Managed Care - March 2008 - (Page 46) But Taylor has also been seeing steady progress in overcoming the obstacles. “If test results can be routinely transferred from Abu Dhabi to New York,” he says, there is no reason why technology cannot connect physicians virtually anywhere in the world. And unions may not be so resistant if someone makes the effort to outline the cost savings associated with good care abroad. Hospital + Hotel ne problem with international health care, says Arnold Milstein, the chief physician for Mercer Human Resource Consulting, is that there are a limited number of hospitals accredited by the Joint Commission outside the United States “I’m told there are about 100,” he says. That includes some top institutions with physicians accredited not just in the United States but the U.K., Canada, Australia, and other countries with high medical standards. All of these hospitals are likely to offer the kind of care that can compare, if not easily beat, what most people would find in their neighborhood hospitals. But at the end of that list lies a group of institutions and physicians that won’t have the same credentials or enjoy the same kind of credibility. For covered workers interested in mixing health care with travel, it doesn’t hurt that this is one trip to the hospital some patients might well savor. At Bumrungrad International Hospital in Bangkok there’s a five-star hotel built into the hospital complex. But then, when almost half of your patients are flying in from around the world, it’s no surprise when the hospitality industry makes a beeline for the neighborhood. “You throw a rock,” says an executive at the Bangkok hospital, “and you hit a hotel.” O Companies start signing up Not all insurers are being brought into the game by big clients. BlueCross BlueShield of South Carolina took a hard look at foreign medical networks and decided to jump in. Last year that company set up Companion Global Healthcare to coordinate travel to international hospitals. But its sights have always been set on recruiting businesses interested in lowering the cost of care. David Boucher, a former hospital CEO, was brought in to set up the global provider network — a job that has taken him around the world. He has come full circle with some glowing recommendations on hospitals and doctors in diverse places like Dublin, Istanbul, Bangkok, and Singapore. “Singapore is stunning,” says Boucher, like a cleaned up version of Las Vegas, complete with an English-speaking population. He didn’t go to Singapore alone. With him went six other executives from stateside companies who wanted a first-hand look. So far, Boucher has signed up a short list of companies: Doctors Care, which operates convenient care clinics in South Carolina; a casino in California; and a Charleston employer with some 5,000 workers that is quietly ramping up to send volunteers abroad for hip and knee surgery, coronary artery bypass graft surgery, heart valve replacements, and spinal fusions. Overseas travel isn’t for every patient, he adds, or every condition. “There are a significant number of procedures where we need to be close to our families,” offers Boucher, citing bone marrow transplants as an example. On the other hand, you could easily list a host of services like orthopedic surgery that could be handled economically abroad. As Americans have been beating a path to hospitals like Bangkok’s Bumrungrad International Hospital — 80,000 in 2006 alone — they’ve been blazing a trail of acceptance for a growing number of companies to follow. And in a field with few hard numbers, there has been at least one significant sign of success. In a survey released in January, the International Foundation of Employee Benefit Plans said that 11 percent of the 400 U.S. corporate benefit managers, professional service providers, public employers, and multi-employer plans they queried covered some foreign medical services. The market may still take some time before it reaches a clear tipping point, says Boucher. “I think what it will take is a handful of groups on the commercial side to actually take a look and say that this is something that we are looking at and will offer to employees.” Far from opposing the move, unions could become its biggest advocates, says Boucher, pointing to auto unions that now are responsible for the health care coverage of retirees. One union chief recently contacted Boucher to sound him out confidentially on the process. Boucher said the man’s attitude was, “We manage our own benefit pool of money, and our members travel around the world. We think there is something to this.” 46 MANAGED CARE / MARCH 2008
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