Traveling thousands of miles can lead to thousands in saving

Medical tourism is gaining traction among Americans, and it can be a tool for brokers seeking to keep their self-funded clients’ health care costs down.

Brokers are tasked with finding ways employers can offer attractive benefit packages at a reasonable cost. Shifting to high-deductible health plans, dropping coverage for spouses and increasing voluntary offerings are a few ways employers are curbing health care costs. Flying abroad for certain procedures can help, too.

While paradoxical, traveling thousands of miles for surgery can equate to tens of thousands in savings. Most procedures have an average savings of $25,000, according to Steve Baker, president and CEO of San Diego, Calif.-based Satori World Medical. “We can save the plan a significant amount of money,” he says.

Medical tourism is a good option for self-funded employers, says Kathy Finnerty, owner of Innovative Cost Management Services. Major medical providers aren’t likely to implement this practice, and if they did, the provider would integrate it into its fully insured program, she says.

Like a claims review or eligibility audit, brokers can recommend medical tourism as a cost-cutting method. “That’s really what we are,” Baker says of Satori, which has 28 facilities located in eight countries. “It’s broadening the perspective of the broker to be able to offer another positive tool rather than a negative tool.”

Satori works closely with brokers to spread the word about its program to U.S.-based self-funded employers. “Brokers are the gateway to many clients,” Baker says.

Finnerty offered Satori’s program as a solution to one of her clients in 2013. At first, the executives were unsure about sending their employees abroad, she says. “We didn’t think employees would go for it.”

They did. After the first knee replacement, three or four employees a year are now going overseas for procedures. “The success of the program really surprised all of us,” Finnerty says. “Our inquiries continue to increase.”

Popular procedures

An estimated 750,000 Americans travel abroad for medical procedures each year — most commonly for heart, dental and cosmetic surgery — according to the Centers for Disease Control and Prevention. Dentistry is one of the most popular reasons for medical travel, says David Boucher, who has witnessed Costa Rican dental centers full of Americans and Canadians. Orthopedic surgery is another common procedure U.S. citizens travel outside of the country for, says Boucher, president and COO of Companion Global Healthcare, Inc., which is based in Columbia, S.C. 

Satori’s focus is on major, non-emergency surgeries like hip and knee replacements, spinal fusion as well as some cardiac procedures. “Things where it can be planned a month or so out,” Baker says. All of the facilities are Joint Commission International accredited. “These are spectacular places,” he says.

Unfortunately, horror stories exist, especially with cosmetic surgeries, says Dr. Miles Varn, chief medical officer of Baltimore-based PinnacleCare. If someone does have a complication, he says, no U.S. doctor will want to assume the liability that comes with attempting to correct the mistake. “The patients really have a challenging problem trying to find someone to fix what was poorly done.”

That’s why going through a facilitator who will connect patients with top-notch care is essential. That isn’t an easy process, Varn says. PinnacleCare spends a lot of time and resources vetting each of the medical centers it partners with.

Brokers need to understand all the risks involved — and ensure a stop-loss policy is in place — before recommending this to a client, Finnerty says. “The communication to employees is extremely important,” she says.

It’s not just medical details that brokers need to understand. “A four-star hotel in the U.S. is not the same as a four-star hotel in Mexico City,” Finnerty says. “Those are all things you have to bring to the table as a broker to get [clients] to really understand what they are getting into.”

Big savings

On average, procedures conducted outside the U.S. cost about half as much as they would if performed domestically, Baker says. Medical tourism facilitators encourage employers to waive an employee’s deductible to eliminate any out-of-pocket expenses as a way to share the savings. Employers can afford to do this because of the five-figure amount they’re saving, Boucher says.

With no per member, per month charge — Satori only earns revenue when a patient travels abroad — this service, which can be added any time of the year, has almost no downside for employers to implement, Baker says. “It’s a very low risk for a broker to present this to a client,” he says. 

Boucher has visited medical centers in 28 countries, and says he’s impressed with the rate at which the quality of care has improved. From 2005 to 2008, the number of JCI-accredited medical centers increased from 76 to more than 220, according to a Deloitte Center for Health Solutions study.

Americans’ appetite for medical tourism is growing as cost-shifting continues and deductibles, co-pays and out-of-pocket expenses increase, says Tony Procaccini, vice president of expatriate benefits at San Francisco-based Global Benefit Associates. “It’s an emerging service offering,” he says. And medical tourism facilitators are popping up everywhere, Procaccini says, “They’re opening up left and right.”

Global companies, like the ones that populate Silicon Valley near Finnerty’s San Jose, Calif.-based firm, are great candidates for medical tourism. Those companies have international workforces, she says, and traveling to countries outside the U.S. isn’t foreign to many of the employees.

Still, corporations haven’t been as quick to adopt medical tourism, Procaccini says. “They tend to be risk-adverse,” he says. But some corporations do offer domestic medical travel benefits. Companies like Boeing, Pepsi, Lowe’s and Walmart pay for insured employees to travel to highly ranked facilities within the U.S. for certain procedures — and Varn expects more companies to follow suit.

There are three parts to medical travel — safety, service and savings — the latter is the main encouragement, Boucher says. “Most of it really is dollar driven.”

Once a new employee travels abroad, Satori typically sees increased interest from their co-workers. “That starts a domino effect,” Baker says. “Word of mouth is a big part of our success.”

Destination America

It’s not just U.S. citizens who are traveling abroad for medical procedures, plenty of foreigners are taking advantage of America’s doctors and facilities, Varn says. Canada, for example, has a great health care system from a provider perspective, he says, but it can take months to see a doctor. “For some people, they can’t wait,” Varn says, so they come to America.

The U.S. has a history of treating residents from Latin America and the Middle East, he says, but there’s been a recent surge of Chinese and Russian patients seeking treatment in America. From a technology standpoint, “We have the greatest health system in the world,” Varn says. “But you have to know how to get to the right place for your problem.”

Not only is connecting patients with the right care important, so is making sure they’re on the correct course of treatment, Varn says, and his company has saved several people from unnecessary surgery. “We’ve always been focused on what’s best for the patient,” he says.

Medial tourism isn’t right for everyone, but clients are curious about learning more, Finnerty says. “There’s an interest in it,” she says, and medical tourism can be another tool for brokers.

“I don’t see it going away,” Finnerty says. “I see it as an opportunity. We bring it up to every self-funded client.”

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