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SPOTLIGHT
Peter Hayes

Peter Hayes, Director of Associate Health & Wellness Hannaford Bros. Co.

This interview provides an employer’s perspective and approach to the growing phenomenon of global healthcare. Peter Hayes is the director of associate health and wellness at Hannaford Bros. Co., a supermarket chain operating in the northeast. Hayes has worked for Hannaford Bros. Co. for 20+ years and has managed the company’s healthcare for approximately 15 years.

During the past several years, Hannaford Bros. Co. has received numerous national awards in recognition of the company’s commitment to working collaboratively with healthcare providers and vendors in delivering health benefits that are focused on quality. Hannaford Bros. Co. has been successful in this arena by focusing on innovative solutions for patient advocacy and disease management programs, and most recently awarded the Gold designation for health promotion programs by the National Business Group on Health.

Our publisher, Laura Carabello, recently had the opportunity to talk with Hayes regarding the company’s approach to medical travel.

Laura Carabello for Medical Travel Today (MTT): Tell me about your role atHannaford’s, how it’s changed with the advent of value based design and your interest in medical tourism.

Peter Hayes (PH): My official title is director of associate health and wellness. I’m responsible for all of the health benefits and other related benefits on the health promotions side. As you know, we are a supermarket chain operating in five New England states with about 150 stores and around 26,000 employees. My job is to think about strategy around healthcare; specifically, how we continue to offer high quality, affordable healthcare for our associates and business.

Our big focus is getting folks the right care, at the right place, at the right price. Right now we have about a 30-50 percent health dividend. We think we can dramatically reduce both the company’s and our employees’ healthcare costs while improving quality.

We see the current cost of healthcare divided between two areas: the first area deals with the things you and I can do each and every day and the choices we make that affect our health. According to Medicare, about half the healthcare costs increases over the last decade are directly linked to weight, nutrition and exercise. These are costs we can directly impact on a daily basis.

The other area is simply the cost of healthcare.

Hannaford’s is owned by Europeans, and our European owners take a look at what the United States is spending on healthcare per capita versus what they contend with over there. There’s currently about a two to three thousand dollar difference per capita in cost between the European market and the US. One out of every five dollars is healthcare related, versus Europe and the other 30 most industrialized countries where healthcare is under 10 percent. In other words, their healthcare cost exactly half of what it costs in the US.

Of course, there’s more to healthcare than just cost. There’s also quality.

If you look at our quality, and measure quality, you’ll find we are really good at getting really, really sick people better. But if you look at our quality measured in how long can you expect to live in the US, versus those other 30 industrialized countries mentioned before, without a disability due to a chronic illness, we are ranked dead last. We’re spending far more and getting far less, which is an economic model for disaster.

So when we really think about that healthcare dividend, we think of it in two ways: 1) how do we get people healthy and taking care of themselves?, and 2) how do we really start to drive the global value and get rid of the big price differential between here and the rest of the world?

That naturally leads to the conversation about the journey to find really high quality efficient providers, and find a way to pass those values on to our members. This isn’t new. It’s a journey we started four years ago.

MTT:That certainly puts you ahead of the curve.

PH: Years ago, we started working with the primary care doctors in our community in the state of Maine. We actually got all the primary care doctors in Maine to come together and voluntarily put out a quality rating system. They agreed to participate with both their quality and cost information, sending a message to our members that we believe in win-win scenarios. We know that if you go to the higher quality doctor, it’s a better result.

If you look at it per episode and at resources consumed, they are about 16 percent more efficient that those that aren’t. We tell our members, if you use those doctors, we’ll give you a 10 percent higher benefit.

That’s something we’ve done for the past four years.

Last year we moved into specialists. Specialists control 80 percent of the cost. We started to identify who the higher quality, more efficient specialists are, and we incentivized people to use them. Essentially, if you go to these physicians, we give you a higher benefit.

At the beginning of this conversation you asked me if my job really changed and it really hasn’t changed. This approach has been part of our strategy for a long time and we have been taking incremental steps forward. But I will tell you what have been the most remarkable learning experiences, and probably one of the most rewarding things that have happened in the last couple weeks: we announced the addition of medical tourism to our benefits offering.

MTT:When did you make that announcement?

PH: Let me give you a little background so you can appreciate the speed with which this happened.

It all really started in February 2007 when Reader’s Digest had an article saying, “Here are the prices and procedures in the US…and here are the prices of those procedures that we think are similar quality outside the US.” By April, I became aware of a company called Medretreat.com, which acts as a business model online. They essentially said, we will provide concierge services and set up medical tourism trips, and here are the procedures and locations. If you want to go we will arrange it. Around the same time I started conversations with our health plan, Aetna.

Their initial reaction was, “No, we don’t have anything to offer and we are really uncomfortable with this direction.”

But we started a dialogue and we continued to have conversations. By August, we moved them to commit to partnering with us on the effort and confirmed that they would help us find partners to work with abroad.

That was followed up with visits to some hospitals in Singapore in the mid-fall. We conducted some focus groups and other research, and then announced the program to our members in September 2007. So, from February to September we took the idea of global healthcare from an idea to actual reality.

MTT:Wow, that’s fast.

PH: What’s even more amazing is that we have not yet had a single patient go abroad.

Since the announcement, however, two absolutely remarkable things have happened.

The first happened after a small blurb about what we’re doing appeared in The Wall Street Journal. Right after that, I got a call from a hospital in Wichita, Kansas saying, ‘We saw that article and we just want you to know that we have decided that we will do knees, hips and all heart procedures except for bypass for $10,000. Just like Singapore.”

Then, about two days after that, I got another call from another start up company, HealthplaceAmerica, that has an organized network of one or two dozen hospitals across America making the same offer.

I just found it remarkable how quickly the market responded.

MTT:Can you tell us the advantages you see for the patient through this type of care and what kind of benefits they are seeking if they opt to go out of the country?

PH: The analogy we use is that the average hip replacement, for us, is about $45,000. Now, of course, there’s also deductibles and co-pays, but for the most part, we have what’s called a “max amount out of pocket.” Eventually, a patient reaches a point where they are only going to pay up to a certain amount out of their pocket.

So in this case, if they have that procedure done in the US they are going to be looking at a potential out-of-pocket cost between $2,500-$3,000. But now, we make the offer that if you want to go to Singapore, we will pay for everything and waive all co-pays, all deductibles, and all out-of-pocket expenses. The message to our members is that we are trying to do things to make healthcare more affordable.

MTT:That’s a nice incentive. But you said you haven’t yet sent any patients abroad. What reasons do you see behind that?

PH: I think there are a couple of reasons. First, it’s early in the year. And, two, our population is one that simply doesn’t require a lot of these procedures. We do have feedback from Aetna that we have four patients that are in conversations with them about the option. They haven’t said no, they haven’t said yes. They are simply exploring it at this time.

MTT:Four patients right now?

PH: Yes. That doesn’t surprise us. We tried to do this in a way that people would consider it and, hopefully, find it works for them. But we also wanted to create some different levels of conversations with our local medical providers. We want to get the discussion and the exploration going on how the world of healthcare is changing.

Right now, we have the medical leadership of one health system fully engaged in that exploration, and that leadership is really saying, “Yes, we need to think about how we add more value for our purchasers.”

On the other side of the coin, we had another health system that initially took the position that if there’s a patient who dares to leave our market area, they won’t treat them when they come back.

Those are two of the polar opposite discussions we’re having and we think it’s important to keep them going and flesh out all the ideas surrounding the subject

MTT:You mentioned Singapore as a destination, but are you looking at other destinations? And would you like to have a whole array of foreign hospitals?

PH: Absolutely! We started with Singapore first because it’s an English speaking country. Also, what was really important to us out of the gate was the question of what will the member experience. We had some concerns about travel to other possible destinations like India, Malaysia, and some other places. Travel to and from these different cultures might really be a foreign experience and present markedly different living conditions than our employees are accustomed to.

We tried to find an experience that would make our US patients feel comfortable. Frankly, Singapore is one of the safest cities in the world. This is an important consideration and we have a high degree of comfort that our patients will be safe.

MTT:That’s very key. Please explain the complexity of your workforce in terms of the number of people who have immigrated to the US and become citizens. Do you think they would want to go back home, so to speak, for their care and return to the US for after care? Is that an issue?

PH: It’s an interesting question. You would think that would be the case but what we found in our focus groups was that the first question people asked us had nothing to do about the country. It was always, “What can you tell me about quality?”

We’d then assure them that the hospitals we selected have quality standards similar to those in America. Once we got them through that part of the conversation, we’d then ask how many would consider care abroad. Nine out of ten raised their hands.

I followed that up with the question of “Why?”

I found the response fascinating. Many said that they had grown up in the town or area they were living in now and many had never traveled out of the state. They saw this as an opportunity, provided they could get the same quality of care. They were going to take this opportunity to see a different part of the world. It really intrigued them.

MTT:Was there any part of the world that was more appealing than another? Was travel a consideration?

PH: When we did the focus groups they didn’t say, “Well gee, why didn’t you look at Costa Rica or any particular area?” Their focus and our conversation were really around trying to find places where we knew they would be safe, the quality of care would be high, and there wouldn’t be a language barrier. We also tried to find places where a traveling companion could be accommodated in the facility and made rooms available as part of the package.

They were very comfortable with the criterion we used and, frankly, I think they were just intrigued. Destination as a driver hasn’t surfaced yet, but it may come in time. I could see the situation in the future where all areas of healthcare start to transition to an eBay type situation. People will start to say, “I need to have my hip replaced, what can you tell me about quality?”

MTT:Are you doing anything pro-actively with educating or making your employees aware of opportunities or options?

PH: Absolutely. We include it in our materials and it is in the benefits section of our Web site. We also have a program that if you need to have an inpatient procedure, you are required to call in and talk to the health advocate provided through Aetna. This call is where we start discussing what their options might be.

MTT:If you could gaze into your crystal ball, would you say that you anticipate significant interest and uptake?

PH: I would have to say no, not yet. We can communicate whatever we want, but it will be the actual experience which will drive the growth.

When we started this process, we thought we would be really, really happy if we had one or two patients that made the selection this year. Because if they go and they have a great experience, they will start telling everyone at work about it. It’s only going to accelerate.

MTT:Rapidly?

PH: My first year goal is that if we send one or two people, I’m going to be really, really happy. I am absolutely delighted with the actual market response. It far exceeds what I anticipated.

There are already two different business models developed that I shared earlier. And Aetna, our partner, has transitioned from a lukewarm supporter to one of full support for domestic tourism as the next place for market opportunity.

I have to believe that in the next 24 months you will start to see U.S. health facilities reconfiguring and reengineering how they deliver services to be part of the global solution. I’m really looking for that. I think it’s really going to get the healthcare community in the U.S. engaged and thinking about how they deliver value to their patients. That’s what I’m really hoping to achieve.

MTT: I think that is already starting to happen. Do you see any potential for partnerships between U.S.-based hospitals and foreign hospital that would materialize in the next few years to make it even sweeter for the American-based patient to feel confident about traveling abroad for medical care?

PH: Wow. Great question. And, yes.

I guess it’s the age-old formula that once you create the right market incentives or once you create the right dollar pathway, then strategic alliances will be created. The next places where I really see this happening are going to be around other ancillary services.

You know a really good example may be radiology. I mean it’s already happening among radiologists here in this country. Radiology is very expensive and radiologists, in general, are one of the top paid specialties.

You can send now digital images across the water to an organization called Nighthawk. They read the images in a very timely manner and very accurately for about a third of the U.S. cost. I can see that being the next place where relationships start up.

In the future, probably a significant portion of specialty visits can be done using telemedicine technologies. They are already doing remote sand robotic surgeries.

MTT:To me that is so fascinating.

PH: Yes, it is. So when you ask where is this going, I think it is going to be all about the patient and convenience.

Just look at the phenomena of the retail clinics that are starting to go into CVS and Wal-Mart. People are saying, “This having to travel to brick and mortar facilities is all at the convenience of the provider community…for the office hours they want and the location they want is…it’s going to change.”

The next evolution might include mobile diagnostic imaging vans that go around to where people are -- at supermarkets, workplaces or malls. They will take the images and immediately send those digital images to Nighthawk. You’ll get the results back within the hour. I mean when you said a partnership, that’s where I can see partnerships.

MTT: Here’s the $64,000 question: Do you think Medicare would ever buy into medical tourism?

PH: Wow. I don’t know. I can see that being a political football. But, they have really been bold, and frankly, you know that the public pays -- between Medicare and Medicaid -- about 50 percent of the healthcare spend. They could be very progressive. You know I don’t know if they will do international tourism, but I could really start seeing them being very impactful in trying to encourage some of this domestic tourism.

I think a lot will depend upon the presidential elections over the next two cycles. Those will have a huge impact of what happens in healthcare.

Peter Hayes serves on the board of directors of The Center for Health Value Innovation. Lau nched in 2007, The Center for Health Value Innovation is a not-for-profit (501c3) organization representing industry stakeholders committed to sharing the evidence that value-based health designs improve health status and reduce health cost inflation. Members include large and mid-size employers, health plans, integrated delivery systems, self-funded unions, municipal and state governments, medical management firms, pharmacy benefits management companies, vendor organizations and others which benefit from analytic tools, educational programs and c ollaborative connections to innovators in value-based health design. Visit www.vbhealth.org .

PERSPECTIVES

Ruben Toral, CEO and Founder of Mednet Asia Ltd.

Ruben Toral is a recognized leader in medical tourism and healthcare globalization. Formerly Group Marketing Director for Bumrungrad International, Toral is widely recognized as one of the driving forces behind medical tourism and Bumrungrad’s position as the world’s premier medical tourism destination. Now owner and operator of a healthcare marketing company, Mednet Asia Ltd., Toral has extensive healthcare experience.

Toral shares his perspectives on the growing industry with Medical Travel Today on a monthly basis. 

An Innovative Approach to Winning the Healthcare War

I just finished reading “Charlie Wilson’s War,” and drew some interesting parallels with the healthcare crisis in America. What does fighting Russians in Afghanistan have to do with finding solutions for better, more affordable healthcare in America? More than you think.

In the book, Congressman Charlie Wilson is the man behind the scenes funding the Afghan resistance against the Russian army. Through his efforts, Congress is funneling hundreds of millions of dollars annually to fight this covert war, but with limited results. The Russians are simply too big and too strong, and they have a super weapon – the Hind helicopter – that is seemingly invincible. Charlie is obsessed with finding a ‘silver bullet’ to bring the Hind down, reasoning that this is the key to winning the war.

It was not. The key to winning the war, it turns out, was developed by Mike Vickers, a lowly CIA operations strategist sitting 10,000 miles away in Langley, Virginia. Mike understood covert warfare and weapons and how to mix the two to lethal effect. He won Charlie Wilson’s war by deploying a mix of innovative weapons and tactics that were field tested, and provided the men on the front line with the tools and training to wage war on their terms. In short, Mike Vickers understood how to fight the fight.

Good story, but what’s the point? There is no silver bullet to solving the healthcare crisis in America and the current tools and tactics being deployed are having little or no effect. Despite spending hundreds of millions of dollars annually to improve healthcare and drive down costs, the reality is that healthcare is getting more expensive, less accessible and is making America less competitive in today’s global economy.

My sense is that Mike Vickers’ approach in Afghanistan is applicable to America’s healthcare crisis. Instead of searching (and spending billions) for the silver bullet, i.e. universal coverage, a more practical approach would be to utilize a range of options that have been proven successful in the field. Channeling the wisdom of Mike Vickers, here is a start to winning the war.

• Promote the widespread adoption of the medical savings account. A tax deductible, interest bearing savings account for medical services creates the right kind of incentives for people to manage their healthcare and healthcare expenditures more judiciously. By treating healthcare as an investment, rather than a consumable, you change the way people approach healthcare spending. The MSA is to healthcare what the IRA is to retirement savings.
• Empower customers with better information, tools and products and watch them save. Now that you have created an incentive to save, give people the tools to do it more effectively. The financial services industry sets a great example. 20 years ago, there was a dearth of consumer-ready investment products available. Today, log on to Fidelity’s website and you are in a candy land of investment products, information and tools all designed to help you make good investment choices. Fidelity stimulated consumers to invest in their future by innovating a new model and new products. Can’t the healthcare industry to the same?
• Web-enable. The Web has transformed tourism, banking, publishing, retail and communications so why not healthcare? The perfect site would allow customers to shop for a wide array of healthcare providers, treatment packages and hospitals; communicate with doctors on-line; and purchase services using a medical savings account. Why doesn’t a Fidelity-like site exist for healthcare?
• Look at global options. Wal-Mart does. There is a reason they can offer everyday low prices, and one of them is that they source globally. There is a growing pool of highly qualified medical doctors and hospitals, offering their services at half the cost of comparable private care in the US so why restrict sourcing providers to local choices when you can go global?

The point here is that the healthcare crisis cannot and should not wait for a silver bullet, because it doesn’t exist. The lesson learned in Charlie Wilson’s war is that the enemy can be defeated by deploying the right mix of tools and tactics and empowering the people on the front line, who literally have their lives at stake. That’s how Charlie won his war.

Just Published: A Medical Tourism Primer for U.S. Physicians

The March/April 2008 issue of Medical Practice Management features an article by our publisher, Laura Carabello entitled “A Medical Tourism Primer for U.S. Physicians.” Intended to provide a framework for discussion points for physician-patient communications regarding medical tourism, the three-page story address the most common questions patients have regarding care abroad, including quality concerns, insurance and cost questions, and risk assessment. A helpful guide for providers facing patient queries related to medical travel, the entire article may be accessed at:

http://www.medicaltraveltoday.com/MTTE08/Mar_Apr_2008_291-294.pdf

Permission granted by The Journal of Medical Practice Management, Greenbranch Publishing, 800-933-3711, www.mpmnetwork.com

Casting Your Net

Medical Times, published in Dubai, recently devoted two pages to the role of the Internet in the growth of medical tourism. Our publisher, Laura Carabello, was quoted throughout the article sharing her thoughts on how the Middle East’s current approach to medical tourism marketing might be falling short.

The following is an excerpt from the article. The complete article can be found at:

http://www.medicaltraveltoday.com/MTTE08/38-39_MT_APR_Doc_Com.pdf

MIDDLE OF NOWHERE

The Middle East has grand ambitions when it comes to medical tourism. A report by the Abu Dhabi Chamber of commerce and Industry (ADCCI) optimistically maintains the United Arab Emirates will pocket AED 7 billion annually in medical tourism profits by 2010. Yet to the burgeoning online medical tourism community, the region remains largely invisible. Laura Carabello is the publisher and managing editor of e-newsletter Medical Travel Today. Established only six months ago, the newsletter has over 20,000 subscribers internationally.

Surprisingly, Carabello states that Medical Times is the first credible source from the region to contact the newsletter. This is symptomatic of the lack of marketing weight behind the Middle East, reasons Carabello: “Everybody is building beautiful facilities for medical tourism but they haven’t spent anywhere near what they need to spend on marketing.” Carabello accuses governments in the region of underestimating what a dogfight the global healthcare market has become and how important a role the Internet has to play. “I think they are looking at the market with rose-colored glasses and they need to take them off, deepen their pockets and spend on marketing, not just the facilities,” she argues. “If foreign governments think they can just come to the US and tell people to come to their country next week for a hip replacement then it is not going to happen.” A concerted online marketing campaign might be a tough sell to Middle Eastern providers, who are used to the more traditional mediums of print and trade shows, but institutions wary of the Internet, which Carabello describes as “the primary vehicle for medical tourism,” risk missing out on the market’s most valuable advertising real estate.

New Zealand Delivers Personalize and Affordable, High Quality Medical Care for North American “Medical Tourists”

Auckland, NZ—April 23, 2008 –New Zealand emerges as one of the most affordable options for Americans and Canadians seeking medical care and treatment in a first world environment where English is the primary language, reports Medtral New Zealand, a health care organization based in New Zealand (www.medtral.com) which coordinates medical travel packages to this destination. New Zealand is highly accessible for patients residing on the west coast—ßwith daily 12-hour direct flights—and offers world-class medical treatment in some of the country’s finest private hospitals at a significantly lower cost than the comparable USA procedure.

“New Zealand is not only one of the most affordable destinations for medical care, but it is also clean, green, American and Canadian friendly with a safe peaceful environment,” states Edward Watson, MD, chairman and founder of Medtral New Zealand. “It also offers extraordinary tourism opportunities, including stunning scenery, winery tours, golf, and fly fishing. Our team of medically focused professionals is ready to assist patients with personalized attention that helps to guide their medical travel experience.”

Private hospitals and medical specialists in the Medtral New Zealand network represent the highest standards, with all specialists speaking English as their first language, and have received their specialist training in either North America or the United Kingdom as well as in New Zealand.

“New Zealand won’t be a foreign experience for medical travelers,” notes Dr Watson. “We are an English-speaking country with a culture that is very similar to the United States and Canada. Our facilities are accredited by the recognized and respected International Society for Quality in Healthcare (ISQua) — but the price tag is a fraction of the cost in North America.”

Medtral New Zealandcan help medical travelers to undergo:

• Total Hip Joint replacement
• Total Knee Joint replacement
• Hip Resurfacing
• Coronary Artery Bypass Graft Surgery (CABG)
• Robotic Prostatectomy

A comprehensive list of the operations is found at www.medtral.com

“Heart bypass surgery–better known as CABG—might cost $110,000 - $125,000 in the U.S. but would cost only $38,000 at one of our facilities,” Watson states. “Our price is all inclusive, including round-trip airfare, accommodations and the procedure itself. Other medical travel organizations operating in a first world environment would be hard-pressed to match this package.”

According to a report issued by the New York-based Commonwealth Fund, New Zealand has one of the world’s best health systems. The country’s private hospitals rival the best in the world, with the latest medical facilities and excellent accommodations. All facilities are staffed by experienced English speaking doctors and nurses who, in many cases, have had training and experience in the United States or Great Britain.

New Zealand maintains strict hygiene control standards in all its hospitals and employs rigorous standards of enforcement regarding appropriate use of antibiotics. As a result, the rates of hospital acquired infections including MRSA (Methicillin Resistant Staph Aureus) and VRE (Vancomycin Resistant Enterococcus) remain low. New Zealand also has a low incidence of HIV infection.

About Medtral New Zealand.

Medtral New Zealand is the leading provider of medical tourism in New Zealand for North American patients, providing world-class, non-acute care and treatment in some of the country’s finest private hospitals. Headquartered in Auckland, New Zealand, Medtral New Zealand can be reached at +64 9 623 6588, or www.medtral.com

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INDUSTRY NEWS

BridgeHealth International, Inc. Announces its World-Class Provider Network™ — First-of-its-kind in the Healthcare Industry

DENVER, Co. – April 28, 2008 – Responding to the growing demand among employers, health plans and other stakeholders for a comprehensive, “world-class” network of international healthcare centers of excellence, BridgeHealth International, Inc. (BridgeHealth) today unveiled its initial system of providers comprised of over 25 hospitals and 600 physicians, dentists and health professionals in over 10 countries. With a focus on serving businesses and individuals for the delivery of international medical care, BridgeHealth developed its World-Class Provider Network™ to offer an extensive range of medical and dental procedures, a wide choice of hospitals and destinations, and options for accessing providers with experience, expertise and high standards of safety.

“The BridgeHealth network is the first-of-its kind in the industry, bringing to the marketplace a best-of-breed option for delivering high quality care and treatments to medical travelers,” says Victor Lazzaro, Jr., CEO of BridgeHealth. “Backed by decades of executive experience in healthcare delivery, BridgeHealth has assembled a network of breadth and depth, with a focus on promoting provider choice and offering a superior client experience. As the recognized leader and innovator in medical travel, we are committed to growing this international system while always maintaining the highest degrees of integrity and concern for quality.”

The BridgeHealth network represents the widest range of choices now available for medical travel, offering patients a vast array of options.

“Some Americans may choose to travel to exotic locations including Singapore or India while others may prefer to be closer to home and opt for Mexico or Panama,” continues Lazzaro. “We offer a broad menu of medical and dental procedures – meeting needs as varied as orthopedic procedures, cardiac surgeries, and bariatric operations. Our goal is to match patients with their location of choice, meet budget expectations, and arrange for the highest quality care available in a specific country. This is all made possible by assembling the most extensive network in the industry.”

In qualifying hospitals and facilities for participation, BridgeHealth utilizes criteria that include:

• Reputation for quality
• Indicated experience in selected procedures
• Accreditation status
• Ability to provide clinical data
• Agreement to participate in our quality assurance and reporting program
• Customer service orientation
• Excellent nurse to patient ratio
• Choice of geographic location
• Familiarity with the needs of international patients
• International standards in clinical delivery and patients’ rooms
• World-class medical infrastructure and equipment

“Hospitals in our World-Class Provider Network™ have often achieved recognition from an international accreditation group,” says Lazzaro, pointing to agencies such as the Trent Accreditation Scheme (TRENT based in UK-Europe and Hong Kong), Joint Commission International (JCI based in the US), Australian Council for Healthcare Standards International (ACHSI - Australia), Canadian Council on Health Services Regulation (CCHSA - Canada) as well as the International Society for Quality in Health Care (ISQua), an Australian-based organization providing international healthcare accreditation.

Through its international business-to-business operations, BridgeHealth serves health plans, insurance carriers, employers, third party administrators, and individuals accessing benefits via voluntary benefits plans, health card programs or Consumer Directed HealthCare Plans (CDHP). BridgeHealth also assists consumers seeking medical travel options, and with the acquisition of Medical Tours International (MTI), operates one of the most robust direct-to-consumer platforms for the coordination of medical travel.

About BridgeHealth International, Inc.
BridgeHealth International, Inc. (BridgeHealth) is the premier service provider in the burgeoning medical travel industry, founded in with a vision “to create a trusted bridge to the world of international healthcare.” 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. Visit www.bridgehealthintl.com

International Medical Travel Association Emerges as the Leading Organization in the Global Medical Travel Industry

Washington, DC, USA /Singapore – April 28, 2008 – The International Medical Travel Association (IMTA; www.intlmta.org) has solidified its leadership position among all stakeholders in the worldwide medical tourism marketplace, establishing offices in both the U.S. and Singapore, and adding numerous international hospitals, healthcare providers and business stakeholders to its membership roster. The IMTA, a not-for-profit association, represents the broad and diverse interests of medical travelers and the medical travel industry, including healthcare providers and medical travel facilitators from around the world.

The IMTA will make its U.S. debut at the Health Care Global Summit, May 4-7, 2008 at the Venetian Resort Hotel in Las Vegas, holding an open meeting on May 6, 2008, 7:45 PM in Galileo Room # 904.

According to Purvi Maniar, a Member of Epstein Becker & Green P.C. in its Global Health Practice, "The development of the IMTA and its expansion from Singapore to Washington, D.C. is an indication of the maturing of the medical travel industry and will help to foster the development of international industry standards and best practices. Given its patient focused mission, the nature of its leadership and elected governance structure and its strategic presence in the United States and internationally, the IMTA is uniquely situated for these purposes."  

Epstein Becker Green is a U.S. law firm with one of the largest and most respected health care and life sciences practices in the country.  The firm's Global Health Practice focuses on international projects and transactions in the health care and life sciences sectors. 

Steven Tucker, M.D., a leading U.S. board-certified medical oncologist and president of the IMTA says, “IMTA began as a regional association, and now brings together all stakeholders in medical travel to build an economically sustainable, high quality and ethical medical travel industry. IMTA is the only global association with this scope of commitment, an elected governing board and a dedicated mission to preserve and protect the doctor-patient relationship -- all in the interests of the international patient."

As global healthcare choices expand, Dr. Tucker says that patients will increasingly travel across the world for access to better and more affordable healthcare. Regardless of whether patients are seeking advanced care not available in a “home” country or less expensive care than their “home” country can offer, industry resources go beyond hospitals and doctors. Patients need qualified experts across the medical and travel industries.

“The IMTA works to promote and protect the safety and well-being of patients through the development of industry networks, creation and distribution of knowledge, sharing of best practices and establishment of standards,” says Dr. Tucker. “Eventually, the IMTA may create quality guidelines for members and promote industry self-regulation.”

Bringing both American and international perspectives to the IMTA, Dr. Tucker is medical director for the US-owned West Clinic International, with centers in Singapore and Shanghai. He earned his MD at the University of Missouri-Colombia and completed postgraduate training at the UCLA Center for Health Sciences. Before moving to Singapore, Dr. Tucker was Director of Prostate and GU Oncology at The Angeles Clinic & Research Institute in Santa Monica, California.

The need for such an organization became apparent at the 2007 Pacific Asia Travel Association conference in Singapore as industry speakers expressed concern about disconcerting trends of patients viewing medical travel as an extension of the tourism industry. Patients were choosing their doctors and hospitals from Web sites without the advice of their own doctors, traveling without adequate preparations and support, with some paying the price of botched surgeries and other mishaps.

“IMTA reaffirms its commitment to patients and the medical tourism community with a goal to boost public confidence in medical travel,” he adds. “The introduction of new industries, practices, and businesses of a foreign nature are always going to be followed with a natural level of uncertainty, mainly because U.S. laws and regulation do not apply abroad. Our mission is to ensure patients that rigorous regulation and accreditation processes are being held for hospitals overseas engaging in medical tourism, and to help foster the right relationships among providers, insurers and third-parties involved in medical travel and global healthcare.”

About The IMTA

The IMTA brings together the healthcare and travel industries to help create a high quality, ethical and economically sustainable medical travel industry as well as to preserve and protect the doctor-patient relationship, all in the interests of the international patient. Visit www.intlmta.org.

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WHAT YOU’RE READING

Healthy Travel Media Announces Second Edition of Patients Beyond Borders

Chapel Hill, NC—4 May 2008: Healthy Travel Media, publishers of Patients Beyond Borders: Everybody’s Guide to Affordable, World-Class Medical Tourism, announced today the July 2008 release of updated and expanded Second Edition of the world’s bestselling consumer guide to medical tourism and international health travel.

 

This impartial, well-researched and easy to navigate trade paperback now gives potential health travelers more than 390 pages of medical travel destinations, resources and advice they need to make safe, cost-effective decisions about traveling abroad for their healthcare.

“We’re pleased to have added several new destinations to the Second Edition, including Jordan, Korea, Panama, the Philippines, Taiwan and Turkey” says Josef Woodman, author of Patients Beyond Borders. “US healthcare costs rose yet another 6% in 2007, and another 800,000 Americans became uninsured. Patients Beyond Borders has helped thousands travel abroad successfully for medical care.”

As the number of uninsured and underinsured Americans continues to grow, travel abroad for treatment is rising dramatically, with international hospitals and clinics reporting a 15-40% increase in the number of Americans seeking treatment. More than 180,000 Americans will cross borders for healthcare this year; and that number is expected to nearly double by 2010.

International patients looking to travel to specific destinations will now have five country specific editions to choose from. With the upcoming releases of Patients Beyond Borders India (August 2008), Patients Beyond Borders Taiwan (August 20 08), Patients Beyond Borders Singapore Second Edition (August 2008), Patients Beyond Borders Malaysia (September 2008), and Patients Beyond Borders Korea (November 2008), patients will have access to in-depth information on accredited hospitals, clinics and specialty centers in a preferred destination.

A special Patients Beyond Borders Orthopedic Edition is slated for release in October 2008 and will feature 20 leading orthopedic “Centers of Excellence,” including eight spinal and neurosurgery centers and four specialty Sports Medicine clinics.

“Of the seven million Americans hospitalized last year for orthopedic procedures, nearly half were un- or under-insured,” says Woodman. “The Orthopedic Edition helps give healthcare consumers an affordable way out of chronic pain.” The Orthopedic Edition covers alternative spinal and neurosurgical procedures, including the latest minimally invasive surgical techniques, including the popular “Birmingham Hip Resurfacing” procedure, recently approved by the FDA.

Woodman says he has been overwhelmed by the response to the Patients Beyond Borders book and subsequent editions. “I’ve received calls and emails from patients around the world considering health travel. While medical travel isn’t for everyone, with diligence, perseverance and good information, traveling abroad for treatment is a legitimate, affordable and safe choice.”

Patients Beyond Borders India Edition Announced

Las Vegas/Global Healthcare Summit—4 May 2008: Healthy Travel Media announces the Patients Beyond Borders India Edition, to be published in English for international distribution in July 2008. Written and produced in collaboration with Wockhardt Hospitals, the 220-page guidebook will offer an in-depth overview of India’s top international hospitals and clinics, selected health travel agents, nearby recovery and guest accommodations, and area travel information.

Long-known as a leading international medical travel destination, India now welcomes more than 180,000 patients annually, offering 30-90% discounts on a wide array of medical procedures, including orthopedic, cardiac, cosmetic, dental, optical and more. India boasts nine JCI-accredited hospitals and clinics, with more than 20 facilities throughout the sub-continent now serving international patients.

The Patients Beyond Borders India Edition was underwritten in part by the renowned Wockhardt Hospitals, one of India’s leading health institutes, with two main hospitals in Mumbai and Bangalore. “We are pleased to contribute to this landmark title, which will serve to reinforce India’s preeminence as a global healthcare center,” says Vishal Bali, CEO of Wockhardt Hospitals. “ India is a rising star of healthcare excellence, with some of the world’s best research, education, doctors, surgeon and medical facilities.”

Penned by Josef Woodman, author of the bestselling book Patients Beyond Borders, the India Edition provides readers information on planning and budgeting a medical journey to India, how to choose the best hospitals and physicians, medical travel do’s and don’ts, and more. The book provides in-depth information on dozens of fully-accredited Indian hospitals, including contact information, treatments offered, Centres of Excellence, subspecialties, and superspecialties. A brief chapter covers tourism and travel information to the leading medical travel destination cities.

“India has so much to offer patients as a high-quality, affordable medical travel destination,” says author Josef Woodman. “With the India Edition, readers everywhere will for the first time have access to all required information in a single guidebook.”

About Healthy Travel Media

Healthy Travel Media, an independent imprint based in Chapel Hill, NC, publishes books on medical travel, treatment and wellness. Patients Beyond Borders is available at Amazon and bookstores everywhere, and is distributed to the retail trade by Publishers Group West.

For more information, please visit: http://www.patientsbeyondborders.com.

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DESTINATION

Philippines
By Robin Elsham

If I had to pick one country most likely to exceed expectations for attracting medical tourists, it'd be the Philippines. But then again, expectations for the Philippines as a global healthcare hub are already pretty lofty in some quarters.

Ian Youngman, author of the 760-page Medical Tourism 2008 - The World-Wide Business Guide, projects the Philippines could become the seventh biggest medical travel treatment destination in the world by 2012, treating 400,000 patients a year by that point, according to Philippine Department of Tourism Director Elizabeth "Betty" Nelle.

Ms. Nelle said the Philippines is already attracting an estimated 150,000 to 200,000 medical tourists a year, which would make it one of the world's five busiest medical travel destinations. More precise figures aren't available now. But by year-end, the government expects to be able to track the number of arriving medical tourists from a question about healthcare being added to the A/D (arrival/departure) card all travelers must complete upon entering the country, Ms. Nelle said.

Information from some Philippine hospitals active in treating medical tourists shows these early numbers, while impressive, don't even begin to demonstrate the Philippines' global market appeal, as a large percentage of the "foreign" patients now traveling to there are people of Philippine descent. At The Medical City, one of two JCI-accredited hospitals so far in the Philippines, 40% of the foreign patients treated there last year were American, many of Philippine birth or ancestry, reflecting the large population of Filipinos living in the United States. Ms. Nelle refers to Filipino-Americans as "low-hanging fruit," the population most readily convinced to start relying on hospitals, dental clinics, Lasik eye surgery clinics, IVF infertility clinics and other medical facilities in the Philippines for healthcare.

The Philippines also draws medical travelers from island societies in the northern Pacific, like Palau, and Guam and Saipan in the Northern Mariana Islands. Governments and insurers in these areas previously sent islanders needing sophisticated medical care to Hawaii. Those patients are now sent to the Philippines, the value-for-money healthcare services leader in the northern Pacific.

That points to the Philippines potential to attract patients from other countries in the north Pacific region. Many of China's 1.3 billion people, as well as Korea and Taiwain, are just a two- to three-hour flight away. And Japan, after the United States the biggest future source of medical value travelers, is only five hours away.

Japan confronts a healthcare-spending crisis different in nature, but just as severe as the United States. Funding for its national healthcare system is racing toward breakdown due to the graying of the Japanese population of 128 million, the 10th-largest in the world. For nearly two decades, Japan has had both the lowest birthrate and longest life expectancy in the world, guaranteeing a future where fewer workers exist to financially support an exploding population of retirees. As Japan's Baby Boomer generation enters retirement, when demand for healthcare services skyrockets, the nation is already a fiscal wreck, with national budget deficits regularly running at about 150%, the highest ratio in the developed world.

To help ease its healthcare funding crisis, Japan recently enacted legislation to issue temporary work permits to foreign healthcare workers. The majority is expected to come from the Philippines, creating a pool of Filipino healthcare workers with years of experience caring for Japanese patients. It won't be long before all those factors combine to begin prompting many Japanese to travel themselves to the Philippines for surgery and other healthcare.

Then there's the Philippines potential to attract patients from English-speaking countries due to its massive pool of fluent English-speaking medical professionals. Every country targeting medical tourism professes to have English-speaking staff. But levels of fluency differ greatly from destination to destination, and nowhere else offers the level of fluency in North American-style English of the Philippines. Singapore, Malaysia, India all offer American and Canadians care at excellent hospitals where most staff—nurses and administrative personnel included—speak fluent English. But in those former British colonies, it's the Queen's English that's spoken. In the Philippines, an American colony from 1898-1935, it's U.S.-style English that is spoken—and more importantly—easily understood. When speaking English, Filipinos do so with American intonation and accent patterns, and pepper their speech with common American slang and idioms. That makes communication with North American patients more seamless, a critical and under-appreciated aspect of global healthcare.

Cultural fit also boosts the appeal of the Philippines in countless other ways. Our international medical travel arranger company was contacted just last week by a woman in search of Birmingham Hip Resurfacing treatment, who specified a preference for undergoing treatment where a Catholic priest could be quickly called to hospital to administer Last Rites if need be. The Philippines is overwhelmingly Catholic, the only predominantly Christian country in Asia. The Philippines is also home to a very substantial population of Muslims, especially in the far south of the country. Recruiting and training medical staff who themselves are Muslims will burnish the Philippines appeal to medical value travelers from Islamic nations in the Mid-East and Gulf region.

Two other factors are also certain to make the Philippines appealing as a global healthcare services hub—the globalization of the Filipino labor force and remarkable caring nature bred into almost all Filipinos.

As a percentage of its population, no other nation produces so many workers with years of experience living and working abroad. According to figures compiled by the Commission on Filipinos Overseas, at the end of 2006, there were 8.2 million Filipinos living outside the Philippines, or nearly a tenth of the country's entire population of 93 million people. Nearly 3.6 million were living in North America, 1.8 million in West Asia, 1.2 million in East or South Asia, and just under a million in Europe. Companies running global operations in particular employ lots of Filipinos—the shipping industry, cruise ship lines, global hotel chains, international media companies, global financial houses. Take a cruise anywhere in the world, and much of the staff—from the onboard nightclub acts and guest activities director to bartenders and cabin staff—are likely to be Filipino. Go into the foreign bureau of global news operations like Reuters or Agence France Presse, or into the sales and administration offices of five-star hotels anywhere, and you're likely to find Philippine-born and educated staff.

The Philippines produces extremely large numbers of well-trained workers. Due to political instability and stuttering economic growth over past decades, millions of Filipino university graduates have headed abroad to work. But that is now changing. Since 2004 the Philippines has surpassed India to become the fastest-growing business process outsourcing destination in the world. That's lifted overall economic growth to more than 7% last year, the fastest rate in over three decades. If sustained, that growth could enable the Philippines to put behind it the instability and security concerns long hobbling its development. " The Philippine government still faces threats from three terrorist groups. But a decades-long Muslim insurgency in the south has led to a peace accord with one group and a ceasefire and peace talks with another," according to the CIA Fact Book.

The Philippine Association of Health Organizations in Medical Tourism (PAHOMT) has nine hospitals so far as members, almost all located in metro Manila. This group incluees Capital Medical Center, Makati Medical Center, Manila Doctor's Hospital, Cardinal Santos Medical Center -- and the country's first two JCI-accredited facilities, The Medical City (TMC) and St. Luke's Medical Center (SLMC).

TMC acquired JCI accreditation in 2006, receiving "perfect scores in standards related to access to care, continuity of care, quality improvement and patient safety," according to hospital literature.

The Medical City is located in Pasig City, 30 minutes from Manila international airport and 15 minutes from the capital's financial and hotel district of Makati. Pasig City itself is an upscale residential area and burgeoning Makati-like business district. The area around the hospital offers lots of lodging options, ranging from ritzy hotels like the Shangri-La to serviced apartments. TMC can provide "home care" to any nearby location, enabling recuperating patients to be visited daily by a doctor, nurse or physiotherapist, depending on need.

TMC, which opened in 1967, had an average occupancy of 85% last year, the highest rate among all private hospitals in the Philippines, according to Margaret Bengzon, the hospital's head of strategic services. It currently has 500 beds on nine floors of a 15-story tower. TMC plans to add another 250 beds by adding 10 floors of rooms to an adjoining tower by the end of next year. There are 12 operating rooms and an ICU unit with 27 beds: 12 beds for cardiac, surgical or medical patients, six special ICU beds, five beds in the telemetry unit, and four pediatric beds. The 18 floors of the Medical Arts Tower houses 280 doctors' clinics. Altogether 1,000 physicians provide medical care, supported by 2,100 medical and administrative staff.

The Medical City offers virtually any sort of treatment typically provided by a tertiary-care institution, and is particularly known for cardio-vascular and orthopedic surgery and cancer treatment. TMC is the only medical center in the Philippines to practice regenerative medicine by offering stem-cell therapy, in partnership with UCLA Medical Center. "There have been some stories of almost miraculous improvement," Bengzon said.

TMC is equipped with the latest high-tech medical equipment, the result of a capital expenditure budget of 500 million to 700 million pesos ($12.5 million to $17.5 million) over recent years. TMC is purchasing a 128-slice CT scanner and Positron Emission Tomography (PET) scanner in the third quarter of this year. It's opening a Lasik eye surgery center by July, and a Wellness & Aesthetic Center by October. TMC, which now operates seven satellite clinics around metro Manila, plans to develop Tier II and III hospitals around the country over coming years, Bengzon said.

TMC treated 1,500 foreign patients, or 3.75% of the total 40,000 inpatients treated at the hospital last year. Another 4,000 foreigners were treated on an outpatient basis. Revenue derived from treating foreign patients totaled 175 million pesos ($4.4 million), or nearly 10% of the hospital's total annual revenue of 1.8 billion pesos ($45 million) in 2007, according to Bengzon.

St. Luke's Medical Center (SLMC), founded in 1903, operates a 650-bed hospital, the first in the Philippines to gain JCI accreditation. SLMC, which has set a goal of being recognized as one of the top five hospital in Asia by 2010, is building a second 600-bed hospital in the Fort Bonafacio Global City area of metro Manila.

Medical care at the current hospital is provided through nine institutes, 13 departments and 19 centers. More than 1,700 hospital-affiliated physicians also see patients through more than 450 private clinics.

St. Luke's centers of excellence are its Cancer Institute, Institute of Digestive Diseases, Heart Institute, Institute of Neurosciences, International Eye Institute, Institute of Orthopedics and Sports Medicine, Institute of Pathology, Institute of Pulmonary Medicine and Institute of Radiology. Within the Institute of Digestive Diseases is the Center for Liver Diseases, which has a Liver Transplant Unit with a highly specialized team composed of transplant surgeons, transplant hepatologists, microvascular surgeons, transplant pathologists and other medical specialists.

St. Luke's boasts of having more ultra-sophisticated medical equipment than 95% of the hospitals in the United States. And the inventory of its major diagnostic and treatment equipment is truly impressive: PET scanner, Tesla 3 MRI scanner, 64-slice CT scanner, SPECT/CT scanner, Intensity Modulated Radiation Therapy (IMRT) device, Stereotactic Radiosurgery System, Intravascular Ultrasound, 4D Ultrasound and much more.

St. Luke's has tie-ups with some leading American medical institutions including New York Presbyterian Hospital, the Memorial Sloan-Kettering Cencer Center and the medical schools of both Columbia and Cornell universities.

Robin Elsham is the managing director of Patients With Passports Corp., an international healthcare arranger based in St. Paul, Minnesota. He can be contacted at robin.elsham@patientswithpassports.com