Have Illness, Will Travel?

Medical tourism emerges as a new option for keeping health-care costs in check.

The companies that have embraced the full-blown overseas experience aren’t all multinational giants. Tim Harding, vice president of Harding’s Market grocery stores, a group within a 29-outlet chain based in Kalamazoo, Michigan, recently signed up with HealthGlobe to offer the 100 employees covered by his company’s medical insurance the option of going overseas for some common high-cost procedures. Harding says he has been talking to local physicians about the idea for several years, and became more comfortable when the stop-loss insurance that the self-insured company buys to cap its losses agreed to participate in reimbursements for it.

The appeal was straightforward: “For the same amount of money, I can give more care,” he says. Harding is hoping that some employees will choose the option to help the company manage costs. “In a company our size, you can typically handle, say, one or two chemotherapy treatment series a year, but if you get three or four, while it’s nobody’s fault, it just blows up the system,” he says. Medical tourism might allow the company to absorb atypically high expenses more economically.

HealthGlobe CEO Carter says that some overseas facilities may even be able to provide superior care. Stomach cancer, for example, tends to be very rare in the United States, and as a result has very low survival rates, since so few doctors have significant experience with it. In Korea, however, the incidence of such cancer is much higher, and so is the survival rate.

Most companies investigating medical travel, though, are taking the Lowe’s approach and staying as local as possible. Pretzel-maker Snyder’s of Hanover, for example, has been trying to direct employees across the country to centers of excellence within their local regions, as identified through independent data and with the help of its company nurse. Penny Opalka, benefits and compensation manager, considers the program fairly successful, with 5% to 10% of all employees with serious conditions electing to use a better-rated facility each year.

In fact, Opalka credits the survival of one employee who had pancreatic cancer to such a decision. To date the company has never had to pay out the $3,000 it offers to cover travel for the employee and a companion, “since we have been able to get people to centers close to where they live,” she says. Snyder’s, which is self-insured, often works with its third-party administrator and PPO provider network to make sure highly rated facilities are in the network and to negotiate good terms with them.

Confronted with the prospect of patients traveling far away from their hometown providers, local health-care concerns will sometimes step up and offer better rates. Sharon Kelley, CFO of MetroHealth System in Cleveland, says her organization recently cut a deal directly with the county in which it operates to create a package that limits county employees to using MetroHealth facilities, in return for a significant discount in premiums both to the county and to the employee, plus extras like a concierge service. “We did this internally rather than going through an insurance company, and I think you’re going to see more such eliminations of the middleman,” says Kelley, who plans to offer the program to other local employers if all goes well.


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