Managed Healthcare Executive - January 2009 - (Page 12)

{ MANAGED CARE OUTLOOK } Non-traditional care sources offer opportunity Medical tourism and other trends create new models for a more ef cient delivery system BY JOHN T. BIGALKE AND PAUL H. KECKLEY, PHD John T. Bigalke is vice chairman and U.S. industry leader, Deloitte’s Health Sciences & Government industry group. ore than 750,000 Americans sought less-expensive medical treatments in other countries, a number projected to grow to 6 million by 2010. This is potentially costing the U.S. healthcare system billions. Hospitals, physicians and plans will need to quickly adapt to such competition from non-traditional players and develop long-term strategies. The emergence of disruptive healthcare innovations—medical tourism, retail clinics, technology-enabled care at home, and cyber visits—presents a new paradigm that suggests partnering with new players outside traditional healthcare sectors will lead to new models of delivery and new ways to operate more e ciently. PLACES FOR CARE M elsewhere in the world or in other states. Retail clinics—another non-traditional competitor—have increased by 220%, from just 250 clinics in 2006 to more than 800 in 2007, and close to 1,000 in 2008. These trends are not fads. While traditional roles in the healthcare delivery system are being threatened by these innovations—creating initial worries for physicians, hospitals and allied health professionals— they may also provide new and rewarding opportunities, particularly for health plans. NEW SERVICES Paul H. Keckley, PhD, is executive director of the Deloitte Center for Health Solutions. The impact of rising U.S. healthcare costs is felt in every household and by every company. Consumers with employer-sponsored health insurance are increasingly considering medical tourism, retail clinics and other innovations as viable care options. The Deloitte 2008 Survey of Health Care Consumers, a nationally representative survey of more than 3,000 Americans, found that two in ve respondents said they would be interested in pursuing treatment abroad if quality were comparable and the savings were 50% or more. By contrast, inbound medical tourism and medical tourism across state lines will continue to be an opportunity for specialty hubs o ering treatments unavailable Long-term strategies to manage this nontraditional competition may include creating new services or service areas through mergers and acquisitions and partnerships. Examples of what some health plans are already doing, or are thinking about doing, to capture value from these innovations include: Creating more convenient and exible options for point of care for consumers and incorporating them into bene t plans; Working with providers domestically and internationally to develop networks and package pricing to cover patients who want to travel for care within the United States or overseas; Partnering with DM companies to o er services at retail pharmacy settings; Developing innovative approaches to pay providers episode-based payments that reward the coordination of care and outcomes versus a patchwork of volume-based payments; Covering cyber visits and/or medical home technology to combat issues such as chronic care; Working with technology companies to implement electronic health records and other innovative technologies to enhance consumers’ ability to research treatment options online; and Exploring how “greening” or sustainability plans will maximize opportunities to reduce costs. MHE 12 JANUARY 2009

Table of Contents Feed for the Digital Edition of Managed Healthcare Executive - January 2009

Managed Healthcare Executive - January 2009 Contents Editorial Advisors For Your Benefit News Analysis Politics & Policy Letter of the Law Managed Care Outlook New Day 5 New Realities of Disease Management Pharmacy Best Practices Health Management Technology State Report: Hawaii MHE Resource Ad/Edit Index

Managed Healthcare Executive - January 2009

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