Domestic Medical Travel: The Next Big Health Benefit Option

In the early phases of health care reform, the medical travel benefit option stands alone as an opportunity for agents to offer employers a quality health care option at greatly reduced prices. In recent years, medical travel has made an interesting shift to encompass a growing number of U.S. Centers of Excellence, where patients can choose from superior clinical results in elective and specialized surgeries. Even better, they’re priced at 20-40 percent less than the average cost of these surgeries.

These benefits position medical travel as something of a no-brainer for informed agents: it’s an innovative offering that helps employers avoid simply cutting benefits or shifting costs to the employee. In 2009, the industry grew steadily, with high expectations for a surge this year and in the years to come. U.S. employers, third party administrators, insurance companies, stop-loss companies, Taft-Hartley groups and others are poised to begin rolling out meaningful domestic medical travel programs that will give employers and employees the chance to save money without compromising quality health care. In fact, a 2009 report by the Deloitte Center for Health Solutions forecasts a sustainable 35 percent annual growth rate for the medical tourism industry.

The selling points

The reasons for this sea change are simple to grasp. Medical travel:

1. Achieves positive health improvement and return-on-investment, particularly if coordinated through reputable health plans and providers.
2. Serves the best interests of employers, individuals and the U.S. health care system, particularly in response to the growing demand for improving quality, aligning costs with outcomes and creating incentives for consumers – such as the ability to compare providers through transparency, cost and quality.
3. Provides greater access to high-quality care at lower cost, particularly for self-insured companies that want to provide the best surgical options for their employees.
4. Has begun to appeal to more companies each year. In fact, some insurers are beginning to actively consider it, and new health insurance plans will follow the lead of Wellpoint, Aetna, Assurant and a number of third-party administrators such as Meritain in offering a medical travel option. Likely adopters also include smaller, regional health plans, PPOs and stop-loss insurance carriers.
5. Has attracted more individuals looking for high quality, low cost on more serious procedures, including orthopedics and joint replacement, cardiac, in vitro fertilization, CyberKnife and bariatrics.
6. Non-covered benefits such as cosmetic and dental implants can be offered to employees at deeply discounted, quality locations at no cost to the employer.

The selling approach

As a selling tool, agents should advocate medical travel service intermediaries — companies that coordinate pre-travel communications between the client and the hospital or physician; arrange after-care needs; and track satisfaction and medical outcomes – with plan prices that include surgery/procedure costs, airfare, lodging, transfers, 24/7 concierge service, savings potential and accredited hospitals.

The best medical travel intermediaries offer surgery education, turnkey member care, marketing, communications and full data reporting (outcomes, savings, claims) to assist in adoption and implementation. It is equally important to align with a medical travel intermediary that can demonstrate genuine health care experience and leadership alongside proven, HIPAA-compliant operating systems, an emerging suite of vendors and in-depth understanding of the health care continuum.

Once you’ve found the right intermediary, you’re ready to start selling. Remember to mention these points:

• Quality: The quality of domestic health care is high, especially if you look for a medical travel intermediary that only consults with the top 25 percent-rated hospitals and Centers of Excellence. Patients will have access to domestic facilities that compete at a global level, performing a high quantity of a given procedure while producing measurably superior clinical results at reasonable rates. Better outcomes mitigate liability claims, which in turn stem the tendency toward defensive medicine.
• Low Cost: Sometimes 20-40 percent less on procedures domestically, and greater abroad.
• Transparent pricing: Providers serving the medical traveler offer predictable cost with fixed dollar, predetermined pricing. Plus, the quoted costs generally include all travel expenses, including airline and hotel accommodations.

Final thoughts

Medical travel quality will continue to be better defined, and will eventually become a household phrase. New business models will emerge; insurers, legislators, and employers will go on exploring pilots and programs; health care providers will become increasingly involved in coordinating care; and more consumers — and agents — will begin to benefit from this exceptional medical benefit option.