Managed Healthcare Executive - December 2008 - (Page 8)

NEWS ANALYSIS Employers asking for care abroad to reduce healthcare costs TRACEY WALKER SENIOR EDITOR NATIONAL REPORTS — Fueled by employer clients seeking access to foreign providers as a means of reducing their claim expenditures, domestic insurers have been evaluating programs and bene ts whereby its customers can elect to seek certain services overseas. “There has been a growing demand by U.S. employers to reduce healthcare costs, and many insurance companies and reinsurance companies have been telling us of this growing demand,” says Jonathan S. Edelheit, president of the Medical Tourism Assn. “Unlike other consumer-driven bene ts, medical tourism is the ultimate consumer-driven bene t in that it guarantees hard cash savings and a signi cant amount, whereas other consumer-driven bene ts o er ‘theoretical savings.’” HEALTH PLAN PROGRAMS WellPoint’s medical tourism bene t pilot program, set to begin next month, will include certain non-emergency procedures such as major joint replacement and upperand lower-back fusion. “In the last year, we noticed an increase in employers asking about medical travel as an option,” says Jill Becher, WellPoint spokesperson. “It’s now a frequent question in RFPs and client conversations.” WellPoint’s program will initially cover about 700 group members and their dependents at Serigraph, a Wisconsin-based specialty printing company. Under the program, WellPoint case managers would collaborate with patients on their travel and medical arrangements with Joint Commission International (JCI)accredited hospitals in Bangalore and New Delhi, India. Serigraph employees will be able to visit the Apollo Health system in year-one of the shift: total knee and hip replacement, spinal fusion, CABG, heart valve replacement, and vaginal hysterectomy. “We have found that, if structured correctly in the employer’s plan, the bene ts of medical travel can be shared,” Boucher says. “One of our employer agreements historically covered inpatient care at 80% after the member paid a $1,000 deductible. This self-funded employer simply layered a 100% bene t over their existing program that EDELHEIT BOUCHER waives copays and the deductible amounts India, “which has a strong reputation for for their associates choosing to travel to a excellence in patient care,” Becher says. Companion Global Healthcare facility for BlueCross BlueShield of South Caro- care, and they will decide on a case-by-case lina launched its global surgical care op- basis whether to cover airfare.” tion, Companion Global Healthcare Inc., in March 2007. Bumrungrad International CARE IN SINGAPORE Medical Center in Bangkok, Thailand, was Aetna has a medical tourism pilot prothe rst hospital accepted into Companion gram in place with one plan sponsor, Global’s network. working with a hospital in Singapore. “We also recognized that an increasing It does not expect to have meaningful number of our members had been receiving data from the pilot until at least 2010, care outside of the United States for mul- says Wendy Morphew, Aetna spokestiple years, so we decided to actually help person. these members travel abroad for care,” says Members participating in the pilot David Boucher, president of Companion have the option of traveling to Singapore Global Healthcare. “We also added a layer for hip and knee joint replacements. Benof due diligence by surveying several of the e t design reduces out-of-pocket expenses. prominent JCI-accredited facilities.” The plan will pay 100% of the cost of the The global surgical care option is avail- procedure and associated rehabilitation in able to all 1.5 million members of the South Singapore, plus it will o er an allowance Carolina Blue plan. The Companion Global to cover travel costs for the member and a Healthcare sta assist with travel arrange- companion. Aetna normally pays 80% of ments for interested members and spend the cost of the procedure when a member extra time and e ort providing bene t- receives care locally. structure consulting to employer groups. Edelheit predicts signi cant growth in Companion Global Healthcare also con- 2009 in medical tourism. But even more tracts with non-BlueCross employers and interesting is that “domestic medical tourTPAs. ism” is about to take o , where Americans While Companion’s agreements with its travel to other cities in the United States for network of international hospitals do not savings, he says. limit what services they provide for reim“After examining ‘all in’ costs including bursement purposes, Boucher says that they the procedure, travel, etc., some domestic have been recommending that employers hospitals are nding that they could deliver consider a measured approach to medical a compelling and competitive price to comtravel by modifying their bene t structure pete for business that might otherwise go for about a half dozen surgical procedures in overseas,” Morphew says. MHE DECEMBER 2008 8

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Managed Healthcare Executive - December 2008 For Your Benefit Editorial Advisors Contents News Analysis Politics & Policy Letter of the Law Puerto Rico’s PLAN State Report Bundled Payment Technology Drug Class Overview Managed Care Outlook Desktop Resource Ad/Edit Index

Managed Healthcare Executive - December 2008

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