Matt Leming, Vice President, Commercial Insurance, Swiss Re

In a recent issue of Medical Travel Today we interviewed Wouter Hoeberechts of WorldMed Assist regarding his company’s new partnership with Swiss Re. For this week’s issue, we caught up with Matt Leming of Swiss Re to learn more about the factors that motivated the company to seek out a medical travel partner and his thoughts on the future of the industry.

MTT: Tell us about what kinds of trends and data prompted Swiss Re to add medical travel coverage to your offerings?

Matt Leming (ML): We really started well over a year ago. One of the issues we were primarily concerned with was how to help employer groups control cost.
Claim expenditures are continuing their steep rise. One study we prepared reported a rise of in-patient hospital expenses up 170 percent during a six-year period.

Obviously, there’s a tremendous need to contain costs. Add to that the fact that employers are looking for employees to contribute more to the cost while others are eliminating benefit plans altogether. We see medical travel as a way to help employers help employees.

MTT: Was the decision in any way prompted by employer demand?

ML:  What we continue to see is that there’s a portion of the under- and uninsured marketplace that’s already utilizing the medical travel option.  These individuals are looking for care at affordable prices so that they can obtain procedures they need but cannot afford in the United States.

Our focus is the insured marketplace. We’re interested in how we can bring this additional choice for employees to employers with self-funded plans. I can’t say that we had employer demand when we started product development, but there was considerable market interest.  We bring medical travel to our clients as another option to consider for their benefit plans.

MTT: Do you anticipate people utilizing the coverage for particular types of services or treatments?

ML: Today, our medical travel product is based upon covered procedures in the employer’s plan document.  If the procedure is not currently covered, it will not be covered under the medical travel option.   It’s the employee’s choice of whether or not to utilize this benefit under the employer’s plan. There is a possibility that employers may consider offering a medical travel option for procedures not covered under their plan document, however, this is not the primary purpose of this offering. 

MTT: What can you tell us about the process of choosing a medical logistics partner? What were the capabilities or approach you were looking for?

ML: I can only discuss this at a high level due to the fact that we have signed confidentiality agreements with companies involved in the review. I can tell you that it was a rigorous process. Philosophically, our search criteria looked closely at the approach of the logistics facilitator and the business of medical travel.

We also looked closely at whom they worked with and how they got their business. We needed to know what quantifiable data they used to select their overseas providers. We were also very interested to know how they could grow with us. Really, we looked at every possible aspect of their business and how they would integrate with our business model. We did this over a six-month period and, as I said, it was rigorous.

We approached 10 U.S.-based companies with a Request For Information (RFI) initially and ultimately pared it down to just one: WorldMed Assist.

MTT: Recognizing that it has only been a few months since you’ve begun offering the product, can you tell us what kind of response you’ve received thus far?

ML: There’s definitely been interest in the marketplace. But it is still nascent. Most employer groups are still trying to wrap their arms around exactly what it is. There’s a lot of education that still needs to take place. On our end, we’ve conducted several webinars with existing clients, and we when we meet with our clients, we spend time educating them about medical travel – what it is, what it offers them as an employer, how it works for their employees. There’s also the education of how a logistics facilitator helps with the process. This is completely new to many folks.
(Click here to view Swiss Re’s webinar located in the right-hand column.)

MTT: What’s your understanding of how other insurers are approaching the medical travel market?

ML: I actually just sat on a panel with some folks from Assurant, CIGNA, Aetna, and others at the World Medical Tourism Congress in San Francisco. The big difference between Swiss Re and the others is that we reimburse plans at an excess level and are not a first-dollar carrier. I don’t know their specific plans or schedule, but I can say that the direct carriers are still researching how they will include and integrate overseas provider networks into existing networks. They also have to look at how they’ll account for quality. They have a whole list of issues to address in terms of quality of care that we rely on WorldMed Assist to accomplish. The prevailing attitude is that this is a market that’s moving forward, and people are looking for ways to maximize benefits or make their dollar stretch further.

The insurance organizations do recognize the market’s potential.

MTT: From your perspective, what possible obstacles exist for the growth of medical travel?

ML: The one thing I see that has the greatest potential to slow the growth of medical travel is the issue of medical malpractice. What happens if something happens to me abroad? This is a question that needs to be addressed by the consumer, the employer, and the insurer. We really need to understand what rights an individual has overseas. But really, so much is dependent upon the marketplace—their acceptance and interest in the opportunity of medical travel. One really good thing, in my opinion, is the American Medical Association’s issuance of guidelines for medical travel. They see it happening, and they’ve evaluated the opportunity and have offered constructive guidelines for both U.S. providers and consumers. Hopefully, that will impact consumer confidence.

About Matt Leming

Matt Leming began his insurance career in 1985 at the Travelers Insurance Co. in Hartford, Conn.  In 1990, Matt joined The Hartford Insurance Group’s stop-loss department as chief underwriter.  Six years later, he was promoted to regional vice president of Sales and moved to Kansas City to open and oversee the department’s regional office.  In 2000, Matt was named regional vice president for National Benefit Resources (NBR).  He later worked for an East Coast managing general underwriter as senior vice president of Sales.  In 2007, Matt joined Swiss Re’s Commercial Insurance as vice president/national sales director in the Medical Expense Group.  His responsibilities include strategic producer/distribution management, product development, and market communications. 

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PERSPECTIVES

Beyond Incentives: Seven Strategies to Drive Utilization of Your Medical Travel Benefit Plan

By Amanda Hayes-Kibreab and Natasha Bellroth, Global MD 

You may have noticed that many U.S. employers are investigating whether they can reduce health care expenses by using medical travel.  But how does this work?  Can your business reduce healthcare costs by using foreign providers?  The answer is complicated.  

Medical travel is the practice of patients receiving care for certain procedures in foreign countries.  Medical travel professionals have built networks of distinguished providers in India, Costa Rica, Singapore and Thailand who are accredited and serving American patients.  These providers offer the same procedures by similarly qualified surgeons at state of the art hospitals for 30% to 50% off of negotiated prices in the U.S.  

Employers and medical travel professionals are putting their heads together to design health plans that allow employees to travel for care and save.  The employers who are embracing medical travel generally either go at it alone or collaborate with a medical travel company to design a benefit add on.  Medical travel companies and other industry experts have a lot of experience and expertise to contribute to this process and should be consulted while building a medical travel benefit.  

Here's why.  Medical travel experts generally focus on financial incentives to drive utilization of foreign providers.  However, your business will see better results if you invest early in the process to understand the employee population.  By analyzing your employee demographics and understanding health consumer behavior, you can design a plan that connects with your target beneficiary group and changes their behavior.  

The Anatomy of a Medical Travel Benefit Package 

Health care consumers, both individuals and groups, are demanding competitive prices, more transparency and better quality care.  Beneficiaries and patients have become health care consumers.  The movement is called consumer-driven health care.  Employers that offer health benefits are responding to this phenomenon with packages that let beneficiaries to take greater responsibility for their care and consumption decisions. 

Global health benefits (as it is referred to by some in the industry) generally follow the health care consumerism model of high deductibles, behavior-inducing co-payments, and a health savings account.  Global health benefits go one step further and offer financial incentives for patients who travel abroad for certain procedures.   

The Role Of Incentives 

Generally global health benefit plans use three types of incentives: financial incentives for patients to use preferred providers, non-use dependent incentives to attract beneficiaries.  Like other low-cost health plans, global health benefits give patients more responsibility for health-related decisions.  Enrollees choose from a network that includes preferred out-of-country providers.  Financial incentives encourage patients to choose foreign providers for specific procedures. 

Financial incentives reward patients who have certain procedures performed abroad.  Employers may have a lower co-pay for foreign providers, pay enrollees cash for choosing foreign providers; and/or cover the cost of travel to and from the location of the procedure.  Employers may also let employees use non-vacation or personal time for in-country recovery. 

Non-use dependent incentives attract new beneficiaries with low cost premiums and reward patients for taking advantage of preventative services like annual health check-ups, mammograms, prostate screenings and immunizations.  While non-use dependent incentives won't directly drive utilization of foreign providers, they support the structure of plans that encourage patients to take control of their health consumption.    

There are limits to the ability of financial incentives to increase utilization of preferred foreign providers.  Incentives do not address what drives health care consumption. 

Without understanding the decision drivers at work, global benefit plans may not reduce health care cost significantly.  A benefit plan must narrowly tailored to the target beneficiary demographic to change their behavior.  

Beyond Incentives: Seven Strategies to Designing Medical Travel Benefits That Work 

Below are seven strategies to help employers design a medical travel benefit that will achieve better results than incentives alone.   

1. Assemble A Team Of Medical Travel Experts 

As with all projects, it is critical to assemble the right team.  Designing a medical travel benefit is no different.  Identify medical travel experts and third party benefit administrators who want to collaborate with you.  Having an experienced and knowledgeable team of experts is imperative. 

2. Analyze Beneficiary Demographics  

The foundation of a successful global health benefit is a complete understanding of the covered population, the group's demographics and behaviors, and what drives their health care decision-making.  Approach the benefit design process from the ground up.  

Start by identifying and analyzing the demographics and health care consumption patterns of the employee population.  You may want to survey the group to find out their opinions about their current doctors, traveling to certain countries, and about health care in those countries.  You may also want to find out how the group spends its health care dollars now and what types of incentives are most likely to work.  The answers to these questions will help you build the right global provider network and design an appropriate beneficiary education campaign. 

3. Build A Benefit Program That Responds To The Needs Of Your Beneficiaries 

Armed with the information learned during the investigatory phase, build a benefit plan and a global provider network that reflects the needs and consumption patterns of the beneficiary population.  For example, if you learn that the beneficiary population is generally over weight and has a proclivity for travel in Latin America over Asia, that information may be used to build a plan that encourages beneficiaries to investigate weight loss surgery in Costa Rica and Mexico.  Surgeons in these countries are expert in bariatrics.  You may also learn that your employee population is more likely to have orthopedic issues and favors Asia.  In that case, a plan that highlights the orthopedic expertise of doctors in India, Singapore and Thailand is more likely to be utilized.  Either way, the plan should specifically address the beneficiary population to increase the likelihood of utilization. 

4. Educate Employee About The Benefits Of Medical Travel 

Work closely with medical travel experts to design and implement a comprehensive employee education campaign that demonstrates the advantages of using foreign providers and the added incentives and benefits available through the medical travel plan. 
 
5. Create A Tiered Provider Network 

Create a tiered provider network that favors higher quality, lower cost providers with lower co-payments.  Enrollees that select preferred foreign providers for specific treatments may have lower or no co-payments associated with that service.  Tiered provider networks are a common health care benefit strategy that can be utilized to encourage beneficiaries to use foreign providers for certain services.  

6. Increase Provider Transparency And Patient Responsibility 

Increased transparency and patient responsibility enhances savings.  Enrollees can make cost savings choices about whether or not to see a doctor (with information about disease self-management), which doctor to see (with information about provider quality, success rates, and costs), and disease treatment and management (with information about symptoms, treatments, risks, and costs).  Plan providers should be encouraged to be transparent with their quality data and pricing.  Giving enrollees the information necessary to make important care decisions aligns their interests with the payer.  By aligning the interests of the consumer and payer, excesses can be eliminated and costs can be contained. 

7. Implement Internet-Based Care Management Tools 

Finally, easy-to-use internet-based care management tools encourage efficient use of wellness programs, on-line nurses, on-line training and more.  Recent studies indicate that patients welcome more and better information that is easily accessible.  Patients indicate that they will use salient and easy-to-use information to make informed choices about their health care consumption.*  By making relevant information accessible and easy-to-use, patients can make more efficient health care consumption choices. 

Conclusion 

Consumer-driven health care is here to stay.  The ability to maximize the benefit of cost containment strategies depends on the ability to innovate and respond to new information.  Health care consumers should not be underestimated.  They are discerning and scrutinizing.  Their behavior is not monolithic.  To predict future consumption, health care payers should carefully analyze beneficiary demographics and consumption patterns and employ sophisticated benefit design strategies that address those findings.  Without a firm understanding of the covered population, incentives alone are insufficient to drive the kind of utilization necessary to realize measurable savings from medical travel. 

* Consumer-Oriented Strategies for Improving Health Benefit Design: An Overview, Prepared by Stanford University-UCSF Evidence-based Practice Center, Stanford, CA for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, July 2007. 

About the Author

Medical travel expert Amanda Hayes-Kibreab helps Americans access premium medical care from some of the world's elite surgeons at value-based prices. Visit Global MD's website today at www.yourglobalmd.com and discover how Global MD can help you reduce healthcare costs and improve quality of care. Call today at 800-903-5690 to speak with an expert Care Coordinator about how we can help you and receive Global MD's Free Guide to Medical Travel.

Copyright Notice© Copyright Global MD, Inc. August 2008

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INDUSTRY NEWS

Trade group's "accreditation" Could Confuse Medical Tourists

Earlier this week, American Medical News took aim at the Medical Tourism Association’s (MTA) recent efforts to claim an accreditation program.

Written by Kevin B. O'Reilly, who covers medical ethics, patient safety and health care quality improvements for AMNews, the October 6 story examines the evolution of the MTA’s program from what began as an “accreditation program,” and later morphed into a “certification” effort. Full Story

www.BOOMj.com Launches Survey About Medical Travel Sponsored by BridgeHealth International 

BOOMj, Inc. www.boomj.com (OTC Bulletin Board: BOMJ) announced today that its website http://www.BOOMj.com, the leading social network for Baby Boomers and Generation Jones -- and now one of the top 50 social networks according to ComScore -- will offer a comprehensive survey about medical travel on http://www.boomj.com, sponsored by Bridge Health International. www.bridgehealthinternational.com

Every area of business is moving toward a global marketplace, and healthcare is no different. Historically, citizens from around the world came to the centers of excellence in the United States, and that of course continues. However, today's high cost of U.S. hospital care and the advances in medical technology around the world are encouraging U.S. Citizens to travel outside the United States for major elective health procedures. Many Americans are boarding planes bound for exotic places -- not for sightseeing or vacation but for knee and hip replacement surgery, bariatric procedures, and heart by-pass surgery.

"Teaming up with BOOMj on a medical travel survey will be invaluable in understanding the perceptions, knowledge, and needs a large consumer audience has for our service," said Victor Lazzaro, Jr., chief executive officer for BridgeHealth International, Inc. "As a leader in the medical tourism space, BridgeHealth places a high premium on the feedback it gets from potential clients in order to better educate and serve its current ones. Even after sending thousands of clients abroad for medical care with exemplary results, we are constantly looking for ways to improve our bridge to world-class healthcare."

Wendy Borow Johnson, president of BOOMj Inc., added, "BridgeHealth International is a great partner."

BridgeHealth has assembled the most extensive provider network in the industry, with more than 25 hospitals and 600 physicians, dentists, and health professionals in more than 10 countries - and growing. The network of accredited facilities and world-class practitioners allows U.S. citizens to take advantage of the benefits of medical travel without the uncertainties and guesswork.

"We believe we have an opportunity to both educate and to learn more about Baby Boomer needs and concerns,” Johnson added. “We are pleased that Bridge Health International is partnering with www.boomj.com to get this important survey out to our demographic. To encourage participation, BOOMj members will receive 500 reward points for completing the survey. BOOMj will also reach out to its expert network to further distribute the survey over the next two months."

About BOOMj, Inc.TM
BOOMj, Inc. (OTC Bulletin Board: BOMJ) owns and operates BOOMj.com http://www.boomj.com the leading niche portal with social networking and e-commerce serving Baby Boomers and Generation Jones. BOOMj.com integrates content, social networking, e-commerce, and advertising in health, finance, politics, technology, entertainment, travel, and lifestyle. BOOMj, Inc. also operates LocalAdLink http://www.localadlink.com, bringing local advertising to the global market and I-Supply http://www.I-Supply.com, the comprehensive e-commerce solution for websites and social networks. For more information regarding the company, please visit http://boomj.ir.stockpr.com/

About BridgeHealth International, Inc.
BridgeHealth International, Inc. (BridgeHealth) is the premier service provider in the burgeoning medical travel industry, founded in 2007 with a vision "to create a trusted bridge to the world of international healthcare." BridgeHealth maintains an international network of physicians and select hospitals and clinics -- the World-Class Provider Network(TM) offering exemplary customer service, significant savings on high value medical procedures, a clear, fixed price and outcome-based measurement systems. BridgeHealth provides access to select international providers for both businesses and individuals. BridgeHealth serves health plans, insurance carriers, employers, third party administrators, individuals accessing benefits via voluntary benefits plans, health and affinity card programs or Consumer Directed Health Care Plans (CDHP), and individual consumers seeking medical travel options

South Korea Creates Self-Governing International Development, Tourist Destination

Tourists from around the world will soon have the opportunity to be among the first to experience the next major global destination—a clean, green natural environment with resort-style living and cutting-edge healthcare and education—Jeju, South Korea.

JDC has recognized that people from around the world are becoming savvy healthcare consumers—looking for the best treatment, in the best locations, for the best price. JDC’s “Healthcare Town” will offer medical tourists a variety of health and wellness therapies. The complex will also be home to a research and development park, which will include a National Anti-Aging R&D Center, Bio Medical R&D Center, and New Medicine R&D Center.

“We believe that Jeju’s beautiful, clean natural environment, coupled with its proximity to some of the world’s most important markets, make it an ideal location for international development,” said Kyung-Taeg Kim, CEO and Chairman of JDC. “While JDC is promoting several important development projects on the island—tow of the most exciting are our new English Education City and Healthcare Town.”

Healthcare Town is expected to provide significant economic benefits for Jeju over the long-term. According to McKinsey and Company, medical travel market gross revenues were US$40 billion worldwide in 2004 and are project to grow up to US$100 billion by 2012. In line with the growth of the global market, Korea’s medical tourism sector is aiming to attract 100, 000 tourists by 2012, toping US$37 billion.

JDC’s Healthcare Town will cost approximately US$315 million to complete. About US$99 million will be an investment from the South Korean Government and US$220 million will come from private investors.

“Healthcare is no longer simply a regional issue,” said Kim. “The medical travel market is growing rapidly every year, and we believe that our international medical facilities, which focus not only on medicine, but also on wellness, will be among the premier healthcare facilities in the world. Every person should have the right to receive cutting-edge care at a fair-price.”

JDC will begin construction of a first-of-its-kind English Education “City” in 2009. The City, will include a settlement-type English-speaking town, which will be equipped with residences, commerce and convenience functions, as well as educational facilities. In addition to more than 12 English-only primary, middle, and high schools, English will be the only language spoken at public buildings, shopping centers, and parks. The goal is to create a total English-language immersion experience for students.

“We know that in today’s global economy, English-language proficiency is a vital skill for professionals all around the world,” said Kim. “Until now, many families faced significant economic hardships to send their children to schools that provided a quality English education, and in Korea, in many cases, there simply are not enough schools to meet the rising demand of middle class families for this type of instruction. We think this project will meet local needs and provide multi-lingual professionals for corporations around the world.”

Doctations Electronic Health Record Technology Receives 2007 Certification Commission for Healthcare Information Technology

The Certification Commission for Healthcare Information Technology (CCHIT®) recently announced that Doctations’ DoctPatientNetwork.com v1.0106062008 is CCHIT Certified® and meets the Commission’s ambulatory electronic health record (EHR) criteria for 2007. Ambulatory EHRs are designed for physician offices and clinics where most Americans get their healthcare. CCHIT – an independent, nonprofit organization – is the Recognized Certification Body in the United States for certifying health information technology products.  

In the second year of the program’s operation, the criteria and testing have been significantly enhanced. The Commission added 96 criteria to the 151 original requirements from last year.  As a CCHIT-certified product, DoctPatientNetwork.com has been tested and passed inspection of 100 percent of a set of updated criteria for functionality, interoperability, and security.

“For 2007, the Commission raised the bar from the previous year’s criteria.  Ambulatory EHRs now must include electronic prescribing, demonstrate an ability to receive lab results, and show enhanced patient safety, quality, and security features,” said Mark Leavitt, M.D., Ph.D., chair, CCHIT. “Investment in 2007 certified ambulatory EHRs gives providers even more powerful tools to improve quality, safety, and efficiency while protecting the privacy of health information.” 

The CCHIT Certified mark — a “seal of approval” for EHR products — provides the first consensus-based, government-recognized benchmark for ambulatory EHR products. By looking to products with the CCHIT Certified seal, physicians and other providers can reduce their risk in selecting an EHR product, allowing them to focus their evaluation on the special needs of their practices.

“We believe that great healthcare begins with a strong doctor/patient relationship, and we are connecting doctors directly to their patients to achieve better quality medical care,” said Dr. Louis Cornacchia III, M.D., F.A.C.S., and president and CEO of Doctations, Inc. “The CCHIT certification process has become the gold standard in the industry and helps assure our physician clients that they've selected a reliable solution that has passed a thorough inspection process for functionality, interoperability, and security. We believe that carrying the CCHIT seal is a validation of our deep understanding of what's required to help physicians deliver safer care while improving the efficiency of their practices. With Doctations, our physician users and their patients can take advantage of the power of collaboration while being sure that their medical records and communications are accessible and completely secure.”

CCHIT’s certification compliance criteria and its design for a certification inspection process have been thoroughly researched, taking into account the state of the art of EHRs and available standards, and comparing certification processes in other industries and other countries. The inspection process is based on real-life medical scenarios designed to test products rigorously against the clinical needs of providers and the quality and safety needs of healthcare consumers and payers. One script, for example, recreates a scenario of an elderly man with poorly controlled diabetes, hypertension, and other chronic conditions in order to test EHR functions such as potential adverse drug reactions, disease management, and treatment plans.

A video overview of the Doctations’ service is available at www.docpatientnetwork.com.  For more information about CCHIT or certification, go to www.cchit.org.

About Doctations
Doctations™ Inc. is a company dedicated to creating innovative new, Internet-based means of transacting healthcare. The goal is to make healthcare more accessible to patients and to substantially improve the process of generating medical documentation in all venues of healthcare: the physician’s private office, the physician group’s office, the ambulatory surgery center, and hospitals. We bring users the benefit of electronic medical records without the burden or expense of difficult-to-use software. We also believe that free-market forces, along with appropriate government regulation, are the best means of achieving improved doctor-patient relationships. We believe that the Internet provides an excellent means for achieving this vision and for catalyzing change that will improve healthcare for patients and doctors. For more information, please visit: www.doctations.com.

About CCHIT
The Certification Commission for Healthcare Information Technology (CCHIT®) is an independent, nonprofit organization that has been named by the federal government as the Recognized Certification Body for health information technology. Its mission is to accelerate the adoption of health information technology by creating a credible, sustainable certification program. The certification requirements are based on widely accepted industry standards and involve the work of hundreds of expert volunteers and input from a variety of stakeholders throughout the healthcare industry. More information on CCHIT and CCHIT Certified® products is available at www.cchit.org.

“CCHIT®” and “CCHIT Certified®” are service marks of the Certification Commission for Healthcare Information Technology.

Lawmaker Backs More Support for Medical Tourism
The Korea Times

A lawmaker said Wednesday that the medical tourism deficit caused by the gap between inbound and outbound medical tourists has been widening in recent years. Rep. Choi Young-hee of the main opposition Democratic Party (DP) called for a bigger government role in helping reduce the deficit and promote Korea as a medical tourism hub for foreigners.

For the rest of the story, click here.

Quality Council of India Launches Standards for Healthcare and Wellness Industry

The Quality Council of India (QCI) launched the Standards for the Indian Health and Wellness Industry, at the Quality @ Wellness workshop, held during the India Retail Forum (IRF) event, at Mumbai on September 17, 2008. Girdhar J. Gyani, secretary general of QCI and CEO of National Accreditation Board for Hospitals & Healthcare Providers (NABH) handed over the health and wellness standards structured by the QCI to R. K. Srivastava, M.D., director of General Health Services, Ministry of Health & Family Welfare, Government of India, to launch the same officially. Many prominent members of the healthcare and wellness industry were present at this momentous occasion, including: Somnath Das, COO Manipal Cure & Care, Anand Rangachary, M.D., Frost & Sullivan, Rakesh Pandey, CEO, Kaya Clinic, Peter Baker, CEO, H&B Stores (Dabur), Ratan Jalan, CEO, Apollo Health and Lifestyle, Ashutosh Garg, C.M.D., Guardian Life Care, Sanjeev K. Chaudhry, M.D., CEO, Religare Wellness, Ashish Kripal Pandit, CEO, VLCC, Madhukar Gangadi, M.D. founder and CEO, MedPlus, Viraj Gandhi, M.D., Medicine Shop, Gautam Jatia, CEO, Emami Frank Ross, Gautam Thadani, director, 98.4.

This launch comes post the announcement by Giridhar Gyani, at the Australian Council on Healthcare Standards International (ACHSI) certification of MCC, in April this year, regarding the QCI’s plans to create a standard for wellness in India on par with standards observed by healthcare industry in other parts of the world. The Indian wellness standards are first of its kind, even internationally, as there is no similar standard in existence abroad. Girdhar Gyani, secretary general at QCI, said, “The Indian health and wellness standards developed by us cover all aspects of the healthcare and wellness industry so comprehensively that these standards will also serve as a reference point for other international accreditation agencies to develop standards in the wellness space.”

The standards for health and wellness are a set of regulations applicable for accredited healthcare and wellness companies offering services to consumers in India. This launch is considered to be a very important development because it will establish credibility globally for the Indian health and wellness industry. This accreditation would now serve as an assurance of quality services from a reliable, safe, and quality conscious operator to the consumer desiring the best.

The standards for health and wellness accreditation will require consideration of a variety of criteria for wellness service providers. These would cover aspects like technology, trained manpower, infrastructure, customer safety, processes and controls, and statutory and regulatory compliances. The standards would lay down stringent regulations for service providers to obtain mandatory full accreditation of the total services offered.

The launch of the standards is the result of the initiative taken by major wellness industry players who conveyed the need for an indigenous standard for health and wellness in India. Somnath Das, COO, MCC, said, “It is not always feasible and economically viable for small Indian wellness operators to obtain accreditation from international agencies. Therefore we felt a strong need to suggest that the QCI frame an Indian standard on par with the international standards, which could be implemented by all in our industry. These standards would thus go a long way in enhancing the growth and credibility of the wellness industry in India, and also build consumer trust in a wellness brand.”

About the Quality Council of India
Quality Council of India has been set up as a joint initiative of the Government of India and the Indian Industry. It is a non-profit, autonomous body registered as a society under the Societies Registration Act.

International Herald Tribune Features Medical Travel

The International Herald Tribune recently published a special supplement called “Health Care in Asia.” Included in the supplement was a five-part feature exploring medical travel options in Asia. The feature can be viewed through the following link:

1:9-25-2008 ASIA HEALTH CARE 1251.pdf
2:9-25-2008 ASIA HEALTH CARE 1251.pdf

BridgeHealth Presents as the SIIA Conference
The Self-Insurance Institute of America, Inc. (SIIA) hosted its National Educational Conference & Expo this past week in Phoenix, Ariz. In addition to traditional topics such as regulatory issues and worker’s compensation, this year’s agenda also featured discussions of medical travel as an option for self-insurers.

The conference’s international track featured six sessions exploring everything from Delivering International Healthcare Around the World and Behind the Global Curtain: Previewing Patient (Employee) Experience With Global Health
Care Programs.

The opening international session, International Plan of Mystery: What Self-Insured Employers Need to Know About Global Health Care Programs, was co-presented by Thomas Emerick, president, Emerick Consulting, LLC, David Hom, chairman of the Center for Health Value Innovation, and Victor Lazzaro, CEO BridgeHealth International, Inc.

Victor Lazzaro was kind enough to share the PowerPoint portion of the presentation with our readers. It can be viewed at the following link:

Powerpoint Presentation

Companion Global Healthcare Expands Hospital Network for Individuals, Employer Groups

Columbia, S.C. – Medical travel company Companion Global Healthcare Inc. announced today that Min-Sheng General Hospital in Taiwan has been accepted into its network of international hospitals that offer surgery and other care to American patients at affordable rates.

The affiliation means Companion Global Healthcare’s individual clients and members of its employer groups may choose Min-Sheng, along with other hospitals in the Companion Global Healthcare network, for obtaining accredited medical care abroad.

Min-Sheng (www.e-ms.com.tw/gin_kwo/intro_english.html) is a state-of-the-art, 600-bed facility that holds the prestigious Joint Commission International (JCI) accreditation. Min-Sheng, with 106 physicians certified in a variety of specialties, becomes the 11th hospital to join Companion Global Healthcare’s network. Other network hospitals are located in India, Costa Rica, Singapore, Thailand, Turkey and Ireland.

All network hospitals are JCI accredited, and all have completed Companion Global Healthcare’s extensive credentialing process. The hospitals’ average fees are substantially lower than those at many U.S. facilities, up to 80 percent less in some cases.

“Min-Sheng hospital has the very latest in medical technology and a top-notch International Services staff that is proficient in English,” said David Boucher, president of Companion Global Healthcare. “It is an ideal fit for our network and our company’s mission, which is to provide members of our self-insured employer groups and our individual clients with as many choices as possible for obtaining fully credentialed medical care at affordable prices.”

Companion Global Healthcare helps Americans access lower-cost health care at its network hospitals by making travel arrangements, identifying providers and offering other services. It contracts with self-insured employers that include the Companion Global Healthcare network in their employee benefit plans as a way to hold down rising health care costs for themselves and their workers.

“We are proud to become part of Companion Global Healthcare’s international hospital network,” said Dr. Fred Yang, Min-Sheng General’s CEO. “Min-Sheng offers the most advanced medical practices, and with daily non-stop flights from the American West Coast, it is easily accessible.”

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DESTINATION

Robin Elsham is busy preparing for a trip to East Asia. We look forward to his upcoming first-hand reports from Korea and Taiwan. In the meantime, you may access previous stories at the following links.

• Guatemala
• New Zealand
• Monterrey
• Panama
• Philippines
• Malaysia
• Changes in air travel certain to cause major changes in medical tourism industry
• Inflation's Threat to Medical Tourism
• Adopting a Global Perspective

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MEDICAL SPOTLIGHT: Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

According to The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism (www.surgeongeneral.gov/topics/deepvein), released last month, deep vein thrombosis (DVT) and pulmonary embolism (PE) affect an estimated 350,000 to 600,000 Americans each year. Those numbers are expected to climb as the U.S. population ages. Together, DVT and PE contribute to at least 100,000 deaths each year.

Most everyone in the medical travel field is familiar with DVT and PE as the risk of occurrence increases when an individual is hospitalized or confined to bed rest, has undergone major surgery, or is traveling for several hours. Medical travel typically involves all three of these risk factors and should, or course, be of concern to patients and providers.

Edward Watson, M.D., executive chairman and director of Medtral New Zealand agrees. “Any prospective medical travel patient should be aware of the risks involved,” says Watson. “Their providers should certainly screen for risk factors and put in place preventative measures. The same message is contained in the AMA guidelines for medical travel (http://www.ama-assn.org/ama1/pub/upload/mm/31/medicaltourism.pdf), and we whole-heartedly agree with it and do our best to abide by it.”

Specifically, Medtral New Zealand uses the following procedures to prepare all patients for international medical travel:

• Screens patients for risk factors before they travel, including looking for a past history of blood clots, malignancy within the past two years, limited mobility, blood clotting disorders, or large varicose veins
• Offers advice on reducing the risk of DVT by maintaining fluids but avoiding alcohol during flights, wearing loose clothing, avoiding sitting with legs crossed, and some degree of mobilization while flying
• Ensures patients are only flown home when appropriate by providing rehabilitative services and assessment on the ground in New Zealand
• Provides all patients with thrombo-embolic deterrent stockings (TED stockings), also known as graduated compression stockings, for their return journey.

Watson adds, “It is worth noting that the risk of a DVT is thought to be similar between air travel and other modes of transport such as car and train travel. It’s the length of time of immobility and lack of fluids that are constant risks in all cases to the development of DVTs.”

Joseph Barcie, M.D., president of Centralized Services, International Hospital Corporation concurs.

“No matter what the mode of transportation, sitting motionless for long periods of time may put some travelers, whether they are medical tourists or recreational tourists, at an increased risk for DVT, usually in the calf or thigh,” says Barcie.

Barcie adds, “For travelers who are at risk either due to conditions such as cancer, varicose veins, pregnancy, excessive weight, taking birth control pills or hormone therapy, should consult their personal physician and discuss other precautions. In some cases these may include duplex ultrasound or venography.”    

 But precautions are recommended for all travelers, even those in good health. “Travelers can reduce their risk of getting DVT, by taking some simple precautions on long trips,” says Barcie. “Last year I took my parents back home to Spain to celebrate their 50th wedding anniversary. Even though they are in good health, I made sure that each of us got up and walked around every 90 minutes or so during the eight-hour flight.  For my mother, who has varicose veins, I made sure she wore TEDS stockings, and I gave each of us a couple of aspirins for the trip. Everything went great.”

FACTS ABOUT DVT AND PE

Nine out of 10 cases of pulmonary embolism are caused by blood clots that form in the legs and then travel to the lungs. More than 600,000 people in the United States have a pulmonary embolism each year, and more than 10 percent of them die from it. Most who die do so within 30 to 60 minutes after symptoms start. Pulmonary embolism occurs equally in men and women. The risk of having a pulmonary embolism doubles for each 10 years after age 60.

Courtesy of International Hospital Corporation, http://www.internationalhospital.com

Dr. Sebastien Diaz, Medical Director, StarHospitals.net notes that there are certain surgical procedures that are more often associated with DVT than others.
Diaz says, “Patients undergoing major pelvic or abdominal surgery, especially for cancer, orthopedic procedures involving hip and knee, or neurosurgical procedures should be particular aware of and alert to the risks of DVTs.”

Is there a topic you’d like to see featured in an upcoming MEDICAL SPOTLIGHT? Let us know at editor@medicaltraveltoday.com

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UPCOMING EVENTS

2008 HBS Health Industry Alumni Conference

The Joseph B. Martin Conference Center at Harvard Medical School

Thursday, November 6
Friday, November 7
Saturday, November 8

The HBS Health Industry Alumni Conference of the HBS Health Industry Alumni Association is open to all Harvard Business School alumni and spouses, current HBS students, and faculty. We have also extended registration on a first-come first-served basis to alumni and current students of Harvard Medical School, Harvard School of Public Health, and the John F. Kennedy School of Government. The conference is not open to any other individuals.

The Saturday session features the following presentation;
Medical Tourism and Telemedicine: International Outsourcing: A Solution for Health Care Access and Cost Problems?

Medical travel is no longer for cosmetic surgery and spas. An estimated half-million Americans seek medical care each year abroad. This is a thriving $60 billion global business, with a growth rate of 20 percent according to Lancet. US insurers can save considerably by reimbursing much lower expenses for elective procedures overseas.

To learn more and to register for the conference, click here.

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Developers Symposium on Cell Phone Use in Healthcare Planned for
November 2008

November 25-26, 2008
The Ambassador Hotel, New Delhi, India
The Center for Cell Phone Applications in Healthcare (C-PAHC), a division of Medical Records Institute, will hold a two-day symposium on phone applications in healthcare on November 25-26, 2008, at the Ambassador Hotel in New Delhi, India.

"Cell phone applications are the next big wave in healthcare," says C-PAHC executive director C. Peter Waegemann. "Hundreds of systems are already available and more are under development - this field is about to explode onto the international healthcare scene. This symposium will describe the range of applications and their hurdles and impact."

Programming will highlight the applications currently available for healthcare and discuss their potential to improve efficiency and quality of healthcare in the international marketplace. Discussion topics will include specific mobile phone applications for patients, doctors, and other healthcare professionals, and how to integrate already successful cell phone applications into existing health information technology (HIT) systems.

Hosted by C-PAHC (Center for Cell Phone Applications in Healthcare)
For more information visit www.C-PAHC.com

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Asia’s Biggest Landmark Healthcare Congress – Global Health Conference (GHC) 2009—Announces Its Agenda

Disease management will directly impact the future models of care. But what shape and form these models will take is of question. Will we see more of specialized hospitals? If so, where will they be located? How will innovative ‘disruptive’ technologies help the future healthcare cities and hospitals cater to and deal directly with new disease management?

The future of healthcare delivery lies mostly in disease-based intervention programs. The healthcare cities and hospitals of the future will greatly benefit from a clearer understanding of how to effectively integrate disease management into future facilities and core competencies to be built.

Another contributing factor that will shape future care models is the growing number of highly valued patients globally – many of whom are crossing international borders in search of quality care and access. How should hospitals convert their centers of excellence to cater to this growing sector? How can they adequately build capacity and expertise to ensure they are able to meet new and growing demands?

Leaders in global healthcare will be tackling these issues head-on at Asia’s biggest landmark healthcare congress, Global Health Conference (GHC) 2009, which will feature two co-located events, “Healthcare Cities & Hospitals of the Future” and “Crossing International Borders” (February 23-26, 2009, Singapore).
For more information on the event, please visit www.magenta-global.com.sg/healthcare or kindly contact:

Attn: Ms Catherina Koh
Conference Director
Magenta Global Pte Ltd
DID: (65) 6391 2539
Email: catherina.koh@magenta-global.com.sg with subject code “GHC-MTT”

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UAE Set to Attract Medical Tourism

DUBAI – The Ministry of Health in the United Arab Emirates (UAE) is at the forefront of developing the necessary infrastructure to attract medical tourists. That’s according to Nasser Khalifa Al-Budoor, the assistant undersecretary for International Relations and Health Affairs at the UAE Ministry of Health.
“We have a department here establishing this,” he said. “We’ll be ready to start receiving patients coming here with their families, whether for plastic surgery, knee replacements, or cardiovascular. We have so many hospitals, with Johns Hopkins, Harvard, some of the biggest names in the world are here doing work.”
Al-Budoor acknowledged that in the past the Middle East would never have been considered a destination for medical tourists, but the situation for the UAE had changed completely.

“People would go to London for shopping with their families and receive a check-up or undergo a small operation. Now Dubai is ready for this,” he said. “We have so much to offer now, with certified hospitals from international agencies.”

Health tourism is a global phenomenon that is allegedly worth $50 billion annually depending on who you talk to. The actual size of the industry is up for discussion. This is but one of many issues in an area of medicine that is attracting a huge amount of attention.

These issues are set to be discussed at the Healthcare Travel Exhibition & Congress 2008 to be held at the Al BustanRotana Hotel in Dubai from November 2-4. SietskeMeerloo, marketing manager at Institute for International Research (IIR) Middle East, indicated that the event is expected to provoke some heated debate.

“There are so many issues relating to medical tourism, and because the area is developing so quickly it’s becoming essential that hospitals, insurers, and policy makers, to name a few, work together closely to streamline processes to cater to this market,” she said. “We’re expecting a great deal of debate at the event, and hopefully we’ll see some practical solutions adopted for many of these issues.”

Medical tourism is already proving to be highly competitive with developing nations offering cheap, quality healthcare. The Ministry of Health in the UAE believes it can find a niche in this market and has endorsed the Healthcare Travel Exhibition & Congress 2008 in which it’s participating.

“I’m really happy to see IIR [highlighting] medical tourism for the first time,” Al-Budoor said. “We have so many hospitals ready to receive patients from abroad.”

For further information please contact:

Peter Donnelly
Science Correspondent
Life Science Division
IIR Middle East
T: +971 4 407 2743
M: +971 50 429 7105
peter.donnelly@iirme.com

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Thailand Convention & Exhibition Bureau to Sponsor the 2009 World Medical Health Tourism Conference in Phuket

Thailand Convention & Exhibition Bureau (TCEB) is set to sponsor the World Medical Health Tourism Conference: A New Way Forward, which will be held in Phuket, Thailand, September 2009.

TCEB’s participation and sponsorship in this internationally diverse networking event will aim to promote Thailand on an international scale as a medical tourism destination and a preferred venue for international MICE events. The whole of Phuket Island is getting behind the conference, which will cater to more than 1,200 delegates. Local supporters range from local community groups, tourism operators, and many of the major hoteliers and resort owners, namely Woraburi Phuket Resort, Millennium Resort Patong, The Moevenpick Resort, Karon Beach Resort of Kata Group, Aquamarine Resort, Cape Panwa Hotel, and Andaman Seaview Hotel group.

Phuket, dubbed as the medical tourism hub in Asia, is the ideal location to hold the conference because of its infrastructure, capacity to host a massive number of international guests, and the availability of cutting-edge technology and internationally trained medical experts manning their world-class medical facilities. Sometime within the next month the floor plan or layout for exhibitors at the venue, Hilton Phuket Arcadia Resort & Spa, will be published online, and application forms will be available for the exhibitors to download from the website.

Many pre-conference and post-conference activities had been planned for the conference, which early estimates expect to bring a windfall to Phuket of about U.S. $10 million over the two-week period.

Interested parties are advised to visit the conference website: www.sosmedicaltourism.com for more information.

Alternatively, for more information call + (66)76-289-800, to request a printable registration brochure by email sosmedical@sosmedicaltourism.com or sosmedical@ymail.com