Surgery costs represent one-third of the total annual medical spending of $2.3 trillion, yet–unlike pharmacy benefits or disease benefits–they are almost completely unmanaged. Given this, surgery costs represent the largest untapped source of potential health savings.
As a result, expanded access to high-quality, high-value surgical providers through medical travel is the most promising consumer-driven product on the market. It is poised to become the integral benefit option for improving employee health and curbing costs.
The Deloitte Center for Health Solutions predicts a 35% annual growth rate for the medical tourism industry in 2010 and beyond. Right now, any broker or consultant offering a way to help control staggering health care costs can reap professional rewards.
For employers, this option offers demonstrable cost control, improvement in quality and outcomes, and increased employee satisfaction. It also gives plan sponsors an opportunity to offer choices for their members, rather than cutting benefits, while improving morale and productivity. Employees can benefit from greater choice, better quality care, and savings on out-of-pocket costs.
“Medical travel” should and does involve more than offering to pay for a patient to fly to a hospital out of town.
A good medical travel provider should offer patients education about the possible benefits–and possible risks–involved with getting surgery, along with concierge services, general member services, and full reporting on claims, outcomes and savings.
Employers and their benefits advisors should align with a medical travel medicine provider that can show that it has extensive health care experience and leadership and proven operating systems that comply with Health Insurance Portability and Accountability Act privacy requirements.
Look for a medical travel service provider that is HIPAA-compliant; coordinates the client’s pre-travel communications with the hospital and physician; arranges to meet the patient’s after-care needs; and tracks satisfaction and medical outcomes. The package should include the cost of surgery and other procedures, airfare, lodging, transfers, 24/7 concierge service, and access to accredited hospitals. The provider also should work with health care organizations that keep track of service and quality outcomes.
The Dartmouth Institute for Health Policy and Clinical Practice has demonstrated that surgery expenditures can be dramatically reduced by providing patients with information about their surgical and non-surgical options.
In the Dartmouth study, 30% of patients who went through a shared decision-making process about surgery opted out of surgery altogether. Thus, coupling a medical travel option with surgery education can provide enormous savings.
Surgery education teaches employees to make informed decisions about surgery, along with its risks and its alternatives, such as evaluating whether surgery is really required or if a less invasive approach might work. It also teaches patients to be better informed advocates for their own care.
Victor Lazzaro Jr. is chief executive officer of BridgeHealth Medical, Greenwood Village, Colo., a medical travel services firm.