Whether you believe that 20,000, or 2 million Americans travel abroad for treatment every year, anybody seeking to target the US market needs to take note of the rise of internal US medical tourism and the increasing number of services on offer.
Difficulties arise when overseas providers make claims such as “treatment in a US hospital costs £100,000 compared to £40,000 in country X”, when an employer or patient may use a domestic network to find out that it is available in a US hospital for £30,000. A USA Today report shows that costs can vary across US healthcare by 600% or more for the same procedure. Travel agent sites sell off ‘spare ‘ hotel accommodation at discount prices, and some US hospitals are looking at selling spare bed/operation capacity. We may see hospital versions of Laterooms.com.
At present, price comparison and availability online has partial coverage and is often targeted at employers. Self-funded healthcare plans are a growth area, and there are 110 million Americans on self-funded plans. Employers are beginning to send plan members out of state to save money; but legal concerns, fear of the unknown, paranoia at political problems in overseas countries and other factors can make those same employers unwilling to send employees overseas.
Austin, Texas based National Surgery Network
(NSN) launched in early 2010 and by the end of 2011 expects to have 50 staff. A provider network for planned medical procedures, NSN helps employers reduce surgery costs while ensuring top-quality care. It manages their medical-loss ratio through direct cost savings on major medical procedures. It uses negotiated global case rates to achieve savings for planned procedures of between 30-50% versus paid costs for most health plans. Global case rates simplify insurance management by creating clarity and predictability around procedure costs. They provide a stable and predictable cost per claim that enables a plan to focus on incidence rates and medical-loss ratio management, so a plan can actually predict its medical-loss ratios and confidently manage costs. NSN’s plan design is customizable, giving employers the flexibility to choose procedures, locations, and other options that make their plan unique to their needs.
NSN is a high technology network designed to drive greater value in the form of improved medical outcomes per unit of cost. Unlike traditional PPO networks, it manages plan member interaction from initial inquiry through long-term post procedure follow-up through the direct monitoring of the outcomes and satisfaction of each case. To ensure the highest quality of care, all hospitals used rank among the top 25th percentile of surgical quality nationally.
NSN can save US employers thousands of dollars off of their employees’ medical bills, and it also offers benefits to employees, an area that few offering overseas medical tourism to employers have considered. NSN only contracts with hospitals that have shown the best track record for surgical procedures. A get-well benefit rewards the patient financially for adhering to discharge protocols and for participating in follow-up. NSN uses technology in support of personal interaction. They provide an on-line health information portal to assist the patient in choosing a provider. They also have care coordinators that establish a personal relationship with each patient. They use a secure on-line medical records system for easy access. Each patient using NSN receives their own electronic personal health record. NSN is also using social media to help patients share their experiences and connect with one another in an environment that protects privacy and anonymity.