| Medical Travel Benefits | | | | behaviors, and what drives their health care |
| You may have noticed that many U.S. employers | | | | decision-making. Approach the benefit design |
| are investigating whether they can reduce health | | | | process from the ground up. |
| care expenses by using medical travel. But how | | | | Start by identifying and analyzing the |
| does this work? Can your business reduce | | | | demographics and health care consumption |
| healthcare costs by using foreign providers? The | | | | patterns of the employee population. You may |
| answer is complicated. | | | | want to survey the group to find out their |
| Medical travel is the practice of patients receiving | | | | opinions about their current doctors, traveling to |
| care for certain procedures in foreign countries. | | | | certain countries, and about health care in those |
| Medical travel professionals have built networks of | | | | countries. You may also want to find out how the |
| distinguished providers in India, Costa Rica, | | | | group spends its health care dollars now and what |
| Singapore and Thailand who are accredited and | | | | types of incentives are most likely to work. The |
| serving American patients. These providers offer | | | | answers to these questions will help you build the |
| the same procedures by similarly qualified | | | | right global provider network and design an |
| surgeons at state of the art hospitals for 30% to | | | | appropriate beneficiary education campaign. |
| 50% off of negotiated prices in the U.S. | | | | 3. Build A Benefit Program That Responds To The |
| Employers and medical travel professionals are | | | | Needs Of Your Beneficiaries |
| putting their heads together to design health plans | | | | Armed with the information learned during the |
| that allow employees to travel for care and save. | | | | investigatory phase, build a benefit plan and a |
| The employers who are embracing medical travel | | | | global provider network that reflects the needs |
| generally either go at it alone or collaborate with a | | | | and consumption patterns of the beneficiary |
| medical travel company to design a benefit add | | | | population. For example, if you learn that the |
| on. Medical travel companies and other industry | | | | beneficiary population is generally over weight and |
| experts have a lot of experience and expertise | | | | has a proclivity for travel in Latin America over |
| to contribute to this process and should be | | | | Asia, that information may be used to build a plan |
| consulted while building a medical travel benefit. | | | | that encourages beneficiaries to investigate weight |
| Here's why. Medical travel experts generally focus | | | | loss surgery in Costa Rica and Mexico. Surgeons in |
| on financial incentives to drive utilization of foreign | | | | these countries are expert in bariatrics. You may |
| providers. However, your business will see better | | | | also learn that your employee population is more |
| results if you invest early in the process to | | | | likely to have orthopedic issues and favors Asia. |
| understand the employee population. By analyzing | | | | In that case, a plan that highlights the orthopedic |
| your employee demographics and understanding | | | | expertise of doctors in India, Singapore and |
| health consumer behavior, you can design a plan | | | | Thailand is more likely to be utilized. Either way, |
| that connects with your target beneficiary group | | | | the plan should specifically address the beneficiary |
| and changes their behavior. | | | | population to increase the likelihood of utilization. |
| The Anatomy of a Medical Travel Benefit | | | | 4. Educate Employee About The Benefits Of |
| Package | | | | Medical Travel |
| Health care consumers, both individuals and | | | | Work closely with medical travel experts to |
| groups, are demanding competitive prices, more | | | | design and implement a comprehensive employee |
| transparency and better quality care. Beneficiaries | | | | education campaign that demonstrates the |
| and patients have become health care consumers. | | | | advantages of using foreign providers and the |
| The movement is called consumer-driven health | | | | added incentives and benefits available through |
| care. Employers that offer health benefits are | | | | the medical travel plan. |
| responding to this phenomenon with packages | | | | 5. Create A Tiered Provider Network |
| that let beneficiaries to take greater responsibility | | | | Create a tiered provider network that favors |
| for their care and consumption decisions. | | | | higher quality, lower cost providers with lower |
| Global health benefits (as it is referred to by | | | | co-payments. Enrollees that select preferred |
| some in the industry) generally follow the health | | | | foreign providers for specific treatments may |
| care consumerism model of high deductibles, | | | | have lower or no co-payments associated with |
| behavior-inducing co-payments, and a health | | | | that service. Tiered provider networks are a |
| savings account. Global health benefits go one | | | | common health care benefit strategy that can be |
| step further and offer financial incentives for | | | | utilized to encourage beneficiaries to use foreign |
| patients who travel abroad for certain procedures. | | | | providers for certain services. |
| The Role Of Incentives | | | | 6. Increase Provider Transparency And Patient |
| Generally global health benefit plans use three | | | | Responsibility |
| types of incentives: financial incentives for patients | | | | Increased transparency and patient responsibility |
| to use preferred providers, non-use dependent | | | | enhances savings. Enrollees can make cost |
| incentives to attract beneficiaries. Like other | | | | savings choices about whether or not to see a |
| low-cost health plans, global health benefits give | | | | doctor (with information about disease |
| patients more responsibility for health-related | | | | self-management), which doctor to see (with |
| decisions. Enrollees choose from a network that | | | | information about provider quality, success rates, |
| includes preferred out-of-country providers. | | | | and costs), and disease treatment and |
| Financial incentives encourage patients to choose | | | | management (with information about symptoms, |
| foreign providers for specific procedures. | | | | treatments, risks, and costs). Plan providers should |
| Financial incentives reward patients who have | | | | be encouraged to be transparent with their quality |
| certain procedures performed abroad. Employers | | | | data and pricing. Giving enrollees the information |
| may have a lower co-pay for foreign providers, | | | | necessary to make important care decisions aligns |
| pay enrollees cash for choosing foreign providers | | | | their interests with the payer. By aligning the |
| and/or cover the cost of travel to and from the | | | | interests of the consumer and payer, excesses |
| location of the procedure. Employers may also let | | | | can be eliminated and costs can be contained. |
| employees use non-vacation or personal time for | | | | 7. Implement Internet-Based Care Management |
| in-country recovery. | | | | Tools |
| Non-use dependent incentives attract new | | | | Finally, easy-to-use internet-based care |
| beneficiaries with low cost premiums and reward | | | | management tools encourage efficient use of |
| patients for taking advantage of preventative | | | | wellness programs, on-line nurses, on-line training |
| services like annual health check-ups, | | | | and more. Recent studies indicate that patients |
| mammograms, prostate screenings and | | | | welcome more and better information that is |
| immunizations. While non-use dependent incentives | | | | easily accessible. Patients indicate that they will |
| won't directly drive utilization of foreign providers, | | | | use salient and easy-to-use information to make |
| they support the structure of plans that | | | | informed choices about their health care |
| encourage patients to take control of their health | | | | consumption.* By making relevant information |
| consumption. | | | | accessible and easy-to-use, patients can make |
| There are limits to the ability of financial incentives | | | | more efficient health care consumption choices. |
| to increase utilization of preferred foreign | | | | Conclusion |
| providers. Incentives do not address what drives | | | | Consumer-driven health care is here to stay. The |
| health care consumption. Without understanding | | | | ability to maximize the benefit of cost |
| the decision drivers at work, global benefit plans | | | | containment strategies depends on the ability to |
| may not reduce health care cost significantly. A | | | | innovate and respond to new information. Health |
| benefit plan must narrowly tailored to the target | | | | care consumers should not be underestimated. |
| beneficiary demographic to change their behavior. | | | | They are discerning and scrutinizing. Their behavior |
| Beyond Incentives: Seven Strategies to Designing | | | | is not monolithic. To predict future consumption, |
| Medical Travel Benefits That Work | | | | health care payers should carefully analyze |
| Below are seven strategies to help employers | | | | beneficiary demographics and consumption |
| design a medical travel benefit that will achieve | | | | patterns and employ sophisticated benefit design |
| better results than incentives alone. | | | | strategies that address those findings. Without a |
| 1. Assemble A Team Of Medical Travel Experts | | | | firm understanding of the covered population, |
| As with all projects, it is critical to assemble the | | | | incentives alone are insufficient to drive the kind |
| right team. Designing a medical travel benefit is no | | | | of utilization necessary to realize measurable |
| different. Identify medical travel experts and third | | | | savings from medical travel. |
| party benefit administrators who want to | | | | * Consumer-Oriented Strategies for Improving |
| collaborate with you. Having an experienced and | | | | Health Benefit Design: An Overview, Prepared by |
| knowledgeable team of experts is imperative. | | | | Stanford University-UCSF Evidence-based Practice |
| 2. Analyze Beneficiary Demographics | | | | Center, Stanford, CA for Agency for Healthcare |
| The foundation of a successful global health | | | | Research and Quality, U.S. Department of Health |
| benefit is a complete understanding of the | | | | and Human Services, July 2007. |
| covered population, the group's demographics and | | | | |