HEALTH ACCESS ALTERNATIvE: MEDICAL TRAvEL By laura CaraBello » founDer anD PrinciPal; PublisHer cPr strategic marketing communications » meDICal travel toDay
The Affordable Care Act’s Impact on Medical Travel Travel to Centers of Excellence — the Latest Cost-Containment Strategy
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edical travel is on its way to becoming commonplace in response to the shift toward quality and increased consumer education — there surely will be a snowball effect as more U.S. companies send employees to COEs and overseas for care. The Affordable Care Act (ACA) is triggering a significant shift toward cost-containment and patient-centric care, and employers now put enormous stock in preventive health care programs and options that offer quality, transparency, and value — key advantages of medical travel. Patients traveling overseas and within U.S. borders to Centers of Excellence (COE) have benefited from highquality, low-cost procedures for After years of operating years. For patients, medical travel means access to high-quality care, outside of market flexibility, and choice, as well as forces, U.S. health optimized outcomes, a better overall experience, and faster recovcare organizations are ery. Furthermore, because of the being held accountable significant savings, most medical travel benefit plans cover travel — and must become and lodging and waive deductibles. Will overseas travel continue competitive to survive. to climb post-ACA implementation? Yes, here’s why. • ACA does not cover many of the medical travel industry’s most popular procedures, such as dentistry, cosmetic and plastic surgery, in-vitro fertilization, and bariatrics, which will continue to attract medical travelers in the same numbers. • ACA waives pre-existing conditions restrictions by insurance companies and makes insurance premiums the same for healthy and chronically ill individuals. If this drives insurance costs up dramatically as I forecast, it will increase the appeal of medical travel as a way to curb costs for employers and insurers. • Globalization of health care continues to compel providers to compete on price and quality, no matter where they are located. • As the senior population grows, expected lack of physician access and long wait times will prompt more people to look overseas for care. 60
Annual Outlook 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
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A number of international hospitals and physicians already meet U.S. standards.1 I forecast that insurance companies will cover international medical bills, especially for more complicated procedures such as heart operations and cancer treatment, and alternative therapies such as stem cell treatments not available in the U.S.
Currently, the size of the medical tourism industry varies from 550,000 to 1.6 million. There are signs employers have greater interest in sending employees abroad for surgery. In Florida, for example, the Osceola County government recently began offering employees an incentive to use lessexpensive elective procedures — including heart bypass, joint replacements, gastric procedures, and hysterectomies — overseas in such countries as India, Singapore, and Turkey.2 Osceola, a self-insured organization, expects to save so much money on each overseas procedure — even after paying for travel — that it can cover the surgery without charging the usual co-pays and deductibles that can cost employees thousands of dollars. A knee replacement might cost $65,000 to $75,000 in the U.S. vs. $25,000 abroad.3 Osceola employees who travel for surgery receive airfare, an average stay of 17 days — staying until they are medically cleared to leave — and accommodations at a four-star hotel for patients’ travel companion. Furthermore, as Americans become more engaged and educated health care consumers in the new reform environment — and with increased positive word-of-mouth — medical travel overseas will become more acceptable as certain culture-based fears about safety and quality begin to fade. According to Josef Woodman, author of Patients Beyond Borders, medical travel from the U.S. will increase in the long run as patients seek global options for more immediate care, and as global health care options become more attractive when cost, quality, and patient experience data becomes increasingly available to consumers. According to David Boucher, president of Companion Global Health Care, citing a decade’s worth of declining Medicare participation and the fact that even four years ago nearly one in three Medicare beneficiaries had difficulty locating a primary care physician, getting treatment overseas will be cheaper and faster for many seniors.