Wednesday, August 05, 2009

Medical Tourism Coverage: Why in the World?

We've certainly blogged about Medical Tourism - traveling out of one's home country for medical care - but we've never really talked about how one pays for such care. Generally, these trips aren't covered by one's insurance, so they're primarily self-pay. That's fine if one has a few thousand extra dollars laying around, or can arrange financing, but what about us "regular folk?" Turns out, there's a whole cottage industry that offers to help fund these ventures, and I was fortunate enough to interview the president of one such company, Companion Global Healthcare's David Boucher. I spoke with David late last week, and asked him about how this kind of coverage works.
David's the former CEO of a hospital, and has extensive private sector experience from both that perspective and as an executive with Blue Cross of South Carolina.
IB: David, thank you for speaking with us about Medical Tourism Coverage. One of the major concerns folks have is the quality of the facilities available.
DB: Well, we don't use just any hospital; all the ones we use are JCI-accredited [ed: this is the Joint Commission International, which FoIB Rick Byrne tells us is " the same organization that Medicare requires American hospitals to be accredited by if they are to receive Medicare reimbursement."] We do an extensive onsite survey of each facility to make sure they meet - and continue to meet - our standards, not just JCI's.
IB: We've blogged about Canadians accessing American health care when their own system can't, or won't , help them. How does this impact that kind of care?
DB: It's not just Canadians, and they're not just driving to Detroit for care. Why should they, when they can get world-class care in Bangkok, and have a wonderful travel experience in the process? Our goal is the "no nurse call" metric; that is, a patient should never have to press that button. If they do, it means we haven't done our job.
Of course, we can't guarantee this every time, but our memebers consistently have a better experience in our foreign facilities than many American hospitals. And, of course, there are significant cost savings in using these types of facilities.
IB: That's great, but I'm looking at this as an agent, and I'm having a hard time picturing myself going to a small group client and saying, "hey, you should add - and pay for - this extra benefit." For one thing, even if MT saves on claims, why should my small business client care? His claims aren't really based on his group's experience.
A large group, especially one that's self-funded, might see some decent savings, but that's not the majority of businesses here. And from the employee's standpoint, there's even less incentive: he's got a deductible and co-insurance to pay regardless, what does he care of it saves the insurance company thousands of dollars on the other end?
DB: That's right, there'd be no real savings for small groups if we just treated this as an ancillary product, like dental or short term disability. But our plan is to package the product as an integral part of the group medical plan, and to convince carriers to add it to their portfolio as an additional benefit, a way to differentiate their policies from their competitors. We'd also like to see them make it more attractive to the employee; for example, by waiving the deductible or the co-insurance of that employee chose to use one of our overseas facilities.
We're already seeing this pay off for our individual clients, by the way; our plan is included in Companion's mini-med product. If one has a limited benefit, which by definition these products do, then one's dollars can go a lot farther by traveling for care. A $2000 daily hospital benefit goes a lot farther in Costa Rica than Dayton, for example.
And it's not just medical care. We have a Global Dental product that provides the same kind of services and pricing. And it really shines because most of the big-ticket dental items are out-of-pocket for the consumer. Dental plans typically have a $1000 or $1500 annual maximum that they'll pay; if one is looking at a procedure that costs $15000 in the states, but $6000 in, say, Costa Rica, why wouldn't you take that trip?
IB: That's a lot to consider. Thanks for all your time, and we'll pass along any questins or comments our readers might have.
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