don't perform surgery on someone who doesn't need it-that is part of the definition of quality. These clinics do a superior job accurately diagnosing patients.

Many spine surgeons around the country will perform spine surgeries on people with somatic back pain, meaning some orthopedic surgeons will do back surgery on a person even if it is stress-induced. 

Our model won't necessarily be utilizing deep discounts, but taking that into consideration, we will offer patients clinics that excel in diagnosing complex health problems correctly and offering treatment that is truly evidence based.

This is a new way of measuring quality.

RC: We are helping plan members travel to destinations that are specially designed to properly diagnose and treat individuals. Our approach helps evaluate quality and ethical practice guidelines. 

USDMT: Who is the ultimate arbiter to determine the diagnosis and what surgeries could be avoided or the appropriate time for surgery?

TE: We will send patients that are eligible for surgery to a COE where doctors will do a complete overview of the patient's medical history. From there, a team assessment will be done to determine who needs, or does not need surgery. 

USDMT: From your vantage point, what percentages of the surgeries are unnecessary?

TE: I've been doing this a long time and I would say at least half, maybe more, of the spine surgeries occurring in the U.S. are unnecessary.

The best doctors tend to do psychological profiles on patients, sometimes discreetly, to determine whether or not someone is experiencing somatic back pain, or if there is in fact something wrong with the patient's back.

USDMT:  Isn't back pain one of the leading reasons why people go to the doctor?

TE:  Yes, it is!

I am aware of a county where there are two major clinics.  If you go to Clinic A with back pain vs. Clinic B you have about a 30 percent higher chance of having surgery.  If you go to Clinic B, they don't do surgery on people's somatic back pain. 

There was a clinic I heard about in Kansas that hired a psychologist to evaluate the patients because this was a very controversial issue. After the evaluations, half of the patients were suffering from somatic back pain and surgery was deemed not necessary.

After 90 days, the clinic fired the psychologist who claimed the surgeries were unnecessary because they were losing the proceeds from the pointless surgeries.

This is money-driven medicine.

USDMT:  You're spot on with this.  Are there other surgeries that are impacted?

TE:  I've been sending transplant cases to COEs since the mid 80's when I was with British Petroleum, then later at Burger King and Wal-Mart. Four out of ten individuals, who were told they needed an organ transplant, clearly didn't need it.  

USDMT:  Four out of ten is a lot! Your clientele are typically what size employers?

TE:  Emerick Consulting has been working with large to medium size employers. I have worked with much smaller groups that consisted of 2,500 lives, although most employers that I deal with are 75,000 and up.   

USDMT:  Your new entity Edison is going to focus on what size employers?

RC:  We're really targeting employers with 10,000 or more plan members.

We are also open to employers that have less than 10,000 lives, but they've got to recognize that they may not have the same annual results that a larger employer would.

USDMT:  If a hospital or a COE wanted to be included in your deck of cards, so to speak, how would they go about that?

RC:  People can contact Tom or me directly, or there is an accessible contact opportunity on our website, www.edisonhealth.net, as well.

TE: We have a screening process we utilize and one of the first questions I tend to ask is, "Are you willing to rehabilitate your model and avoid doing unnecessary surgery on people?"

I want these hospitals and COEs to have doctors collaborate on surgery decisions and collaborate on diagnoses.  Most facilities that express an interest don't agree with this.

USDMT:  So do you typically have a COE for oncology or for orthopedics, or is it more general hospitals that do acute care?

TE:  It's usually major centers like Mercy in Springfield, Missouri, Virginia Mason in Seattle, Intermountain in Salt Lake, the Oklahoma Heart Hospital in Oklahoma City, Geisinger in Pennsylvania, and a few others.

Out of the box, we are starting with cardiac surgery -- heart and valves -- spine surgery, and transplants.  We expect that we will expand into orthopedics and maybe some cancer/oncology, but it is not our primary focus right now.

We think we're going to have some cancer solutions available by the end of the year, but there are challenges with cancer because it is hard to move people with a treatment.

A facility I am working with promises to be a cancer COE by January 1, 2015, or shortly after.

SPOTLIGHT: Robin Gelburd, President, FAIR Health



About Robin Gelburd
Prior to being recruited as president of FAIR Health, Inc., Robin served for eight years as general counsel of a medical research foundation comprised of approximately 30 premiere academic medical centers, hospitals, and research institutions in New York dedicated to the promotion of medical research.

During her tenure at this consortium, Ms. Gelburd was also appointed chairperson of the New Yorkers for the Advancement of Medical Research, a statewide coalition comprised of over 40 organizations which Ms. Gelburd helped found in 2003 and which had as its mission the promotion of state funding and support for stem cell research. Prior to her tenure as general counsel, Ms. Gelburd was a health law partner at the New York City law firm Kalklines, Arky, Zall & Bernstein (now Manatt, Phelps & Philips LLP). During her 10 years at that firm, she represented a wide array of healthcare-based clients, including hospitals, provider groups and organizations, payers, skilled nursing facilities, special needs plans, ambulatory care centers and the like on a variety of strategic, regulatory, policy, governance, business, and contractual matters. Previously, Ms. Gelburd worked as a litigation and corporate associate at the international law firm Morrison & Foerster. She began her legal career as a federal appellate law clerk to the Honorable Francis D. Murnaghan, Jr. from the Court of Appeals, 4th Circuit.

About FAIR Health
FAIR Health is a national, independent, not-for-profit corporation whose mission is to bring transparency to healthcare costs and health insurance information. We strive to develop robust, unbiased data tools to meet the needs of those we serve, which includes all stakeholders in the healthcare sector including but not limited to consumers, health plans, policymakers, bill review companies, administrators, healthcare providers, government officials and researchers. We accomplish this by dedicating all of our resources and expertise to making the nation's largest collection of private medical and dental claims data available to the most users in the formats that are most helpful to them.

U.S. Domestic Medical Travel (USDMT): There are so many organizations that promote transparency, how does FAIR Health differ from the rest?

Robin Gelburd (RG): We are very distinct-one could say we are like a unicorn in the market of transparency.

We have very unique origins. FAIR Health came out of a settlement agreement that was achieved by then Attorney General Cuomo and the insurance industry in New York. There were questions raised about the way in which certain claims were being adjudicated, and about the data that was being relied upon to adjudicate those claims.

When the matter was probed more deeply, they found that there were impermissible conflicts of interest in that adjudication process, and so the matter never went to trial; all of the parties agreed that it was critical to bring integrity and fairness to the healthcare industry. At the end of the process, all appropriate parties paid funds into a settlement fund, and out of that fund, they agreed to create a new independent, conflict-free, not-for-profit organization - FAIR Health.

We were tasked with creating a database of healthcare claims using the best algorithms and methodologies recommended by a consortium of academic researchers, economists and statisticians. It was contemplated that the data within that repository would then be used and shaped into products and custom analytics that could be relied upon by all the different stakeholders in the industry - health plans, providers, government officials and so forth.

We were also tasked with launching a free consumer website that would give consumers access to cost estimates for medical and dental procedures in their relevant geographic market.

As part of the settlement, it was also understood that we would make our data available to the research community and policymakers to help health systems researchers, economists, public health officials and others ask and answer the hard questions that are plaguing the healthcare industry.

FAIR Health varies from other organizations because we have the largest private healthcare claims collection in the country. We had data on 140 million covered lives, but that number just increased because we received new contributors. Now, we have data on 151 million covered lives that contribute information into our repository.

From 2002 until now, we have over 17 billion billed medical and dental procedures nationwide in the repository. It is interesting that even though FAIR Health was created in a New York investigation, it became a national remedy that is now heavily relied upon by all stakeholders in the healthcare ecosystem. We have hundreds of data licensees who use our data to adjudicate claims on behalf of 191 million covered lives. The difference between the 151 million and the 191 million is that not every customer is a contributor. Contribution is voluntary, except for several insurers who initially are participating pursuant to the settlement but who, we believe, will continue to participate. We are also written into statutes and regulations to help support state workers' compensation programs, automobile liability programs, and emergency care adjudication.

Our data is not held virtually by the contributors. We take possession of the claims and we audit, validate, aggregate and standardize the data in a way that is meaningful to our customers.

It is our mission to provide robust, transparent and fair data to the healthcare industry.

USDMT: Is it easy for a consumer to visit your website and determine the pricing differential between hospitals in Massachusetts vs. hospitals in Arizona?

RG: The data that we have right now is for professional services, so they are able to view the price differentials between gastroenterologists in Ohio vs. gastroenterologists in Massachusetts.

Additionally, the consumers are able to search data in 491 different geo-zips, which tend to track with the first three digits of a zip code-a very granular geographic offering. For example, Medicare has approximately 90 physician fee schedule configurations compared to our 491 geo-zips.

In terms of consumer access, we are very proud to mention that FAIR Health was singled out as one of three healthcare-related websites that the White House featured at its Summit on Smart Disclosure, which promoted sound consumer decision-making. Also, albeit unsolicited, we were just listed by AHRQ as a Quality Tool on its Innovation Exchange and last fall URAC presented us with a Silver Award for Best Consumer Engagement and Protection.

Nationwide, consumers claim that they have used our website to:

  • Conduct research to determine what their out-of-pocket responsibility would be if they accessed certain services out-of-network
  • Learn the fundamentals about healthcare insurance, the healthcare reimbursement system and the Affordable Care Act
  • Initiate constructive dialogues with providers regarding cost
  • Initiate constructive dialogues with health plans once they receive an explanation of benefits
  • Support appeals and adjudication questions and processes

Cost transparency is a national conversation now. You cannot open the newspaper, turn on the radio or surf the Web without seeing an article about transparency.

However, at FAIR Health, we focus more in terms of "clarity" versus "transparency." Making data readily accessible or transparent to consumers is only half of the equation. The data must then be properly contextualized and explained to be truly meaningful.

We try to provide information in a manner that supports healthy decision making, which includes not only the data, but also the proper healthcare vocabulary and principles.

There is a concern about health insurance "illiteracy" in this country. There have been surveys conducted that document a majority of responding adults who do not even know the meaning of "co-pay," "co-insurance" and "deductible," which are all basic terms.

We try to fill the gaps of healthcare illiteracy and present data that does not add to the consumer's confusion, but rather enables them to make sound choices.

USDMT: Why is it that "for-profit" organizations claim to be the first to provide cost transparency if it has already been done?

RG: There are many ways to characterize "cost transparency."' Thus, it would be very difficult to identify any one organization as the "first" in this field. For FAIR Health, transparency means disclosure about the quantity and nature of our data, the processes used to analyze, validate and aggregate our data, our outreach and accessibility to all stakeholders in the healthcare industry, and our governance structure and network of advisors.

That being said, this is a very fertile field that allows for many approaches and innovative pathways.

What is unique about FAIR Health is our ability to work with all types of companies seeking to provide cost transparency solutions. Because of our independence and the breadth of our data, our tools and resources become essential to others in powering their solutions. We, in effect, become like the "Intel chip" in other systems.

FAIR Health is completely self-supporting through licensing fees for the products and tools that we offer.

It has truly been a privilege to see the reception that we've had in the industry.

For example, in New York all of the qualified health plans operating on the exchange were required to provide certain transparency tools. FAIR Health was expressly written into one of the FAQ's on the official exchange site which indicated that our website would meet this particular requirement. Now, we have been pleased to work with a number of plans that have been repurposing and privately labeling our tools. By doing so, they can leverage our rich educational content and tools and avoid having to reinvent the wheel.

FAIR Health feels privileged that stakeholders in the industry have come to trust us and advocate on behalf of us in their state to have us incorporated into a number of their provisions and health-related programs.

Will U.S. Keep Ebola in Check Here at Home?
by Jane M. Orient, M.D., President, Doctors For Disaster Preparedness

www.aapsonline.org -Some 3,000 American soldiers are arriving in Africa to fight an Ebola epidemic that is doubling about every three weeks, with the number of infections projected to reach 1.4 million by January. President Obama said: "It will require an ‘air bridge' to get health workers and medical supplies to areas that are affected."

Meanwhile, the virus has used the air bridge of a commercial flight to reach Dallas. So far, only the index patient is ill, but 100 contacts are being observed.

Although a large number of experts agree that the likelihood of a widespread outbreak is "vanishingly small," owing to our "highly sophisticated public health system," a number of breaches in our invulnerability are already manifest.

  • The hospital where the patient initially presented failed to follow federal guidelines. He told a nurse that he had been in Liberia and should have been placed in isolation and tested for Ebola immediately. Instead, he was sent home on antibiotics, which are useless for viral infections.
  • The patient vomited copiously outside his apartment before returning to the hospital by ambulance. No precautions were taken in cleaning up.
  • The ambulance was kept in service with no special disinfecting, and the crews were not informed.
  • Even now, the patient is being treated under BSL-2 (biosafety level 2) conditions, although the World Health Organization states that BSL-4 precautions are needed for working with Ebola virus.
  • Rules requiring international passengers to fill out a detailed health questionnaire have not been implemented, although the Centers for Disease Control and Prevention (CDC) called them "critical to protecting Americans from dangerous diseases spread by travelers"-in 2006.

Officials are frequently reassuring people that the virus is not "airborne" and that "direct contact" with a sick person is required to get infected. It is not possible, we are told, to get Ebola from a person who does not have symptoms. We just need hand-washing and other "simple, basic precautions."

Meanwhile, CDC officials are in full hazmat gear, and some say that you need a buddy to make sure that every square millimeter of your skin is covered at all times. A tiny pinprick through your glove, and you've got Ebola.

The official website of the Public Health Agency of Canada stated that "airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated." Then, sometime between Oct 1 and Oct 2 the Agency actually changed the language of their Pathogen Safety Data Sheet on Ebola to softer, less alarming language on airborne transmission, including the removal of citations to key scientific literature.

It would be quite remarkable for body fluids like vomitus or saliva to be infectious while on the patient, or after landing on a surface (where they may remain infectious for days), but not while aerosolized between the patient and their landing place. Cells in the skin and mucous membranes contain receptors targeted by the virus.

And how can one be sure that an asymptomatic patient cannot transmit disease? The virus is multiplying in his body-what is to prevent it from being shed before he notices fever or headache? It's a matter of degree. Corpses are teeming with virus, but it only takes a very few particles to infect someone.

Understandably, public health officials do not wish to cause a panic, as panic itself can cause countless casualties. But absolute statements that prove to be false will destroy the credibility of the authorities.

The potential for devastating loss of life is real. The disease must be stopped before there are millions of persons exposed instead of 100. These precautions are clearly needed now:

  • Restricted entry: Travelers from affected areas need to be carefully screened and quarantined when indicated.
  • A high index of suspicion: travel and exposure history are essential in any patients with fever and symptoms that could be Ebola (headache, muscle pains, prostration, nausea and vomiting, a spotty rash).
  • Precautionary isolation: When Ebola is a possibility, patients need to be tested and isolated until results are known to be negative.
  • Meticulous contact tracing: At-risk persons need to be identified, notified, monitored and isolated as needed.
  • Preparedness: Hospitals need to train all personnel, assure adequate supplies of protective gear, assure that their housekeeping is fastidious, and have a high level of alertness.

Disease has defeated mighty armies and brought down empires before. The U.S. is not immune. We need hard-headed realism, not complacent reassurance.

About the author/contributor: Jane M. Orient, M.D., Internal Medicine, 1601 N. Tucson Blvd. Suite 9, Tucson, AZ 85716, Telephone: 520-323-3110, janeorientmd@gmail.com

Jane M. Orient obtained her undergraduate degrees in Chemistry and Mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an Internal Medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals, and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as executive director of the Association of American Physicians and Surgeons (AAPS) since 1989. She is currently president of Doctors for Disaster Preparedness. Since 1988, she has been chairman of the Public Health Committee of the Pima County (Arizona) Medical Society. She is the author of YOUR Doctor Is Not In: Healthy Skepticism about National Healthcare; Sutton's Law (a novel about where the money is in medicine today); and the second through fourth editions of Sapira's Art and Science of Bedside Diagnosis,published by Lippincott, Williams & Wilkins. She authored books for schoolchildren, Professor Klugimkopf's Old-Fashioned English Grammar and Professor Klugimkopf's Spellling Method, published by Robinson Books, and coauthored two novels published as Kindle books, Neomorts and Moonshine, More than 100 of her papers have been published in the scientific and popular literature on a variety of subjects, including risk assessment, natural and technological hazards and nonhazards, and medical economics and ethics. She is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives, and is the managing editor of the Journal of American Physicians and Surgeons.

AAAASF provides outpatient facilities with Ebola checklist
Public also should be informed

Outpatient facilities accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF) treat and filter many patients daily. Since patient safety is the mission of AAAASF, the organization is providing a facility preparedness checklist for Ebola, as well as facts about the virus in the United States.

Checklist for outpatient facilities

  • Monitor the situation at the CDC website at http://www.cdc.gov/vhf/ebola.
  • Assess and ensure availability of appropriate personal protective equipment and other infection control supplies such as hand hygiene supplies.
  • Review facility infection control policies.
  • Recognize a case of Ebola and be prepared to use appropriate infection control measures.
  • Review environmental cleaning procedures.
  • Begin education and refresher training for healthcare providers on Ebola virus disease signs and symptoms, diagnosis, how to obtain specimens for testing, triage procedures, employee sick leave policies, how and to whom Ebola cases should be reported and procedures to take following unprotected exposures.
  • Avoid contact with the blood or bodily fluids of an infected patient.
  • Have the capability to request diagnostic tests or prepare samples for shipping and testing elsewhere.
  • Ensure laboratories review procedures for appropriate specimen collection, transport and testing of specimens from patients who may be infected with Ebola virus.

Facts about Ebola in the United States

  • Ebola is a severe, often fatal disease in humans and non-human primates such as monkeys, gorillas and chimpanzees.
  • Humans cannot get Ebola through the air, water or food.
  • Ebola can be obtained by touching the blood or bodily fluids of a person who is sick with or has died from Ebola.
  • Ebola can be obtained by touching contaminated objects, such as needles.
  • Ebola can be obtained by touching infected animals, their blood or other bodily fluids, or their
  • eat.
  • Those infected with the Ebola virus should be isolated, provided intravenous fluids and balancing electrolytes and maintain oxygen status and blood pressure.

Signs and symptoms of Ebola
According to the CDC, a person infected with Ebola is not contagious until symptoms appear. Signs and symptoms typically include a fever of more than 101.5, severe headache, muscle pain, vomiting, diarrhea, stomach pain and unexplained bleeding or bruising. Symptoms may appear anywhere from two to 21 days after exposure to Ebola with the average being eight to 10 days. For more information about the Ebola virus, visit aaaasf.org.

About the AAAASF
The American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF) was established in 1980 to develop an accreditation program to standardize and improve the quality of medical and surgical care in outpatient facilities while assuring the public that patient safety is top priority in an accredited facility.

Today, more than 2,100 outpatient facilities are accredited by AAAASF, one of the largest not-for-profit accrediting organizations in the United States. Surgeons, legislators, state and national health agencies and patients acknowledge that AAAASF stands alone as the program setting the "gold standard" for quality patient care. For more information, visit http://www.aaaasf.org or Facebook, LinkedIn and Twitter.

For immediate release: Oct. 6, 2014
Contact: Public Relations and Marketing Manager Kim Kubiak
Phone: 847-775-7915
Email: kim@aaaasf.org

New Gallup-Healthways Global Well-Being Index Creates a Catalyst for Worldwide Change
Latest Milestone in the Organizations' Six-Year Partnership Establishes One-of-a-Kind Well-Being Dataset and Insights to Help Businesses and Governments Realize Sustainable Lifestyle Improvements, Stronger Communities and Significant Cost Savings

As part of their ongoing partnership in innovation, global well-being improvement leader Healthways (NASDAQ: HWAY) and world-leading management consulting firm Gallup have released their inaugural analysis of the state of global well-being. More than 133,000 surveys in 135 countries or other areas led to the new report, entitled, "State of Global Well-Being: Results of the Gallup-Healthways Global Well-Being Index," which outlines the growing importance of well-being as an indicator of societies' prosperity and progress, compares countries across five key elements of well-being, and offers strategies for population-based well-being improvement.

"Working together, Gallup and Healthways have the unique ability to measure well-being at individual, organization and geographic levels, creating a ‘golden thread' of data and insights that allows us to act with precision to create meaningful change in populations. By understanding individuals in the context of their social frameworks, work environments, communities, states, countries and ultimately the world - in ever-widening circles - we are able to create a very straight path to a return on value from a wide array of well-being improvement initiatives," said Ben R. Leedle, Jr., president and chief executive officer, Healthways.

"Every leader, in every country, has a duty to improve the lives and communities of the populations they serve," added Jim Clifton, chairman and chief executive officer, Gallup. "As the Gallup-Healthways partnership expands its global view, discovering new opportunities and challenges, this landmark index provides a significant step for our partnership in becoming the world's official statistician for well-being and the leading provider of well-being improvement strategies across the globe."

Since 2008, Gallup and Healthways have examined the well-being of U.S. adults via the Well-Being Index, a definitive measure and empiric database of real-time changes in well-being. The index uses a holistic definition of well-being and self-reported data from individuals to capture the important aspects of how people feel about and experience their daily lives, extending well beyond conventional measures of physical health or economic indicators. Measuring well-being gives leaders a unique, quantitative perspective on how their populations self-report the state of their lives currently and how they anticipate their lives will be in the future - information that is vital to inform well-being improvement strategies. With the launch of the Global Well-Being Index, the two companies have formed the most comprehensive measure of well-being in the world.
Well-being has five prominent elements:

  • Purpose: Liking what you do each day and being motivated to achieve your goals
  • Social: Having supportive relationships and love in your life
  • Financial: Managing your economic life to reduce stress and increase security
  • Community: Liking where you live, feeling safe and having pride in your community
  • Physical: Having good health and enough energy to get things done daily

Gallup conducted face-to-face and telephone interviews with respondents in the 135 countries and regional areas. Approximately 1,000 interviews were conducted in the majority of countries, for a total of more than 133,000 interviews in 2013. Responses were then used to determine whether a country had high, medium or low levels of well-being in each of the five elements.
The ten countries or areas with the highest overall well-being in the world, as assessed by the percentage of their populations indicating that they are thriving in three or more of the five elements, are as follows:

  • Panama (61%)
  • Costa Rica (44%)
  • Denmark (40%)
  • Austria (39%)
  • Brazil (39%)
  • Uruguay (37%)
  • El Salvador (37%)
  • Sweden (36%)
  • Guatemala (34%)
  • Canada (34%)

The United States surprisingly fell outside the top 10, ranking #12 in global well-being. The U.S. ranks in the top 20 worldwide in purpose and social well-being, with strong levels of thriving and relatively low suffering in each element that set it apart. In other areas of well-being, however, the United States does not stand out. The percentage of American adults who are suffering in physical and community well-being is comparable to global levels.

The ten countries or areas with the lowest overall well-being in the world, as assessed by the percentage of their populations indicating that they are thriving in three or more of the five elements, are as follows:

  • Syria (1%)
  • Afghanistan (1%)
  • Haiti (3%)
  • Democratic Republic of the Congo (5%)
  • Chad (5%)
  • Madagascar (6%)
  • Uganda (6%)
  • Benin (6%)
  • Croatia (7%)
  • Georgia (7%)

Globally, only 17 percent of the world's population is thriving in three or more elements. Of all the regions, the Americas have the highest levels of well-being, with all elements out-performing the global percentages. The difference relative to global thriving rates was greatest in social well-being (where the Americas achieved 20 percentage points more than the global percentage; 23 percent global versus 43 percent Americas). Financial well-being had the smallest difference relative to global thriving rates, with a four percentage point difference (25 percent global versus 29 percent Americas).
"Improvement in each of the five well-being elements uniquely contributes to an increase in organizational value and reduction in cost. Their individual contributions, however, will vary based on the outcome being examined. While improvement in any one element will already positively affect the other four, strategies to improve well-being are optimally effective when the elements are addressed in concert with one another," said Peter Choueiri, president of Healthways International.

In the United States, improving well-being has been shown to lower healthcare costs and increase worker productivity, in turn enhancing organizational and community competitiveness. Globally, higher well-being correlates with outcomes indicative of stability and resilience - for example, healthcare utilization, intent to migrate, trust in elections and local institutions, daily stress, food/shelter security, volunteerism and willingness to help strangers.

Visit http://info.healthways.com/wellbeingindex to access any of the Well-Being Index reports, including "State of Global Well-Being," "State of American Well-Being" and individual reports for each of the 50 American states.

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 68 million people on four continents. Learn more at www.silversneakers.com or www.healthways.com.


Bruce Middlebrooks, 615-614-4463
Johnathan Tozer, +44-207-950-4400

Most Consumers Value Integrated Benefits for Time and Cost Savings
WellPoint Survey Finds Americans Value Integration as Newest Innovation

Whether it's dental insurance or the smartphone, consumers want products that offer simplification and savings. In a new survey, WellPoint asked Americans what products make their lives easier and the findings revealed that integrated products and services are highly valued - for example, the smartphone (74 percent), printer/copier/scanner (64 percent) and the toaster oven (36 percent). And, when it comes to insurance, consumers overwhelmingly (81 percent) said it would be extremely helpful to trust the same carrier to provide their dental, vision and health coverage.

So, what specifically are consumers looking for when it comes to selecting an insurance plan? Survey respondents said a range of factors are important to consider, but they most frequently point to cost as being an extremely important aspect (67 percent), followed by comprehensiveness of coverage (61 percent), customer service (60 percent) and ease of use (58 percent). Additionally, 86 percent would expect to save time, save money or receive improved care if they had the same carrier integrate dental with their vision and medical benefits.

In the current healthcare environment, employers are looking for products that offer their employees exceptional valuei. The good news is that simpler processes, vast networks and deep discounts offered by multiline carriers like WellPoint can provide employers and employees with the exceptional value they are seeking.

"For example, we offer a vast choice of dental benefits that employees want, along with large, reliable provider networks that make it easy and affordable for consumers to maintain good oral health," said Dani Fjelstad, president of WellPoint's Dental business. "And, we've built strong relationships with the dentists in our network and we have negotiated rates, which saves members on average 25 to 32 percent on their covered dental services."

In addition to seeing a cost savings, consumers can expect to save time when they selecting a multiline carrier. Half of the consumers surveyed (50 percent) say that figuring out costs is the most time consuming aspect of health management. Two in five also say it's time consuming to find healthcare providers that accept their insurance (41 percent) and to get their doctors to talk with each other to coordinate care (39 percent).

"With all of the advantages available to consumers and employers who get their benefits from a multiline carrier, there's no reason to settle for the inefficiencies of having multiple benefit providers," said Fjelstad. "We're meeting the needs of both employer and employee by providing affordable and comprehensive coverage benefits, which helps both save money and time every step of the way."
This report presents the findings of a telephone survey conducted among 1,005 adults, 503 men and 502 women 18 years of age and older, living in the continental United States. Interviewing for this ORC International CARAVAN® Survey was completed on July 10-13, 2014. 605 interviews were from the landline sample and 400 interviews from the cell phone sample.

The margin of error for the total sample is ±3.0 percent at the 95 percent confidence level. This means that if we were to replicate the study, we would expect to get the same results within 3.0 percentage points 95 times out of 100.

About WellPoint, Inc.
WellPoint is working to transform healthcare with trusted and caring solutions. Our health plan companies deliver quality products and services that give their members access to the care they need. With nearly 69 million people served by its affiliated companies, including more than 37 million enrolled in its family of health plans, WellPoint is one of nation's leading health benefits companies. WellPoint companies serve members as the Blue Cross licensee for California; and as the Blue Cross and Blue Shield licensees for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. In most of these service areas, WellPoint does business as Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Georgia and Empire Blue Cross Blue Shield, or Empire Blue Cross (in the New York service areas). It also serves customers in other states through its Amerigroup, CareMore and UniCare subsidiaries.

To find out more about WellPoint, go to wellpoint.com.

iCorporate Executive Board (2012). To Keep Your Customers, Keep It Simple
Source: WellPoint, Inc.
WellPoint, Inc.
Donna Page, 404-842-8105

To view the original release click here.

Fourth Annual Innovation Centers Summit Workshop to be held November 17-18, 2014 at the new Innovation Lab in Newport Beach, California

BluePrint Healthcare IT, The Innovation Institute and the Innovation Lab jointly announced today the Fourth Innovation Centers Summit Workshop to be held at the Innovation Lab in Newport Beach, California, on November 17-18, 2014. Open to provider-based healthcare innovation centers, the workshop's theme, "Optimizing innovation centers to lead healthcare transformation," will be tackled over two days. The unique and highly interactive forum features breakout sessions, BluePrint's hallmark speed dating sessions and new master workshops. St. Joseph Health and Bon Secours Health System are members of The Innovation Institute.

According to Mike Squires, vice president, Innovation and Public Policy, BluePrint Healthcare IT, this event will build on the work of the first three Summit Workshops, and will continue to focus on innovation center and program operations. "Rather than listening to presentations and ‘talking heads,' participants will select topics of greatest interest for the breakout and master workshop sessions ahead of time and meet in concentrated dialogues with peers based on matched speed dating selections," said Squires.

Topics for breakout sessions may include the role of innovation centers in addressing new models of care, metrics to support ROI, tools and processes that support innovation, the role of small and big data in transforming care, as well as commercialization and stakeholder engagement. Possible topics for new master workshops range from accelerators and hackathons to formal innovation frameworks, as well as social media strategy and planning for physical and virtual innovation centers.

Summit participants will also have the opportunity to be among the first to experience the new Innovation Lab facilities set up by The Innovation Institute, opening this fall in Newport Beach, California.

Co-chairpersons for the event include Larry Stofko,  executive vice president of The Innovation Institute and Mike Squires, vice president, Innovation and Public Policy of BluePrint Healthcare IT.

"As innovators in healthcare, we have a responsibility to one another to exchange ideas and share experiences that will benefit patients, care teams, and physicians, as well as our organizations and the entire healthcare system," said Stofko. "With the opening of our new Innovation Lab facility, hosting BluePrint's Innovation Centers Summit Workshop will be a great opportunity for healthcare innovation centers across North America to collaborate."

Squires said, "Accelerating the development of a continuous learning healthcare innovation (centers) eco-system is the objective of BluePrint Healthcare IT Innovation Exchange (BIX) Summit Series. BluePrint's public policy initiative grew out of our focus on innovation as central to healthcare transformation. As more innovation centers are seeking to capitalize on employee ideas, commercialize technology, and deliver better healthcare at reduced costs, everyone will benefit from the cross-fertilization of ideas and learnings."

Forty-three provider-based healthcare innovation centers and initiatives have joined the Summit Workshop series, with 20 to 25 centers at each. The first Summit Workshop was held at Kaiser Permanente's Garfield Innovation Center in 2012, the second at KP's Center for Total Health in 2013 and the third in the spring of 2014 at Johns Hopkins Hospital, hosted by Johns Hopkins Center for Bioengineering Innovation & Design. Post-summit feedback showed participants agreed the overall goal of cross-fertilization between independent healthcare innovation centers was successful and would recommend similar workshops to colleagues at their organization and others.

Please contact Mike Squires at mike.squires@blueprinthit.com or 908.391.6191 or write Pamela Macey at pamela.macey@blueprinthit.com if you have any questions about participating or supporting sponsorship of this event.

Interested innovation center executives and staff can find additional information or register online at http://www.blueprinthit.com/innovation/Fall-2014-Innovation-Centers-Summit

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About BluePrint Healthcare IT
BluePrint Healthcare IT is a professional services and software company working with healthcare organizations to create secure, connected communities of care to achieve the Triple Aim. Founded in 2003 in Cranbury, New Jersey, BluePrint Healthcare IT supports hospitals, healthcare systems, accountable care organizations, regional healthcare initiatives and health plans. BluePrint became a Microsoft Managed Partner with the development of Care Navigator™, the care coordination technology platform used to enable active, scalable communication for the whole extended care team from physician to patient. BluePrint's Innovation Exchange (BIX) public policy initiative supports cross-fertilization and collaboration among its expanding network of provider-based innovation centers. To learn more visit http://www.blueprinthit.com.

About The Innovation Institute 
The Innovation Institute is an independent, for-profit LLC structured to cultivate innovative solutions to transform healthcare delivery. The Innovation Institute will be owned by seven non-profit health systems. This collaborative will tap into physicians, employees, and industry business partners to incubate and commercialize new products and ideas. Comprised of three distinct elements - an innovation lab, an investment fund, and a shared services group (Enterprise Development Group), the Institute strives to "do more, with less, for more people." For more information, visit http://www.ii4change.com.

UnitedHealth's Price Transparency Tools Help Consumers Choose High-Quality Docs
by Dina Overland

Fiercehealthpayer.com- When consumers used UnitedHealth's price transparency tools, they were able to comparison shop for lower costs and search for high-quality providers, according to a new study of the insurer's myHealthcare Cost Estimator (myHCE).

To read the original article click here.

How to Build a Successful Bundled Payment Program
by Dina Overland

Fiercehealthpayer.com- As the health insurance industry continues its shift toward a value-based reimbursement system, more payers are experiencing with bundled payments.

To read the original article click here.

American Healthcare: More for Less?
by Diana Manos  

Fiercehealthpayer.com-A new trend in healthcare is underway in America, writes Vox's Sarah Kliff in her latest analysis. She's calling it "the get more, pay less" era.

To read the original article click here.

Before You Travel With Your Baby
by Vitals

The summer travel season is upon us. For most, it's an exciting time where plans for visiting oft dreamed about destinations finally come to fruition. But for new parents, the excitement of going on vacation is tempered by the worry of how your little one will handle the journey.

Read the full story here: What You Need to Know Before Traveling With a Baby

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

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

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


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U.S. Domestic Medical Travel™

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

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Spotlight Interview

Tom Emerick, President, Emerick Consulting LLC and Co-founder, Edison Health
Rick Chelko, President and Founder, The Chelko Consulting Group and Co-founder, Edison Health

Robin Gelburd, President, FAIR Health

News in Review

Will U.S. Keep Ebola in Check Here at Home?

AAAASF provides outpatient facilities with Ebola checklist

New Gallup-Healthways Global Well-Being Index Creates a Catalyst for Worldwide Change

Most Consumers Value Integrated Benefits for Time and Cost Savings

Fourth Annual Innovation Centers Summit Workshop to be held November 17-18, 2014 at the new Innovation Lab in Newport Beach, California

UnitedHealth's Price Transparency Tools Help Consumers Choose High-Quality Docs

How to Build a Successful Bundled Payment Program

American Healthcare: More for Less?

Before You Travel With Your Baby

Help Save a Life and Support MatchingDonors