The players in the medical tourism industry are trying to show your individual clients–and the health insurers and employers groups you work with–that they can provide top-quality care at rock-bottom prices.
Making sure that overseas providers deliver on their promises and arrange for appropriate follow-up care is an important consideration, according to Brent McCallum, a Certified Public Accountant and executive in residence at the University of Connecticut at Storrs.
“Clients understandably have concerns,” McCallum said recently at the World Medical Tourism and Global Health Congress in San Francisco, according to a written version of his remarks.
But McCallum and others who spoke at the conference said the opportunity to take advantage of the vast difference in the price of U.S. medical care and comparable non-U.S. care is too attractive for financial professionals, their client patients, and health plans to ignore.
Until recently, the non-U.S. providers were taking the initiative to try to make U.S. prospects aware of their existence.
Today, “employers and health plans are driving awareness,” said Alison Hagan, a senior manager in the San Francisco office of Deloitte Consulting Ltd., at the world medical tourism conference.
Payers–including patients who must pay for their own care out of pocket-are learning that they can achieve up to 90% in net savings by getting care outside the United States, even after paying travel costs, and Deloitte consultants are predicting that spreading awareness will increase the number of U.S. medical tourists to about 6 million in 2010, from 750,000 in 2007, Hagan said.
Medical tourism industry participants set up the Medical Tourism Association, West Palm Beach, Fla., the organizer of the world medical tourism conference, in 2007, to promote communications between the providers, the payers and the patients.
Another organization, the International Medical Travel Association, Singapore, a group founded in 2006, also seeks to unite the parties involved in efforts to cross borders to get and provide medical care.
Medical tourism has been around since the days when ailing patients journeyed to hot springs and religious shrines in the hope of obtaining miraculous cures.
In recent decades, patients from around the world have traveled to the United States for care at legendary medical institutions such as the Mayo Clinic, and health plans themselves have promoted domestic medical tourism, by requiring patients needing some types of expensive, specialized care, such as transplants, to head to a handful of “centers of excellence.”
When Deloitte consultants surveyed 3,031 U.S. residents ages 18 and over, they found that 12% had traveled outside their communities for medical care, and 3% had sought care outside the United States, Hagan said.
Many health plans provide little or no coverage for medical care obtained outside the United States.
But the American Medical Association, Chicago, raised the profile of medical tourism in June, by adopting medical tourism guidelines.
The AMA has declared that seeking “medical care outside the U.S. must be voluntary” and that “financial incentives to travel outside the U.S. for medical care should not inappropriately limit the diagnostic and therapeutic alternatives that are offered to patients, or restrict treatment or referral options.”
When a U.S. payer covers the cost of seeking medical care outside the United States, the coverage also “must include the costs of necessary follow-up care upon return to the U.S.,” the AMA says.
The National Business Group on Health, Washington, a coalition of large employers, added to the interest in July, when it released an issue brief on programs that help patients save money by seeking medical care outside the U.S.
Employers should think about matters such as medical malpractice, patient privacy, the need to avoid discrimination against workers with disabilities, and tax implications when considering moves to support medical tourism, NBGH analysts write in the brief.
Researchers at the University of California, Los Angeles, for example, recently published a study comparing 33 U.S. patients who went to other countries for kidney transplants with 66 patients treated at UCLA. The kidney rejection rate was 30% for the medical tourists, compared with 12% for the UCLA patients, the researchers report.
But WorldMedAssist L.L.C., Concord, Calif., a medical travel logistics firm, says a survey of the patients it has helped found that most of them have been happy with the quality of the non-U.S. medical care and U.S. follow-up care that they received.
The patients most obviously suited for medical tourism programs are those who would like to travel and need non-urgent procedures that would cost at least $15,000 in the United States, according to Wouter Hoeberechts, chief executive of WorldMedAssist.
Ideal candidates also should be seeking care that is likely to involve a limited amount of easily planned follow-up care, Hoeberechts said at the world medical tourism conference.
Many of the patients now seeking care overseas are traveling for cosmetic surgery, or for heart, orthopedic or dental procedures.
At WorldMedAssist, the typical customers who look for help arranging for non-U.S. medical care are uninsured individuals ages 50 to 65 or employers that are sponsoring self-funded health plans, Hoeberechts said.
Customers are looking for a way to cope with the fact that U.S. health care costs have increased 87% in the past 5 years, Hoeberechts said.
Health care accreditation bodies are starting to set up international health care provider accreditation programs, and some U.S. medical centers already have affiliates overseas, and some doctors at hospitals outside the United States have medical degrees from U.S. medical schools.
Including the cost of travel, getting a hysterectomy from a high-quality, low-cost non-U.S. provider might be about $2,100, compared with an average cost of about $6,100 for a hysterectomy completed on an outpatient basis in the United States, while the cost of a shoulder arthroplasty might be about $2,500 outside the United States and $9,000 in the United States, Deloitte consultants report.
Although the non-U.S. prices are low by U.S. standards, the non-U.S. providers see U.S. patients as a welcome new source of patients, according to MTA President Jonathan Edelheit.
Edelheit gave a presentation at the recent MTA conference specifically aimed at non-U.S. hospitals that want to appeal to the U.S. medical tourism market.
“The hospitals getting the contracts with insurance companies and facilities are the ones that are aggressive about branding,” Edelheit said.
Medical procedure outcome statistics are important, and so are photographs showing what a hospital or other medical facility looks like, Edelheit said.
Barriers to increased use of medical tourism include the difficulty of coordinating care.
In some cases, patients who try to arrange non-U.S. care on their own may end up without the follow-up care they need, and they may have difficulty reaching the non-U.S. providers, according to Christi de Moraes of MedNetBrazil Concierge Services Inc., Deerfield Beach, Fla.
For insurance agents and brokers and others involved in arranging medical travel, the key is to avoid the urge to offer medical advice, said Scott Edelstein, a lawyer at Squire, Sanders & Dempsey L.L.P., Washington.
“Be careful not to diagnose or recommend a procedure or course of treatment,” Edelstein said.