“(CNN) — When Godfrey Davies learned he needed surgery to remove polyps blocking his nasal airways, the self-described bargain shopper set out on a mission to find an affordable surgeon. He quickly learned a good deal is hard to find.”

CNN shares a story of Godfrey Davies, a man who saved nearly $30,000 on a simple procedure that would have cost him $33,127 or more here in the U.S. After jumping through hoops to try and find an affordable price in Indianapolis, Indiana, he turned to family members across the Atlantic to help him broaden his search for affordable surgery… What they found left Davies “speechless”, and resulted in him embarking on a medical journey to the U.K.

Click here to read the full story  on www.cnn.com

By Jessica Yarbrough, Marketing & Communications Manager, Satori World Medical

Year after year, U.S. employers continue to face double-digit rate increases on health insurance premiums.  Since 2000, the majority of employers have seen costs increase 100 percent or more in order to offer their employees a comprehensive medical plan.  Their increases are not linked to new coverage or benefits, just renewals.

What new strategy can be implemented to help reduce plan sponsor cost without increasing employees’ out-of- pocket expenses or restricting access to quality providers of their choice?

Medical tourism or medical travel, whereby U.S. patients travel outside the U.S. to receive quality medical care at a fraction of the cost, is a benefit strategy that employers are using to achieve lower claim costs on a medical plan, provide additional choice of providers, and engage and reward consumerism within the scope of their existing medical benefit plan.

The key word is choice.  Plan sponsors now offer their employees a choice of domestic network providers and networks provide plan sponsors with discounts of 20-40 percent off providers’ “retail” prices. The benefit plan provides incentives to use lower-cost participating network medical providers over often more expensive, non-participating medical providers.

Satori World Medical, a global health care company specializing in the medical travel space, offers an all-inclusive plan that waives all the out-of-pocket expenses for the employee when choosing a Satori Global Network™ hospital and physician.  Additionally, using a proprietary model, Satori World Medical helps clients design a shared savings feature whereby the employer would share a portion of the $30,000 to $75,000 savings for their surgical procedure through a Health Reimbursement Account (HRA) contribution to the employee.  The HRA is tax-free to the employee and tax-deductible to the employer.  On average, the total cost savings of participating in Satori World Medical’s global health care network are as much as 40-80 percent per procedure, which is extremely compelling.  Additionally, medical travel programs, like Satori, can be offered as an additional benefit to any existing health plan design, and does not replace any domestic provider choice.

Of course employees are only going to travel abroad for medical care if the quality of care is comparable or better than in the U.S.  The global economy has grown, and as a result, competition to provide the best possible health care services, has also grown.  Just as high-quality products and technologies are produced across the globe, and organizations purchase various goods and services from international companies based on price and quality, so too are a number of high quality hospitals and physicians and medical services now available globally.

Companies like Satori World Medical, which specialize in medical tourism, are now making it easier for employers and payors to embrace global health care programs because they have already built the infrastructure, performed the due diligence, and provided contracts that can be supported by U.S. third -party payors.

With the cost of healthcare and health insurance premiums being higher than in any other nation in the world, it is the right time to embrace innovative, cost-saving alternatives like medical tourism. As the industry emerges, we see that the interest in global health care among American companies will continue to grow significantly.

How global healthcare programs provide high quality and affordable healthcare solutions

By Jessica Yarbrough, Marketing & Communications Manager of Satori World Medical

Soaring U.S. healthcare costs, coupled by a crippled economy, continue to put U.S. Healthcare Reform at the top of our nation’s agenda.

U.S. government economists predict that public and private health spending will hit $2.5 trillion this year, taking up a 17.6 percent share of gross domestic product. (Source: Reuters, “Obama sets up formal office for healthcare reform,” Apr. 9, 2009) That ranks the U.S. the most expensive nation in the world for healthcare.

For large multinational corporations, footing healthcare costs presents an enormous expense. General Motors, for instance, covers more than 1.1 million current and former employees, and the company says it spent roughly $5.6 billion on healthcare expenses in 2006. (Source: Associated Press, “Upfront costs complicate Obama’s health care plan,” by Ricardo Alonso-Zaldivar, May 10, 2009) GM’s retiree health care expenses alone add up to $50 billion a year.

Meanwhile, as healthcare costs continue to rise more employers are being forced to shift a larger portion of the costs of healthcare to their employees in order to remain profitable. As a result, America’s employees have become responsible for a greater share of their own healthcare expenses (deductibles, co-pays, co-insurances, etc.)

How Can Medical Tourism Help Address America’s Healthcare Crisis?

One concept that is continuing to gain widespread appeal among the U.S. public and private sectors is medical tourism, whereby patients travel to hospitals outside the U.S. to receive quality medical care at a fraction of the cost domestically.

A number of factors are driving this movement, including the high quality of care that is available internationally, the ability to dramatically reduce a U.S. patient’s out-of-pocket expenses for typical high-cost surgical procedures, as well as the adoption and integration of global healthcare benefits into plan sponsors’ plan design.

What’s particularly interesting is just how well aligned global healthcare programs are with the key established principles of Obama’s Healthcare Reform agenda.

For example, President Obama has announced three bedrock requirements for real healthcare reform, which Satori World Medical’s business and care model specifically addresses.

·       Reduce Costs: Rising healthcare costs are crushing the budgets of governments, businesses, individuals and families and they must be brought under control. U.S. patients now have the ability to undergo high quality surgical procedures performed at International Centers of Excellence through the Satori Global Network™ and tremendously reduce their medical expenses. Additionally, the individual seeking care actually receives a portion of the savings through an employer-funded, tax-advantaged Health Reimbursement Account (HRA) which can be used to offset their future medical expenses. 

·       Guarantee Choice: Americans must have the freedom to keep whatever doctor and healthcare plan they have, or to select a new doctor or healthcare plan if they choose. Consumer choice is extremely important because employers, health plans and policy-makers recognize that unless consumers are more engaged in decisions about their health and the costs associated with those decisions, costs will continue to soar.

Satori World Medical is directly aligned with this fundamental principle because consumer choice is one of the main hallmarks of its program. The Satori Global Network™ has been specifically designed, so that it can be seamlessly integrated with any existing domestic employer-funded health plan.  It does not replace an existing health plan, but rather augments it to provide individuals with more healthcare choices.

·       Ensure Affordable Care for All: All Americans must have access to quality and affordable healthcare. That’s why global healthcare programs make so much sense. Any employer can participate in the Satori World Medical program because it can be implemented without any startup costs to the employer or payor, and with no out-of-pocket costs for the employee (including all hotel and travel for the patient and a companion).

The ability to provide all Americans with access to quality, affordable healthcare is no longer an option, it’s a necessity. While global healthcare certainly isn’t the only answer to solving our nation’s healthcare crisis, clearly global healthcare programs, such as those offered by Satori World Medical, make a lot of sense.

Notes from my presentation at last week’s World Health Care Congress in DC

By Steven Lash, President & CEO of Satori World Medical

Last week, I attended the 6^th Annual 2009 World Health Care Congress (WHCC), Apr. 14-16, in Washington, DC, one of the year’s most important industry events for America’s health care executives. About 2,000 health care professionals attended this year, including CEOs, senior executives and government officials from the nation’s largest employers, hospitals, health systems, health plans, pharmaceutical and biotech companies, and leading government agencies.

To no surprise, the biggest theme of the event was the U.S. health care crisis and strategies around health care reform. It was evident throughout the conference that fundamental changes to our health care system are needed and innovations in health care delivery will be the driving force. Among the innovations presented at the conference was the concept of global health care, also known as medical tourism.

I actually had the opportunity to moderate a panel discussion on global health care at this year’s conference. The presentation specifically delved into the growing phenomenon of medical tourism, how and why more U.S. employers and payors are embracing global health care programs, and how to develop a successful international health care partnership.

Speakers on the panel also included former Aetna Medical Director, Charles Cutler, M.D., M.S., who is a member of Satori World Medical’s Medical Quality Advisory Board, and George McGregor, President & CEO of McGregor & Associates.

So for those of you who were unable to attend the conference, I wanted to share with you some of the most key points of our discussion:

·       Why the U.S. health care system is the most expensive in the world:  

Among the biggest problems responsible for America’s escalating health care costs are the rising costs of medical technology and prescription drugs, high administrative costs resulting from multiple complex payor systems, and the growing shift from non-profit to for-profit health care providers.

·       Why more and more U.S. employers, health plans and government agencies are embracing global health care:

With America’s health care system being the most expensive in the world, Americans are taking a serious look at cost-effective alternatives like medical tourism.

According to a 2008 Deloitte consumer survey on medical tourism, it is forecasted that six million Americans will travel outside the U.S. for quality and affordable medical care, and by 2011 medical tourism will become a $13.9 billion industry. Among the biggest reasons for the growing popularity of medical travel include the high quality of care now available in many hospitals around the world, the tremendous potential for cost savings, and a shift in consumers’ responsibility for their own health care expense.

·       How to choose the right global health care partner:

Not all global health care companies are the same, which is why it’s important that when embracing a medical tourism program, the employer or payor selects the right global health care partner.

Among the important qualities to look for in a global health care company include a high level of experience in international contracting, an incentive model that actually shares the financial savings with the employee, a program that does not require any startup, administrative or other participation costs to the employer or payor, and a superior quality assurance program (which also includes follow-up care) to ensure the highest level of patient care and overall experience.

·       Understanding some of the potential issues or challenges of adoption:

A medical tourism benefit program will only succeed if employees are willing to participate. Therefore, it’s essential for employers to be able to overcome concerns or issues that might prevent someone from receiving medical care outside the U.S. Among the most common issues are the lack of awareness or understanding about medical travel and its benefits, the patient’s concern of overall health care quality and safety, their understanding of what to expect when undergoing a surgical procedure abroad, and the ability to have a close friend or loved one as a travel companion to support them throughout their entire experience.

·       Why U.S. payors, as well, are embracing partnerships with global health care facilitators:

Many U.S. payors are also partnering with global health care companies to offer medical tourism as a benefit option to its members. But why don’t payors and health plans just create their own global health care network?

Well, for one reason, developing a high-quality global health care network is extremely costly and time-consuming. Additionally, as part of the quality assurance process, the payor or insurance company would have to actually travel to each of the international hospitals in its network to undergo due diligence site visits. Furthermore, contract negotiations are extremely time consuming and involve complicated legal concerns. On the other hand, vendors that can provide these services are a more efficient and cost effective solution for health plans.

In conclusion, while the medical tourism industry is just in its early stages, I’m thrilled to see that so many U.S. employers and payors are beginning to embrace the concept. That is the key to the industry’s growth and adoption. Education is also important which is why discussions like these are so critical.

Ron Johnson, M.D., F.A.C.S., Chief Medical Officer of Satori World Medical 

The new Administration has placed high priority on healthcare reform, to lower costs and improve quality.  Maybe a recent article in Health Affairs (Lessons from India in Organizational Innovation:  A Tale of Two Heart Hospitals, Sept. 08) can help.  Authors from the Duke University schools of law, business and medicine describe how organizational innovation has made Indian heart hospitals a low cost, high quality success story.  Can the US do the same? 

The Indian market is different – with over a billion people and a large middle class, only 14% has health insurance, so Indian hospitals understand that their services have to meet the middle-class family budget.  Lower labor costs are important, but much of their success is due to developing and improving innovative organizational structures to provide care.

• Hospital Management Structure.  Many leading healthcare organizations in India are led by dynamic physician-executives, and there is much more collaboration between physicians and senior administrators than in the US.  Hospital management teams come with experience in the hotel industry to give a more focused customer/patient approach.
• Pricing.  Hospitals are competing on both price and quality – they have developed differential pricing, to target different income sectors and maintain volume and efficiency.  Fixed or capitated pricing is offered, to allow patients and payers to “shop” for procedures and compare prices.  This also shifts financial risk to the service providers, and makes them continually evaluate cost drivers and develop new, innovative approaches to care delivery.
• Drive for efficiency in supply and delivery chains.  The competitive market and fixed costs demand efficiency, increased production volumes, with reengineering service delivery models to maximize use of capital equipment.  Some develop and manufacture routine equipment to reduce costs.  There is considerable investment in information technology.
• Competing on quality, paying for mistakes.  Because Indian hospitals compete on both quality and price, hospital managers have instituted quality assurance and improvement as integral to the business models.  As one physician said, in this business model, “we can’t afford to have complications.”

Can US hospitals learn from these Indian successes, where quality care is provided at a fraction of the cost in the US?  There are barriers to this experimentation, entrepreneurialism and technological progress.

• Medicare and insurance payment policies.  The Medicare DRG payment system does not reward innovation or efficiency or price flexibility.  Private insurance does little to stimulate price competition.  Innovation – new procedures or delivery models – is discouraged.
• Legal Barriers.  The Stark Amendment, the Medicare Prescription Drug, Improvement, and Modernization Act, and other laws stifle physician ownership and investment in new facilities and discourage their involvement in corporate strategy – both beneficial in the Indian heart hospitals. 
• Tort standards.  Even the US medical malpractice system discourages innovation – the “community standard” often locks in expensive and conventional practices.

The Duke University authors conclude that “although most innovation-intensive industries have enjoyed a history of producing new generations of industry leaders, offering dramatic improvements in both capability and affordability, the US health sector has not.  The US health sector, however, may soon resemble other innovation-intensive industries in one important respect: it may find its industry leaders displaced by Indian offerings.  If dramatic cost differences persist between procedures performed in Indian and US hospitals, it might not be long before employers and insurers begin sending patients to India for treatment.”