2013 IHC Forum West




Volume 1, Issue 5

Dear Colleagues,

Las Vegas has a worldwide reputation for some of the most glamorous hotels, gaming casinos and nightclubs. 

Now, the city that is regarded as the capital of adult entertainment has a new claim to fame:  a leader in the nation's growing domestic medical tourism industry.  With ample infrastructure to support business and leisure tourism, Las Vegas is working aggressively to further deliver accessible, high quality healthcare services.

In this issue, medical tourism experts, Michael J. Crovetti Jr., D.O., and Doug Geinzer discuss the expansive opportunities for current and prospective medical travel patients in Las Vegas.
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: Michael J. Crovetti Jr., D.O.
Founder and CEO
Outpatient Surgical Recovery Suites, and Crovetti Orthopaedics and Sports Medicine

Michael J. Crovetti Jr., D.O


About Michael J. Crovetti Jr., D.O.
Dr. Michael J. Crovetti loves his work. His passion for joint replacement and orthopaedic surgery has resulted in the creation of a surgery and recovery center that is the first of its kind, and promises to be a model for innovative joint procedures for years to come.

Dr. Crovetti founded Crovetti Orthopaedics and Sports Medicine in 2000, The Coronado Surgery Center in 2008 and the Coronado Surgical Recovery Suites in 2010. The Coronado Surgery Center and the Coronado Surgical Recovery Suites represent Dr. Crovetti's pursuit of excellence in orthopaedics and joint replacement surgeries.

When he's not pursuing his orthopaedic passion, Dr. Crovetti spends time with his family, enjoying snowboarding, sports and travel. Because he loves his own active lifestyle, Dr. Crovetti can relate to his patients. "I love these people. They are essentially me," he says.

About Crovetti Orthopaedics and Sports Medicine
Crovetti Orthopaedics and Sports Medicine (COSM), has been providing orthopaedic care in the Las Vegas valley for more than ten years. Its founder, Dr. Michael Crovetti, is a Board Certified orthopaedic surgeon and treats orthopaedic problems in the hip, knee and shoulder.

For hips, Dr. Crovetti specializes in hip replacement, hip resurfacing and arthroscopy of the hip. For knees, he specializes in knee replacement, anterior cruciate reconstruction, knee arthroscopy and cartilage and bone transplantation. For shoulders, Dr. Crovetti specializes in arthroscopic reconstruction and shoulder replacement surgery.

As a surgeon, Dr. Crovetti prides himself on maintaining a very low infection and complication rate, excellent post-operative pain control, and the use of cutting-edge technologies in the treatment of hip, knee and shoulder problems.

As an innovator, Dr. Crovetti has and continues to develop new orthopaedic instrumentation and surgical devices. As a result, he has had the opportunity to learn from surgeons all over the world. In turn, he has dedicated his career to training surgeons from around the world on disorders and new technologies in hip, knee and shoulder surgery.

To learn more about Crovetti Orthopaedics and Sports Medicine, please visit http://www.crovettiortho.com/ or to learn more about Outpatient Surgical Recovery Suites, please visit: http://www.osrsvip.com/.

U.S. Domestic Medical Travel (USDMT):   Tell us a little bit about your organization.

Dr. Michael J. Crovetti Jr. (MC): Crovetti Orthopaedics launched in 2000, after I completed a fellowship in reconstruction of the hip, knee and shoulder. On a daily basis, I specialize in sports medicine and perform replacement surgeries of the hip, knee and shoulder.

Our Outpatient Surgical Recovery Suites (OSRS) is a unique model. 

Following a minimally invasive surgery, the patient is then discharged. But rather than going home, the patient is instead admitted to OSRS where they are offered 48 hours of amazing, personalized post-operative care. 

During this time, and within three and a half hours of surgery, patients are instructed to walk on a special device called Secure-Tracks. They also receive gourmet meals, and our nurses provide the necessary education for a safe transition to home. 

The Recovery Suites offer patients an "out of hospital" experience, limiting the exposure to infection and preventing the typical complications of joint replacement surgery, including infection and blood clots.

USDMT: Las Vegas has become a leading medical tourism destination in the U.S.-how has domestic medical tourism directly impacted the area, and specifically your practice?

MC: Tourism is a focal point in our medical community.  Las Vegas offers great opportunities and has grown to be a potential leader in medical tourism. 

While Las Vegas has developed a reputation for being an adult playground, its medical community has a growing reputation for greatness and innovation. This includes our unique model, as well as research and game-changing institutions such as the Ruvo Brain Center, where the Cleveland Clinic participates in research and programs to improve neurologic disorders.

USDMT: Do you notice your medical tourism patients coming from particular areas in the U.S., or are they generally traveling from all over the nation?

MC: We have patients who travel from all over the world, not just within the U.S.

Individuals have traveled from states as close as Arizona, neighboring countries such as Canada, and as far away as China.

In terms of domestic medical tourism, we have noticed a rising number of patients traveling from Alaska to Nevada to access treatment. 

USDMT:  What is it specifically about your services that attract patients to journey to your practice for treatment -- rather than receiving care in their home state?

MC: Our unique model and exceptional results.

Patients are concerned about having joint replacement surgery in a hospital setting because of the risk of infection and the lack of personal attention. When patients come to Vegas, they are offered amazing, safe, quality care -- much like one would receive staying at a five star hotel.

USDMT:  How does the overall treatment plan work -- from start to finish -- when dealing with patients who are traveling to you for care?

MC: Once contacted by the patient, we introduce ourselves, review our protocol and answer any questions they may have. We then request all medical records, including MRI and X-Rays, to be sent over for review.

After this initial review, the patient is then contacted to schedule a surgery date, as well as a pre-op appointment with me. I examine the patient and take additional X-rays if necessary.

Once scheduling is done, our coordinator follows up on medical clearance if it has not been provided. We always give the patient our link to the local hotel we work with so that they can reserve a room for the entire episode of care at a negotiated rate. 

Immediately following the surgery, the patient is admitted to our Recovery Suites where we provide 24-hour supervised nursing, on-site physical therapy with early mobilization, and healthy catered meals.

The patients stay with us for two days before being discharged. Our home healthcare team provides on-site physical therapy during the patients 7 to 10-day hotel stay, ending with a post-operative exam for authorization to return home. 

Throughout the entire process, my entire team partners with insurance providers to ensure better care, control outcomes, and save on healthcare dollars.

SPOTLIGHT: Doug Geinzer, CEO, Southern Nevada Medical Industry Coalition


Doug Geinzer


About Doug Geinzer
Doug Geinzer is a skilled and successful entrepreneur who has built and sold several businesses throughout his career. Most of his success has been found in the healthcare, technology and employment industries. Today, Doug considers himself more of a social entrepreneur, spending a significant amount of his time improving Southern Nevada's healthcare infrastructure and positioning Las Vegas to become the most globally recognized medical tourism destination.

As CEO of the Southern Nevada Medical Industry Coalition, Doug oversees the mission "to foster strategic alliances in the healthcare community, collaborating on workforce issues and being a proactive force for legislative initiatives to improve access and the delivery of quality healthcare in Southern Nevada."

Doug has been the recipient of many awards, including Entrepreneur of the Year, Healthcare Hero, Innovative Business Leader, Top 40 under 40, "Most Influential" in employment, and a ‘Who's Who' in healthcare. He is also the incoming president of the Las Vegas Chamber of Commerce's Business Council.

Born and raised in Pittsburgh, Penn., Doug relocated to Las Vegas in 1993 to build a media company he later sold to Cox and Landmark Communications. He is married with a young daughter. As an avid water sports fanatic, you will find Doug stand-up paddling on Lake Sahara most mornings.

U.S. Domestic Medical Travel (USDMT): Can you explain to our readers how you initially got involved with medical tourism, what your current role within the industry is, as well as what they can expect from you in the future?

Doug Geinzer (DG): As the CEO of the Southern Nevada Medical Industry Coalition, which resides in Las Vegas, we have been interested in the whole notion of medical tourism for some time.

Las Vegas is the most recognized brand in the world and the destination most traveled to. We have all of the necessary ‘tourism' assets in place and have been identifying the health and wellness centers of excellence over the past year.

We entered into the strategic planning process in February 2013 and expect to surface from that process by the end of the summer with a very thorough strategic plan as to what role Las Vegas will play in global health and wellness travel.

USDMT: How have you seen medical tourism expand and develop over time?

DG: Medical tourism clearly started out as a way to deliver inexpensive treatments to patients in foreign countries, and has continued to evolve.

Patients have traveled to seek access to various types of treatments that they are not able to receive in their home countries. The biggest driving factor has been cost. We will not be able to-nor do we want to-compete on cost in Las Vegas. It is our intent to compete on the basis of quality and easy access.

USDMT: You were involved in arranging the first medical tourism symposium in Las Vegas back in January-if you don't mind sharing with the readers, what were some of the goals you hoped to accomplish for the industry through this event? Was it successful?

DG: In January 2012 we were just starting our journey to enter this new world of medical tourism. We did not know a lot of what we know today. But the one thing we did know was that this effort was going to require ‘buy-in' from more than just the medical industry.

When Las Vegas gets behind any initiative, it is a community-wide effort. In this case, we brought together leaders from healthcare, hospitality, government and the community at large.

It was the start of the conversation that continues today. The event was a major success. We had over 110 of the most influential leaders of Las Vegas under one roof. They walked out committed to explore if Las Vegas could not only enter, but also redefine what is commonly called medical tourism. Our entry into this area will be much different than what most think of when they think medical tourism.

USDMT: What is it about Las Vegas that attracts so many prospective patients to the location for treatment?

DG: Las Vegas is one of the most globally accessible destinations.

We have nearly 40 million visitors that come to Las Vegas each and every year, which includes millions and millions of business executives who travel to Las Vegas for annual meetings and conventions.

We have over 150,000 hotel rooms, the best restaurants, world-class shopping and award-winning entertainment. But what Las Vegas is known for more than any other destination is our ability to protect the anonymity of our visitors.

The entire "What happens in Vegas, stays in Vegas" campaign just reinforced our ability to support adult freedom. Much of what is done in medical tourism requires protecting a patient's anonymity and privacy. There is no destination that does that better than Las Vegas.

USDMT: Have you noticed any specific trends healthcare professionals have initiated to ensure that Las Vegas becomes the world's leading medical travel destination?

DG: We are blessed in Las Vegas because most of our infrastructure is already developed. Other cities and countries have to focus on developing hotels, restaurants and transportation. The fact that our brand, "Las Vegas," is the most recognized brand in the world surely helps.

The destination has been delivering world-class experiences to its visitors for decades. We are aggressively working on bringing that ‘experience expertise' into the healthcare delivery system. We are fortunate to have the University of Nevada, Las Vegas (UNLV) hospitality school right in our backyard. UNLV graduates work in nearly every country and have been the deliverers of amazing visitor experiences.

USDMT: Aside from Las Vegas, have you noticed other destinations in the U.S. gaining recognition for medical tourism? What about globally?

DG: We are closely following the progress being made in Florida.

We have spent a considerable amount of time looking into other destinations that offer world-class healthcare delivery systems, such as Houston, Pittsburgh and Boston. There are elements of each that will be brought into Las Vegas' long-term strategic plan.

There are a lot of global destinations that have received attention from their medical tourism initiatives. Las Vegas will have a hard time competing with those destinations on price, but we are confident we will be able to deliver a better outcome (quality). There is not a city in the world that has the reputation of delivering a better traveler experience than what Las Vegas offers. It would take decades for any destination to catch up to us in that area.

USDMT: Other than the obvious patient advantages of medical tourism-lower costs and equal or increased quality of care-do treating doctors and providers experience benefits from medical tourism? Are there economic benefits?

DG: Practitioners benefit from the changed payer mix. Medical travelers are typically more affluent and pay cash for procedures or bring a better paying insurance policy. This is important in today's changing model of healthcare reimbursement.

I believe medical tourism will allow us to retain our top-performing physicians in their profession longer, which will obviously deliver an economic benefit to the doctor, the industry and the region.

USDMT: In terms of implementing different marketing strategies, what would you suggest that healthcare professionals, providers and industry leaders launch in order to help expand medical tourism across the nation?

DG: For U.S.-based providers it will be necessary for us to focus on quality outcomes and not try and win the war on price. Medical services should not, and cannot, be commoditized like so many services and products have been.

If medical providers all entered the ‘race to zero' in terms of pricing, the populations that we serve lose. Is it worth saving $5,000 or even $50,000 if you put your life in jeopardy? I don't think so. We need to stay focused on quality, not pricing.

USDMT: What are some of the biggest challenges you have observed in regards to the growth of medical tourism?

DG: Patients are just not educated enough on the procedures they seek, or the expected outcomes from the medical services they want to receive. Many are not aware of the complexities that come with seeking and receiving care abroad-how much travel expenses may be, infection rates and after-care tend to be after-thoughts that have long lasting impacts if overlooked.

For providers, there are challenges with the handling of foreign patients and ensuring that accommodations and proper dietary needs are met. In Las Vegas, we are fortunate to already be a global destination, and our hospitality employees speak hundreds of different languages. With over 150,000 rooms in Las Vegas, we can accommodate nearly any type of need.

USDMT: Do you find the majority of individuals you are in contact with to be in acceptance of the medical tourism industry, or skeptical?

DG: This has been a mixed bag - and an educational process.

Medical tourism is relatively new and most maintain the perception that medical tourism only happens outside of the U.S. Although this has been true in the past, it is about to change. As Americans, we only look at healthcare delivery through ‘insurance lenses,' which has been cost-driven more than it has been quality focused.

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

DG: Although Las Vegas' strategic plan to become a world-class health and wellness destination will be completed by the end of summer 2013, we have already accepted that it will be a working document and will be updated regularly.

Our plan is much different than what most think of when they hear the term ‘medical tourism.' We have changed our vocabulary to be more centric to health and wellness travel. We will probably want to do another interview with U.S. Domestic Medical Travel Today after the plan is released, because we will be able to speak more to the specific strategy and Las Vegas' offerings.

Las Vegas Betting Big on Medical Tourism
by Erin Conroy

Las Vegas is the new player in the medical tourism game.

Dr. Geoffrey Sher says he's responsible for the births of at least 17,000 babies around the world, although he hasn't had to travel very far to make that happen. About 85 percent of his clients have journeyed from out of state or overseas for his in vitro services, while about 3,000 people visit his website each day, perhaps planning their own pilgrimage of sorts for artificial insemination, genetic testing or egg freezing.

So where is this fertility treatment mecca, where hopeful couples must settle in for half a month to commit to a long string of consultations and treatments? It's a city associated more with luck than with medicine. Las Vegas is seeing patients from around the world flock to the city for spinal care, cancer treatments, research of Alzheimer's and Parkinson's diseases, obesity surgeries and cosmetic procedures - so much so that the city has recently made medical tourism one of its top priorities.

While slots or cabarets might not be at the forefront of one's mind when planning a time-consuming and costly medical procedure, doctors and city officials say Sin City is ripe for international recognition as a health hub.

"Las Vegas is an attractive place - there is easy entertainment, it is a relatively inexpensive destination, and it's just a fun city for people to stay for two weeks, especially when, for instance, the procedure they came for does not incapacitate them," says Dr. Sher. "They can go out and play and enjoy themselves, rather than sitting in a hotel room worrying or waiting. In these fields of niche care, boutique medical centers can offer unique services, and in a fun environment."

Perhaps the best sign that Las Vegas is being taken seriously by the medical community is the fact that it will host the World Medical Tourism and Global Health Care Conference in November. The event, to be held at Caesars Palace and hosted by the Medical Tourism Association (MTA), will bring together about 2,000 medical directors, doctors and decision-makers to brainstorm on topics, including communication with global health insurers, and transparency in total pricing for overseas patients.

"We saw Las Vegas as a good place to hold the event this year, because medical tourism there is growing hugely at the moment, and there seems to be opportunity there for it to expand," says Jean Rodriguez, marketing and engagement coordinator for MTA, which is based in Palm Beach Gardens, Fla.

So will what happens in Vegas, stay in Vegas? When Carolyn Goodman was elected mayor in 2011, she pushed for medical tourism in her first two state-of-the-city addresses, promising that it could become one of the city's biggest economic drivers in a bid to revive the city's image and to diversify its industry. While Las Vegas has always been a destination for cosmetic surgery, Goodman saw the state-of-the-art Cleveland Clinic Lou Ruvo Center for Brain Health, which opened in 2009, as an anchor for the city's serious credentials for top-tier medical tourism.

A medical wellness and tourism manager was appointed to the Las Vegas Convention and Visitors Authority, which also put out a 176-page Health and Wellness Destination Guide with a list of treatment centers and details for how much visitors should plan to spend on their trip (about $2,400 in addition to their procedure).

"People are initially surprised because historically Las Vegas has not promoted itself as a destination for health and wellness," says Cheryl Smith, hired last year to look at ways to blend healthcare with the city's $45 billion tourism industry. The Las Vegas Convention and Visitors Authority (LVCVA) partnered last year with the Las Vegas Spa Association, and with Las Vegas HEALS, formerly known as the Southern Nevada Medical Industry Coalition, a nonprofit organization with more than 600 healthcare professionals.

Doug Geinzer, the chief executive of HEALS, says it will take some time before Las Vegas is seen as a medical hub. But it does have a few things on its side, including the fact that its grasp on hospitality is difficult to match.

"We have the top hospitality universities in the world, and what we can learn from that, we hope we can deliver to patients - exceptional customer service, something that Las Vegas has always excelled at," Geinzer says. "We hope we could develop a reputation for delivering that same kind of expertise in the healthcare space. We firmly understand that we're not going to be a transplant capital of the world, but we do have core competencies in areas such as bariatrics and brain health, and with 41 million annual visitors we have the capacity in terms of rooms, entertainment, dining or shopping."

Geinzer says local experts are working together to determine how best to take advantage of the high concentration of spas on The Strip, which in total can see up to 1,000 patients an hour and offer a diverse menu of therapy treatments ranging from Turkish to Indian to Brazilian.

"How can doctors collaborate with those therapists - for example, orthopaedics?" he says. "They're looking at bundled payment models and how that can be applied to other areas of expertise."
Battling skin cancer for the past two decades himself, Geinzer says there is also a great advantage to having a fully exposed body for an hour during a massage. A dermatologist could be on hand to offer preventative checks.

Promoting Prevention

In fact, Las Vegas could be a base for preventative health measures for fast-moving businessmen who travel often and have little time to make such appointments back home. Holding 22,000 conventions just last year, "we could easily take advantage of those folks regularly coming to Las Vegas once or twice a year for annual check-ups, scheduled around their meetings," Geinzer says.

There are doubters, however. Jim Rogers, former chancellor of the Nevada System of Higher Education, has been one of the industry's biggest critics.

"There is a very serious question about the quality of practice of medicine in this city or part of the state, whether doctors are working together, and why the medical school is 40 years behind its counterparts in Arizona, Utah and New Mexico," Rogers says. "There is no cohesion in the medical community, and in fact there is the backstabbing and handling of competitors that is so very common in this town."

The University of Nevada School of Medicine only graduates 50 students a year, 45 of which leave the state because it has no sufficient residency programs for doctors, Rogers says. "Until they get their act together, medical care is not going to improve here," he says. "And if people think that all they have to do is provide entertainment or things to do instead of sitting in the waiting room, I'm not sure that is the right attitude to take when it comes to quality of care."

Dr. Nicholas Vogelzang, an expert in prostate, kidney, bladder and testicular cancers, disagrees, saying that in the 10 years that he has been practicing in the state, he has seen support from the city and from other medical professionals. He says people will travel to Nevada for care for several reasons. In his case, patients often come for the sought-after Cyberknife technology he uses for treating cancer. But he believes it is also a place that is accessible to people with modest means or constrictive insurance plans.

"Not everyone can afford to go to the spas or spend thousands at the casinos, but flights are affordable and plentiful, there's lots of choice for hotel, the airport is close, and it's easy to get around," Vogelzang says. "For advanced cancer patients the treatments are frequent, and toxic. These patients don't mind having a comfortable experience. At the same time, when it comes to medical care, of course people love their home doctors and prefer to stay in their hometowns. Why would people leave for medical care? Their home doctors don't have the expertise -- that's really the reason."

Dr. Vogelzang, who is now in private practice, says he left his base in Chicago to run the Comprehensive Cancer Centers of Nevada with the promise that it would soon become a destination cancer center.

"That was always part of the plan, but we did not have the funding to keep it alive," he says. "But that does not blunt the idea. We have world-class surgeons and experts here who have come together and created a medical community here."

Having published 450 papers on cancer research, he has seen patients from around the world. But does he believe Las Vegas will become more renowned for its operation tables than for its poker tables?

"Las Vegas is always going to be Las Vegas, it's never going to become Houston or New York," he says. "There will always be that aura of gambling or relaxation, but there are good reasons to come for medical care, and people can then relax and not feel like they're going to an out-of-the- way joint. But are we better than UCLA or the University of Colorado? Of course not. We're in the same league at some levels, and not at other levels."

The Best Treatment for Weight Loss is Found Right Here in the U.S.

While medical tourism continues to grow in popularity, the incredible medical professionals at Beverly Hills Physicians prove you don't have to travel far for effective weight loss surgery

For some individuals struggling with obesity, the opportunity to live a healthy, contented lifestyle as soon as possible leads to decisions that may seem wise in the short term, but soon prove to have long-term consequences. One recent trend among those seeking quick weight loss through gastric sleeve with little initial investment has been to travel to foreign countries for treatment - a practice known as medical tourism. However, the informal channels of communication and scheduling between medical service providers and customers often mean that there are few regulations and little oversight to ensure competence and quality of gastric sleeve surgery. That means that in the event that an issue arises, the potential for expensive and long-term physical injury is far greater for medical tourists - a stark contrast to the impeccable medical treatments like lap band, gastric sleeve and more offered at Beverly Hills Physicians. 

For those suffering from obesity or excess weight, reaching health, beauty and wellness goals may seem like a nearly impossible task. However, with the network of dedicated, board-certified medical professionals at Beverly Hills Physicians, there is new hope for the growing number of individuals who are looking for truly effective weight loss solutions. At BHP, weight loss treatments are not only exceptionally effective, but they are also among the least invasive surgical options for weight loss. In fact, for those who choose to undergo the popular lap band treatment from their surgeons, patients benefit from both their network of empathetic, knowledgeable surgeons and a surgery that is fully reversible.

By focusing on providing each patient with health and wellness solutions that allow them to enjoy a truly fulfilling lifestyle, BHP is able to treat weight loss patients using methods that have been shown to lead to lasting results. With bariatric surgery like the sleeve gastrectomy or even the fully reversible lap band procedure, patients are able to lose weight without experiencing a loss of energy or strong feelings of hunger. That's because the procedures result in a significantly reduced stomach that fills up quickly, sending a message to the brain that it is full. Not only do these treatments limit overeating, but they also aid in cultivating healthier eating habits.

Perhaps best of all, during each step of their weight loss treatment, BHP patients enjoy the peace of mind that comes from skilled, knowledgeable surgeons, spa-like facilities and unparalleled patient services. With experienced consultants that guide each patient through their surgical experience, questions are answered, often before they even arise, regarding pre- and post-operative care as well as financing concerns.

Don't be tempted by foreign weight loss surgery; where you go matters and BHP offers safe, effective procedures. With surgical facilities that are fully accredited by the American Association for Ambulatory Healthcare and state-of-the-art instruments, the network of medical professionals at Beverly Hills Physicians is ready and willing to assist you with truly world-class weight loss solutions. You can visit the medical group's website at www.beverlyhillsphysicians.com or call them at 800-788-1416.

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10 Things You Should Know About the New Defenders Lodge

Nation's largest free hotel for veterans and their caregivers will open its doors soon
The Pentagon Federal Credit Union Foundation (PenFed Foundation), a nationally recognized nonprofit organization working to meet the unmet needs of military personnel and their families, is putting the finishing touches on the nation's largest free hotel for veterans undergoing medical care -- an $11 million gift from the PenFed Foundation to the Department of Veterans Affairs. The Defenders Lodge, made possible through the generous donation by Lee and Penny Anderson, had a ribbon-cutting ceremony last week in Palo Alto, Calif., and doors will officially open for guests in January 2014.

Here are ten things you should know about the new Defenders Lodge:

1. The Defenders Lodge will provide caregivers and veterans undergoing care at the Department of Veterans Affairs (VA) hospital in Palo Alto, Calif., short-term accommodations for free up to seven nights.
2. The hotel will provide 20,000 free nights of stay for veterans and their caregivers.
3. With upgraded accommodations, the lodge will feature 52 first-class private rooms and 104 beds.
4. The hotel was designed by Radcliff Associates and developed by Gilbane.
5. The lodge will save wounded veterans $3,088,800 per year on average in lodging costs (assuming a 10 percent vacancy rate). With most patients coming for appointments once a month requiring two nights of stay each visit, this translates into a savings of $2,500 to $4,000 per veteran each year.
6. The total gross area of the Defenders Lodge is 34,465 sq. ft., making it the nation's largest free hotel for veterans undergoing medical care.
7. The entire project from the ground up takes accessibility into account. Every doorway and bathroom is wheelchair accessible.
8. Using natural light and a soothing interior color scheme, the hotel is designed to be calming and relaxing to help improve outcomes. 
9. In addition to free Wi-Fi throughout the lodge, a family room with a fireplace, an upgraded kitchen, an activity room, a laundry room, and an open-air atrium, the lodge will feature a library stocked with books.
10. The PenFed Foundation is leading the effort in creating the lodge through a $17 million public/private partnership with the VA and is funding $11 million of it to cover the cost of construction through private donations. 

To learn more about the Defenders Lodge visit: www.defenderslodge.org

About the Pentagon Federal Credit Union Foundation (the PenFed Foundation)
The PenFed Foundation is a nationally recognized nonprofit organization working to meet the unmet needs of military members and their families through supporting wounded warriors and providing financial management assistance and home ownership aid. The foundation is also the primary sponsor of a new free hotel for veterans called the Defenders Lodge, a $17 million public-private partnership with the Department of Veterans Affairs in which the foundation is raising $11 million to cover the cost of construction. PenFed (Pentagon Federal Credit Union) covers all labor expenses for the foundation so every dollar donated goes directly to supporting its programs.

To make a donation or learn more about the foundation visit: www.penfedfoundation.org.

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.

Interview: ‘Patient-Centered' Promises Missing In Endocrinology, Fueling Shortages, Wait Times

The promise of "patient-centered" healthcare, with a focus on rewarding outcomes, would seem to be good news for endocrinologists. But according to a leader in their community, the rhetoric of healthcare reform isn't matching the reality. The results are shortages of endocrinologists and long wait times for patients. To confront epidemics of obesity and diabetes, a prescription of different compensation and management structures is in order.

New compensation models that are "patient-centered" and designed to reward outcomes, not procedures, should be just what's needed to overcome challenges in endocrinology, right?

So far, the rhetoric of healthcare reform isn't matching the reality, according to an interview with George Grunberger, M.D., FACP, FACE, the vice president of the American Association of Clinical Endocrinologists. Dr. Grunberger spoke with Evidenced-Based Diabetes Management (EBDM), a supplement to The American Journal of Managed Care, in its most recent issue.

Dr. Grunberger, a leader with 30 years' experience in the field, recommended the following in an interview: New compensation structures, such as loan forgiveness, to encourage new doctors to enter endocrinology.

Financial incentives to draw endocrinologists in regulatory or research areas back into clinical practice.
Revisiting billing codes to recognize the challenges of cognitive specialties, which require patience and knowledge built over time.

Changing insurance and reimbursement requirements to allow senior endocrinologists to oversee teams of nurses and physician's assistants, for more efficient delivery of care.

EBDM spoke with Dr. Grunberger in the wake of ongoing shortages of endocrinologists that have extended wait times and left entire states without subspecialists, such as pediatric endocrinologists. This is occurring at a time when the alarming levels of obesity and diabetes have made endocrinologists more important than ever. (In June, the American Medical Association declared obesity a disease.)

Dr. Grunberger said the shortage of endocrinologists has long been exacerbated by compensation levels, which do not adequately reward these cognitive specialists for the added training needed to take on complicated cases with patients who may or may not follow instructions. But things got worse in 2010 under new billing codes from the Centers for Medicare & Medicaid Services (CMS).

"My reimbursements both by Medicare and private insurers have been cut," he said.

A decade ago, a landmark report by Robert Rizza, M.D., and colleagues found there was a 12 percent shortage of endocrinologists in the U.S. and that the shortage would grow. While the report correctly predicted a rising need, its estimates failed to gauge how rapidly the epidemics of obesity and diabetics would escalate, leaving practicing endocrinologists more overworked than ever.

By January of 2013, the American Diabetes Association (ADA) and the American Academy of Pediatrics (AAP) issued updated guidelines for handling the crisis, including an emphasis on the need for better education on how to diagnose diabetes in children. Among the concerns, "In 2011, three states had no pediatric endocrinologists, and 22 had fewer than 10, and the situation is not likely to improve in the near future." Estimates of 5,000 practicing endocrinologists, compared with 26 million Americans with diabetes and 79 million with pre-diabetes, show the math just doesn't work.

Most reports on the endocrinologist shortage have cited pay as the major factor in the crisis. A 2011 Medscape/WebMD survey found that most full-time practicing endocrinologists earned between $150,000 and $175,000 in 2010.

So far, Dr. Grunberger told EBDM, compensation structures have been slow to reward those who work to change patient behavior and prevent illness, rather than treat those who have become ill.

"Healthcare, by definition, should be focused on maintaining the health of people. If you focus on screening and prevention so people don't get sick in the first place, it costs less to serve more people. We haven't done that, and we are now stuck in an epidemic of these metabolic diseases," he said. 

For the full interview click here.

For more information on this press release visit here.

Media Contact: Mary Caffrey
Company Name: American Journal of Managed Care
Email: mcaffrey@ajmc.com
Phone: (609) 716-777 x 144
Address: 666 Plainsboro Road Suite 300, Plainsboro, N.J., United States
Website: www.ajmc.com

Wellness Tourism Worldwide Announces Top 10 Wellness Travel Trends for 2014
2nd Annual Forecast Pre-Release 

Wellness Tourism Worldwide (WTW; www.wellnesstourismworldwide.com), a leading wellness travel business, is pleased to announce the release of its "Top 10 Wellness Travel Trends of 2014." The forecast is based on data collection and research conducted throughout the year that consolidated trends across several sectors and industries to deliver practical knowledge to both individuals and businesses, and to help businesses boost sales and maximize profits.

WTW's data and trend analysis included: site visits, literary review, surveys, interviews and feedback from consumers, travel trade, healthcare professionals, wellness experts and academia.

Camille Hoheb, wellness travel industry expert and founder of Wellness Tourism Worldwide and editor of the Wellness Travel Journal, noted, "The multi-dimensionality of wellness opens the door to a whole new world. This forecast will encourage consumers and business to think of vacation travel in new ways. Our data shows that consumers view vacations as an important way to improve health, happiness and productivity. Vacation trips are often a catalyst for transformation and consumers view wellness travel as a personal investment."  

While last year's forecast focused on the impact of wellness on air transit, hotel accommodation and destinations, this year's report is focused on business and marketing strategy.  The report, "Top 10 Wellness Travel Trends for 2014: Boosting Sales & Maximizing Profits," will be released in January.  
Snapshot: Top 10 Wellness Travel Trends for 2014 (descriptions below)

1.     Mind Matters
2.     The Rise of Wellness Travel Agents
3.     La Local Vita
4.     Breaking Bread with Wellness Travel
5.     Vacation Rx
6.     Looking for Personal Enrichment
7.     Burgeoning Secondary Wellness Market
8.     Slow Travel
9.     Affluent and Altruistic
10.   Spas on a Mission

Mind Matters: Consumers have caught on to mindful vacations that offer mental restoration.  Practices learned on a trip such as meditation, yoga, qi going and journaling can be incorporated at home to help manage stress, improve cognitive capacity and maintain emotional equilibrium.  

The Rise of Wellness Travel Agents
With the growing interest in trips to enhance mind, body and spirit, wellness tourism has created a new niche for travel agents to grow or expand their business while offering a personally and professionally rewarding career specialty.  

La Local Vita: Consumers have developed a deeper appreciation for locally relevant and authentic experiences with an emphasis on living "la local vita" (the local life).  Mindsets have shifted away from tourist behavior to a keen interest in community-based exploration where getting to know the locals in a meaningful way sweetens the experience.

Breaking Bread With Wellness
Food tourism is a big trend intersecting with wellness travel. In addition to the physical aspect of sustenance, food tours, cooking classes, agriculture and farm-to-table experiences speak to the emotional, social, intellectual and sustainable aspects of well-being.  

Vacation Rx: "Take 2 weeks and call me in the morning." Physicians are now prescribing vacations as an antidote from stress.  Doctor's orders for physical activity in parks are also being written to help combat obesity and diabetes in children.  

Looking for Personal Enrichment
With the understanding that wellness is more than fitness and nutrition, consumers are choosing trips that either focus solely on personal enrichment or as a part of their travel plans. Many consumers are viewing vacations, weekend getaways and retreats as a catalyst for change.  

Slow Travel: Have you ever felt pressured to run through your vacation checking off sites to see and things to do? Slow travel advocates change the pace in order to sip, savor and revel in the vacation experience.  

Affluent and Altruistic: Spurned by personal growth and discovery, affluent travelers value experiences connecting them to charitable causes and local communities. Volunteering on vacation has become increasingly popular and research shows altruism can improve well-being.  

Burgeoning Secondary Wellness Market: There is a large segment of travelers who may not opt for wellness retreats or tours but are committed to maintaining their healthy lifestyle on the road. Air transit and hotels are investing resources to attract guests who are both business and leisure travelers. 

Spas on a Mission: The spa industry is staking a claim on wellness tourism and on wellness in general. Eager to shake the image of pampering for the affluent, spas are repacking and rebranding as wellness providers to attract a larger market. 

To request a free download of the Infographic "Top 10 Wellness Travel Trends for 2014" please go to www.wellnesstourismworldwide.com.   

About Wellness Tourism Worldwide
Wellness Tourism Worldwide's (WTW) mission is to improve well-being and economic growth through travel by providing market intelligence, education, training, and promotion of wellness travel to destinations, suppliers, sellers and consumers. Our consulting team is responsible for tourism education, development, branding and promotion, healthy destination accreditation, spa operations, hotel management, leisure travel sales, hospital administration and health promotion. WTW publishes the Wellness Travel Journal (WTJ), a monthly e-publication inspiring, educating and motivating readers to invest in themselves through wellness vacations and retreats. Our B2C approach offers advertisers a direct line to consumers worldwide while also linking buyers to suppliers, making WTJ a valuable resource for industry and consumers alike. www.wellnesstourismworldwide.com

Domestic Medical Tourism Gaining Traction

The American Bar Association previously published an article entitled, "Domestic Medical Tourism Gaining Traction," written by Samuel S. Choy and Stacey L. Stewart, focusing on the benefits of U.S. domestic medical tourism, how the industry can benefit employers, and where the future of the industry is headed.

To read the article in its entirety, please click here.


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. 

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

www.USDomesticMedicalTravel.com, www.twitter.com/usmedicaltravel, www.facebook.com/USDomesticMedicalTravel

Spotlight Interview

Michael J. Crovetti Jr., D.O.Founder and CEO Outpatient Surgical Recovery Suites, and Crovetti Orthopaedics and Sports Medicine

Doug Geinzer, CEO, Southern Nevada Medical Industry Coalition

News in Review

Las Vegas Betting Big on Medical Tourism

The Best Treatment for Weight Loss is Found Right Here in the U.S.

10 Things You Should Know About the New Defenders Lodge

Aquarius Announcement - Columbia University and Aquarius Capital Announce 19 New Research Projects

Interview: ‘Patient-Centered' Promises Missing In Endocrinology, Fueling Shortages, Wait Times

Wellness Tourism Worldwide Announces Top 10 Wellness Travel Trends for 2014

Domestic Medical Tourism Gaining Traction