2013 IHC Forum West




Volume 1, Issue 4

Dear Colleagues,

For decades, many high-profile hospitals and Centers of Excellence throughout the country have been actively recruiting international patients as the way to increase their volume and enhance revenues. Now, the opportunity to attract foreigners is trickling down to the not-so-famous institutions that regard these new sources of business as within their reach.

This class of trade is not simply the very rich Sultans or oil magnates. Today, middle and upper-middle class residents of nations from Russia to North Africa, China, and South America are seeking access to care in the US - and not necessarily at the top-branded institutions.

The challenge for smaller hospitals and systems that do not have deep pockets will be how to penetrate the foreign markets. Let's not forget, the competition for these patients is worldwide, with many hospitals and institutions throughout the globe also working to capture these patients.

But the US is still considered by many to be the optimal standard of care, and mid-size hospitals can market effectively. It can be an expensive, daunting task - but may well produce a robust ROI.

We have interviewed Scott Becker, JD, editor and publisher of the leading hospital publication, Becker's Hospital Review, who shares some unique perspectives.

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

Spotlight: Scott Becker, McGuireWoods, LLP
Editor and Publisher, Becker's Hospital Review

Scott Becker

T: +1 312 750 6016 F: +1 312 920 6135 
77 West Wacker Drive Suite 4100
Chicago, IL 60601-1818

About Becker's Hospital Review
Becker's Hospital Review offers forward-looking business and legal news, analysis and guidance relating to acute-care hospitals and health systems. Each of the publication's various properties - print issues, the website, E-Weeklies, etc. - provide valuable content, including hospital and health system news, best practices and legal guidance specifically for high-level hospital and health system leaders.

U.S. Domestic Medical Travel (USDMT): Although there is a vast opportunity to attract foreigners to the U.S. for medical treatment, it appears that U.S. hospitals haven't really captured significant volume. Please comment.

Scott Becker (SB): Larger institutions nationwide that possess the resources to market internationally tend to target wealthy countries and higher revenue patients that are able to pay out-of-pocket for procedures.

In order to progress and move forward, many small-to-midsized institutions will need to find creative ways to market to international patients and develop a patient population that makes them less reliant on the larger hospital networks.

Increasingly, what we are beginning to witness nationwide are the small and mid-size hospitals deliberating on whether or not they should stay independent and make themselves less reliant on accountable care organizations and the accountable networks. An increased volume of international patients might impact their decisions.

USDMT: Do you think ambulatory surgery centers (ASCs) that are attracting foreign patients are equipped to handle that kind of patient influx?

SB: I am not sure that the patient influx will be so significant that we have to worry about them having the capability for it.

It's more important that facilities have the proper marketing tactics to reach out internationally, as well as the perseverance and effort to run domestic medical travel programs.

USDMT: What are your thoughts on employers adopting a domestic medical travel benefit?

SB: Generally, larger employers try to limit the amount of parties that they do business with to simplify the supply side.

In that aspect, it makes sense for larger employers to adopt a domestic medical travel benefit because they have the necessary resources and leadership to have the added benefit in place.

This doesn't mean that small, independent or mid-size hospitals can't do this, it just requires somebody at these smaller hospitals to take a leadership position and develop the program.

USDMT: Are the hospitals in Florida that are working hard to get South American and Latin American patients to come to the U.S. simply a regional phenomenon?

SB: Recently, I had a conversation with an individual who was developing a hospital strictly aimed at attracting Hispanic patients.

I see these kinds of efforts in states where there is a large population of a specific ethnic group, or the state is connected overseas to a similar population.

USDMT: Do you hear more from the employers or the hospitals who are looking for an opportunity like that?

SB: When it comes to attracting patients from different locations, I hear more from the hospitals and surgery centers as opposed to employers.

Employers-particularly larger employers-have become increasingly sophisticated and it's one of the reasons, aside from bond and debt, why organizations like the Cleveland Clinic advertise the benefits of their facilities in the Wall Street Journal.

USDMT: Do you think we need a trade association for the U.S. domestic medical travel industry?

SB: There are a lot of regulations, education and lobbying necessary for a trade association.
A trade association would make sense when more people with similar interests about the industry join together.

USDMT: Do you think there is any merit in introducing insurance that caps the costs of care? This is becoming prevalent outside the United States: when a patient is quoted $10,000 for a surgery, it is going to be $10,000 no matter what the outcome is.

SB: Yes, that is a similar concept to individuals opting for bundled packages that offer quality service and cost-savings.

This option allows the patient to avoid major out-of-pocket expenses and entices the employer to sponsor the patient traveling for care.

News in Review

The Signs of Charleston Have Never Seemed Clearer

The term medical tourism applies to patients traveling to other destinations to undergo a medical procedure. In the past, this term has often been associated with international travel, however, what many people may not realize is that medical tourism is a growing trend with domestic travel as well. Patients are taking the opportunity to travel to enticing U.S. destinations to undergo their procedures in state-of-the-art facilities with world-class doctors, while enjoying a getaway.

Charleston, SC area based and internationally recognized eye surgeon, Dr. Kerry Solomon is a prime example of the growing U.S. domestic medical travel trend. Recognized as a "Top Doctor" by U.S. News & World Report (honoring the top 1% of physicians, the highest rating an ophthalmologist can attain), Dr. Solomon performs procedures on patients from across the U.S. every year. In the past year over half of his patients, 57 percent to be exact, have traveled from outside of the Charleston area from places such as Arizona, California, and New York to benefit from the next-generation technology available.

The quick recovery time of ophthalmology procedures performed such as LASIK, cataract removal/sight restoration surgery and dry eye therapy, lend themselves well to coupling the medical trip with a vacation.

A startling 20.5 million Americans over the age of 40 suffer from cataracts as a natural part of the aging process. Even more alarming are the results of a recent survey produced by Alcon and AARP which found that only two in five cataract patients plan to have surgery in the next two years.
"When one’s lifestyle is negatively affected by their vision, such as driving at night, it is time for a treatment," states Dr. Solomon. "Cataract surgery is far different than it was 20 years ago. It is conducted on an out-patient basis, involves numbing drops (versus IVs), there are no stitches and patients can often return to their same activity the day of the procedure."

A managing partner in Carolina Eyecare and a consultant for medical device, technology and pharmaceutical companies, Dr. Solomon is often selected to be the first to conduct clinical trials and present his findings to the medical community. In fact, he was recently the first doctor in South Carolina to introduce VerifEYE, a revolutionary new way to analyze the eye during premium cataract surgery. Additionally, Dr. Solomon is among a few selected physicians in the world conducting clinical trials on a breakthrough technology that will be available this fall.

For more information on Dr. Kerry Solomon, please visit www.drkerrysolomon.com or call 843-881-3937.


Mercy Part of 'Destination Medicine' for Hip and Knee Replacements

News-leader.com - Mercy Hospital Springfield has been selected as part of a program as that will bring patients from other parts of the country to the Ozarks for knee and hip replacements at Mercy’s new orthopedic hospital.

Walmart, Lowe’s and other large employers have joined the Pacific Business Group on Health Negotiating Alliance in an agreement that covers 1.5 million employees and their dependents who are enrolled in the companies’ medical plans.

They will be eligible for no-cost knee and hip-replacement surgeries at four hospital systems in the United States, which have been designated as "Centers of Excellence." Those systems include Mercy Hospital Springfield; Johns Hopkins, Bayview Medical Center in Baltimore; Kaiser Permanente Orange County Irvine Medical Center in Irvine, Calif.; and Virginia Mason Medical Center in Seattle.

"These companies are working to help make sure that their employees get higher quality care and incur lower costs," said David Lansky, president and CEO of PBGH. "The national Employers Centers of Excellence Network is designed to serve as a model for delivering high quality health care with transparent and predictable costs."

The program is similar to an arrangement that Mercy has with Walmart for spinal care. In that agreement, which started Jan. 1, Walmart employees and their family members who have spine problems can come to Springfield from 30 states.

Walmart pays the entire cost for patients who agree to travel for medical care, including the travel costs and lodging for the employee and a caregiver. Employees must be healthy enough to travel. Those who opt for care with their local doctors will have to pay the standard deductibles and co-pays.

If employees travel to one of the Centers of Excellence for care, they will receive consultations and surgeries covered at 100 percent with no deductible or coinsurance, plus travel, lodging and living expenses for the patient and a caregiver. The program is voluntary and employees and their covered dependents can still choose to receive care from local providers and incur routine costs.

"This national program is about providing our associates with exceptional care and reducing their medical costs so that they pay nothing out of pocket when they use one of the designated facilities," said Sally Welborn, senior vice president of global benefits at Walmart. "Each of these providers has a proven record of practicing evidence-based medicine with above average positive patient outcomes in knee and hip replacement procedures."

The idea of traveling for care is often referred to as "destination medicine."

"When people from other places choose to come here for care, it’s good for our community in a variety of ways," explained Dr. Robert Steele, president of Mercy Hospital Springfield. "It not only brings in visitors and revenue, it means we’re offering the kind of value people are willing to leave home to find. That assures our local patients they don’t need to go anywhere else for exceptional care."

Patients who come to Springfield will receive their care at Mercy Orthopedic Hospital Springfield. The newly-opened facility includes doctors’ offices, 10 operating rooms and 48 inpatient beds.

To view the original article click here.

Domestic Medical Tourism: A New Trend
by Michael Meulemans

Insurance.about.com - A new trend is building within American healthcare. Domestic medical tourism- that is the act of seeking out better care or less costly care out of network. By that I mean, way out of network and different time zones. This has occurred internationally for some affluent patients but is now also trendy and more mainstream, domestically as well.

To continue reading the original article click here.

Aquarius Announcement - Columbia University & Aquarius Capital Announce Nineteen (19) New Research Projects

Michael Frank and Donald Rusconi of Aquarius Capital to teach as professors at Columbia University in the Masters in Actuarial Science program. They will teach a course called "A Global Perspective on the Health Insurance Market" beginning in September 2013, similar to the two previous courses taught in 2012 and 2013. The program will be expanded to include focus on different aspects of the healthcare insurance industry including products available, delivery systems (US vs. International), healthcare reform, accountable care organizations, CMS grants, finance, reinsurance, self-funding and capital markets.

The course will be expanded to include research projects around healthcare reform (PPACA) focused on the implementation and impact of health insurance exchanges. The course will include sixty (60) graduate students in actuarial science at Columbia University, and similar to past years, students will be involved in research projects that will benefit the actuarial and insurance industry.

Research Projects

We are pleased to announce nineteen (19) new research projects to be undertaken by Columbia University students. Projects include the following:

  • The review and evaluation of nine (9) health insurance exchanges including federal, state and partnership exchanges.
  • The studying and evaluation of six (6) publicly traded HMOs.
  • Evaluation of four (4) additional international healthcare systems, which will include Italy, Israel, Greece and Thailand. This is in addition to the twenty (20) healthcare systems previously evaluated in the prior classes.

As part of the review of international healthcare systems, students will review provider delivery systems, local healthcare reform, evaluate private vs. social insurance, roles of insurance regulators plus comparisons to the US healthcare system. Students will also study the actuarial resources in the local country plus the reinsurance markets for those countries.

Students in the course will also be involved in the research and evaluation of medical tourism and advancements in healthcare technology as well as review managed care programs that have applied for CMS grants as part of the course.

The program will also include opportunities for insurance and reinsurance professionals and organizations to participate in research as part of the program with the Columbia University students. If an interest in participating in research or alternatively access to graduate student for possible internships, then contact Michael Frank at (914) 933-0063 or michael.frank@aquariuscapital.com. To learn more about the Columbia University, Masters in Actuarial Science, visit http://ce.columbia.edu/actuarial-Science.

About Aquarius Capital
Aquarius Capital is an independently owned company with offices in New York and Connecticut. Formed in 2002, Aquarius Capital provides an array of services to its clients in the life, accident & health insurance industry including actuarial, underwriting, insurance/employee benefits brokering, product development, managed care analysis, and reinsurance risk management services. Actuarial services include managed care pricing, rate filings, reserve valuations/opinions, new product development, capitation reviews, financial forecasts, reinsurance pricing/underwriting, other post-employment benefit valuations (e.g., GASB 45, FAS 106), healthcare reform consulting, CMS grant applications, and life insurance valuations.

Aquarius insurance clients include employers, insurance companies, reinsurers, managed care companies, municipalities, managing general underwriters, school districts, brokerage firms, health care providers, Fortune 500 companies, brokerage firms and other actuarial organizations requiring expertise in the life, accident and healthcare market. Employer clients include both municipal and private sector companies purchasing insurance on a fully insured or self-funded basis.

Aquarius is also active in the capital markets having consulted more than eighty (80) financial institutions including investment bankers, private equity firms, hedge funds, asset managers and research organizations in US and international business ventures.

Contact Michael Frank at 914-933-0063, michael.frank@aquariuscapital.com or visit www.AquariusCapital.com for additional information.


would like to extend a personal invitation for you to attend the IHC FORUM WEST Conference
"Making HealthCare Consumerism Work"

Health and benefit costs are arguably the number one challenge that employers face today. With the uncertainty of exchanges and defined contribution during this fall's open enrollment, along with urgent compliance standards, analysis and discussion with stakeholders from all corners of the industry has become a necessity. Healthcare consumerism has been the clear answer to lowering your healthcare cost and empowering your employees to become better consumers of health and healthcare.

Our conference will give you tools and solutions you can use right now to create a comprehensive, cost-effective healthcare consumerism program that serves your employees' needs and your bottom line. No matter where you are on your journey, the IHC FORUM will equip you with the money-saving strategies you need to successfully navigate the healthcare consumerism landscape and avoid the bumps along the road.

Through five cutting-edge general sessions, 24 interactive workshops, intimate roundtable discussions and unlimited networking opportunities, you'll:

  • LEARN collectively, think innovatively, and drive change cooperatively with actionable solutions. Click here to see agenda
  • CONNECT with forward-thinking experts and industry professionals on leading practices and successful strategies. Click here to view past attendees
  • SHARE valuable insights and ideas, opinions and research, and more on the latest topics and current trends.

"The IHC FORUM is the only conference series 100 percent dedicated to innovative health and benefit management."

WHERE: Red Rock Casino Resort - Las Vegas, NV
WHEN: Dec 5-6, 2013

Register now to LEARN, CONNECT and SHAREhttp://www.theihcc.com/portals/cdhc/eblast/ihc_logo.png

Produced by: The Institute for HealthCare Consumerism
292 South Main Street, Ste 400
Alpharetta, GA 30009


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Copyright © 2013
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

Scott Becker, McGuireWoods, LLP

News in Review

The Signs of Charleston Have Never Seemed Clearer

Mercy Part of 'Destination Medicine' for Hip and Knee Replacements

Domestic Medical Tourism: A New Trend

Aquarius Announcement - Columbia University & Aquarius Capital Announce Nineteen (19) New Research Projects

IHC Forum West 2013