Does Blue Cross Blue Shield Pay For Weight Loss Surgery Your Employees Will Be Global Healthcare Consumers – Are You Prepared to Communicate With Them?

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Your Employees Will Be Global Healthcare Consumers – Are You Prepared to Communicate With Them?

Get ready, because a similar storm is brewing in the healthcare industry, and a significant disruption will occur to conventional health communication systems.

Important Trends are Working

These powerful fronts collide:

• Quick access and self-help to health care resources and data. Healthcare consumers equip themselves with information at their fingertips. Reliable Internet resources abound, and today’s patients can quickly scan reports, share links, ask questions, and post comments.

• Rising health care costs, coupled with worries about money issues. Persistent anxiety and hypertension. Widespread concerns about medical (and other) expenses remain. Most workers are covered under their current insurance plans for various medical issues, and some even feel confident that they have funds in savings, but now more than ever, they occupy a global buyer’s market. Healthcare consumers, like savvy retail shoppers, are price conscious and determined to find maximum overall value.

• Confusion about the future of the US healthcare industry. Are your employees confident that they will be eligible for heart surgery or other major procedures in a few years? The more confusing the U.S. health care system becomes — and the more wrangling continues over future laws and regulations — the more consumers will seek alternative options for care. In general, we don’t like to wait, especially to be told what to do.

Patients Realize Their Power

The combination of these powerful trends will generate at least one important result: More of your employees will become global patients.

“Medical tourism,” the practice of traveling to receive medical, dental or surgical care, is not new, but it is changing. US residents have long traveled to other countries for care, particularly for cosmetic surgery, dental work, procedures not covered by insurance and procedures not yet approved by the US Food and Drug Administration (FDA). Today, however, many “medical tourists” are fully insured workers seeking all kinds of care procedures—cardiology, orthopedic surgery, spine fusion, cancer treatment, bariatric surgery, fertility treatment, eye surgery and more.

The biggest draw for medical tourists is no secret – the often huge cost savings. A heart valve replacement that costs $200,000 or more in an American hospital can cost $10,000 in India, according to the University of Delaware, and that price includes airfare and a post-surgery vacation package. Medical tourists who receive treatment in Thailand save about 70 percent on average, and those who travel to Latin America typically save at least 50 percent, according to the Medical Tourism Association.

Simple truth: Individuals will choose to travel for care when the care is of higher quality, more affordable and/or more readily available than what they can receive at home.

“Many people believe the market performs better than the government in allocating resources, and is quicker to respond to consumer demand,” said Fred Hansen, a physician and journalist. “Patients realize that the power of the consumer vote, exercised many times every day on choices in different markets. The Internet and low-cost airline fares have increased consumer opportunity and choice by creating a new consumer-driven market.”

Hoping to get a share of that market, several countries – notably India, Singapore and Thailand – are offering state-of-the-art facilities that specifically cater to medical tourists. These facilities have state-of-the-art technology and equipment, and often employ physicians who are trained and board-certified in the United States.

Employers and Benefit Firms are Responding

More employers and employees are giving serious consideration to medical tourism options. A June 2010 survey conducted by the Medical Tourism Association at the Society for Human Resource Management (SHRM) conference found that 48% of employers surveyed were “interested” in offering medical tourism to their employers on a voluntary basis, with 36% indicating they were “Possibly interested.”

Experts say the medical tourism industry could change if enough US employers and insurers actively promote and underwrite it. Medical tourism is now being considered by industry giants such as CIGNA, Aetna and BlueCross BlueShield, all of which say they have either started or will soon start pilot programs that will offer partial travel medical insurance.

Other insurers have already launched pilot programs:

• Wellpoint began offering a pilot program with Serigraph Inc., a Wisconsin-based printing company. Under the program, Serigraph health plan members can choose to travel to India for certain procedures, including major joint replacements and upper and lower back fusions, and pay lower out-of-pocket costs.

• IDMI Systems Inc., a Georgia-based automation software developer, contracted with Companion Global Healthcare to provide medical travel options for certain medical procedures to employees and dependents covered by the company’s self-funded health plan.

Disruption Is Coming

We believe more companies will realize the credibility and viability of medical tourism, and will start offering options for employees. Additionally, companies with self-funded plans will begin incentivizing employees to travel abroad for care.

The coming rise of medical tourism will disrupt conventional healthcare systems in profound ways:

• It will reduce the purchasing power of affiliates when they approach health care providers.

• It will lead to new “centers of excellence” located around the world. Latin America is already one for dental work, and India is one for heart surgery.

• It will showcase the fact that employers will not give up their right to affordable healthcare in an open global economy.

Are You Ready?

Is the medical tourism option right for your employees? You need to take into account a number of different factors, including current health plan options, employee demographics, risks associated with receiving care abroad and the choice of medical travel benefits offered by the insurer.

Regardless of what you think about medical tourism, it’s wise to prepare your communications. If you choose to help employees obtain care abroad, what educational messages and materials can you offer so they can gain a clearer understanding of the benefits of medical tourism? Providing and promoting this material will help them decide if medical tourism is right for them.

If you choose not to help employees get care abroad, how will you communicate that decision and defend your reasoning?

Here are two common questions employees ask about medical tourism and perspectives you can share:

• Why don’t more insurance companies offer medical travel options? Insurers want to take reasonable steps to ensure that overseas providers are qualified to provide adequate care. They are also concerned about continuity of care – for example, how much are they willing to pay for physical therapy in the US?

• Is the treatment performed in a low-quality facility? Not often. Medical tourists can find facilities abroad that are just as good as in the U.S. About 220 overseas hospitals are certified by the Joint Commission International, and most doctors who treat medical tourists have practiced in the United States, Australia, Canada or Europe.

In addition to answering employee questions, here are some tidbits to keep in mind when considering (or implementing) a medical tourism benefit option:

• New medical tourism guidelines have been established. US organizations have begun creating medical tourism guidelines and programs to help people choose the right healthcare for their needs. Employers should ensure that employees have a variety of materials available to them to help them decide on the appropriate path to care. These resources include new medical tourism guidelines from the American Medical Association that employer organizations, insurance companies and other entities that facilitate or incentivize medical tourism should adhere to. These guidelines suggest that patients should be referred only to facilities that have been accredited by a recognized international accreditation body, such as the International Joint Commission or the International Association for Quality in Healthcare.

• The Medical Tourism Association recently launched the Quality of Care Project. The project focuses on improving the transparency of quality of care worldwide so that employers, patients and insurers can better evaluate and compare facilities around the world. The project aims to create a methodology for reporting certain quality statistics and indicators, so that individuals and companies can compare quality, cost, patient volume and patient safety records.

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