Journal of Healthcare Management - May/June 2014 - (Page 213)

e M ployer -b ased c overage their employees sign releases or disclaimers exempting the organization from litigation. They could also limit their MT options to facilities in countries with adequate malpractice policies (e.g., Canada, Japan, Australia, European countries) or to overseas centers of excellence that offer the same services and amenities as those in a Western hospital; are fully accredited by Joint Commission International (JCI); and employ English-speaking medical staff, many of whom are trained and board certified in Western countries. Finally, they could purchase insurance for medical complications occurring as the result of a treatment received abroad. Although the decision-making process may be straightforward for self-insured businesses, which assume their employees' healthcare expenses, it is less so for fully insured employers. These employers would only achieve premium savings if a sufficient number of employees selected the MT option. Such options are always voluntary, and there has been no press report of massive enrollment in employer-sponsored MT. Therefore, the additional costs of travel, missed work, and incentives may not be offset for fully insured employers. For these employers, the elusiveness of cost savings magnifies the importance of quality in the value equation. Several reputable sources have indicated that the quality of care at overseas centers of excellence compares favorably to that of most U.S. hospitals. As Millstein and Smith (2006, p. 1639) report, "We doubt . . . that the average U.S. hospital can offer better outcomes for common complex operations such as coronary- and M edIcal t ravel o ptI ons artery bypass grafting, for which several JCI-accredited offshore hospitals report gross mortality rates of less than 1%." In some cases, their greater experience with a given procedure represents a competitive advantage (see Roy, 2012). Additionally, many overseas centers of excellence are leaders in incorporating hospitality principles in the operation of their facilities, which bolsters their service quality appeal (Wu, Robson, & Hollis, 2013). Ease of use promotes the adoption of technological innovations (Davis, Bagozzi, & Warshaw, 1989; Moore & Benbasat, 1996). In the case of HR innovations such as an MT option, the ease-of-use concept can be extended to ease of implementation. Indeed, a deterrent to organizational innovation is the extra effort-and cost-involved in implementing the innovation. As one of our interviewees mentioned, "in most companies, the HR staff is very lean because of cutbacks. So you must also be able to tell the employer that there will be very little administrative work [to implement the HR innovation]." The magnitude of implementation efforts is likely to depend on the characteristics of the organization, as explained later. Organizational Innovation and MT As organizations age, their systems become more bureaucratic and rigid, inhibiting innovation (Aiken & Alford, 1970). Conversely, younger organizations enjoy flexible structures, which facilitate change. Unencumbered by entrenched EBC traditions, they are better positioned to implement new benefits. Size is another characteristic that influences innovation. Because 213

Table of Contents for the Digital Edition of Journal of Healthcare Management - May/June 2014

Journal of Healthcare Management - May/June 2014
Contents
Interview With Christopher D. Van Gorder, FACHE, President and CEO of Scripps Health
Successful Strategic Planning for a Reformed Delivery System
You, Inc.
Assessing the Feasibility of a Virtual Tumor Board Program: A Case Study
Physician Clinical Alignment and Integration: A Community–Academic Hospital Approach
Employer-Based Coverage and Medical Travel Options: Lessons for Healthcare Managers
Composite Model for Profiling Physicians Across Domains of Care

Journal of Healthcare Management - May/June 2014