Interview: Suzanne Taylor, former Vice President, HealthSmart

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About Suzanne Taylor, former Vice President, HealthSmart Suzanne is a seasoned professional, driven to deliver results in everything she does. Leadership, team management, strategy development and execution, and achieving goals are what she does best. Specialties: Healthcare business expertise in managed care provider contracting for hospitals, physicians and allied and ancillary providers; financial analysis; complex fee and rate methodologies; contract review; relationship management; shared risk management for varied membership populations. She has experience: with all insurance products, including commercial/group health (HMO/PPO), workers’ compensation and auto/medical; working with specialty populations, including both Medicare and Medicaid, in highly managed programs; and management of innovative care delivery models for specialty populations based on need to improve care outcomes and reduce cost of care; nursing education combined with business education and training. Suzanne delivers a unique perspective that is essential in the changing healthcare business environment. Medical Travel Today (MTT): Please describe your experience as former vice president at HealthSmart, as well as your knowledge about medical tourism. Suzanne Taylor (ST): As vice president at HealthSmart, my team was responsible for contracting hospitals, physicians and allied ancillary providers throughout 11 Western states. Our primary focus was California and Nevada, considering that is where we had most of our business, or where we were targeting our new business. I’ve lived in California for the past decade and have been actively contracting in the West Coast region for well over 15 years. A medical tourism group near San Diego approached one of my contractors and myself, and wanted to familiarize us with what they did and see if we wanted to facilitate an entrée at executive levels with HealthSmart management. I’ve always been familiar with the idea of medical tourism as I am a nurse by training. I have consistently worked with UCLA and other various organizations that do a lot of foreign treatment. It always intrigued me to see how medical tourism for Americans is really on the rise, especially now going to foreign countries and seeing what the potential cost differentials can be with the same kind of quality outcomes — or better. MTT: Has your interest in medical travel grown or waned as you became more familiar with the opportunities in the industry? ST: My interest in medical travel has significantly increased. Certainly the cost differential connected to the industry is incredibly enlightening. When I was approached by the medical tourism group near San Diego, we specifically discussed different approaches that would convince employers that medical travel could be a good option to offer employees. What I liked about this group was that employers are only expected to pay for the program if they utilize it. This minimizes risk for employers that don’t want to do a lot of up-front payment on the slight chance that an individual is going to use something on a cap basis or pre-paid basis. If I was a patient and needed an expensive procedure-elective or mandatory-I would now consider the benefits of medical tourism. I am used to individuals traveling to different places to access treatment, but I have always seen this take place within the United States or Canada. I haven’t seen many patients traveling to truly foreign facilities in Thailand, and Singapore, etc. MTT: Can you elaborate on your thoughts on domestic medical tourism, people traveling within the United States for care? ST: When I was the former director at Beech Street, we had a number of patients that would seek care in California. We also had a big business in Alaska that would send patients down to the lower 48 states for cost-effective, quality healthcare because care is extremely expensive in Alaska. MTT: Do you think medical travel is appropriate for workers’ compensation? ST: Personally, I think anybody that needs specialized medical care-workers’ compensation cases included-could be a potential candidate for medical travel. MTT: Currently, there is a lot of commentary on that particular thought, but no program in place yet. ST: Of course. There is especially going to be a challenge with various state bureaucracies to try and implement a program like that considering it is an “out-of-the-box” idea, and sometimes workers’ compensation and state governments aren’t very out-of-the box thinkers. There is always the challenge of convincing members that this is a beneficial option. There’s also the challenge of convincing a bureaucracy that it is something to consider. I think it is definitely a future opportunity-but I am not sure how long it will take to actually be put in place. MTT: Do you think healthcare reforms will negatively impact medical travel as an industry? ST: I think there is potential for healthcare reforms to create a gradual boost in the medical travel industry. Almost 15-20 years ago, I saw foreigners traveling for specialized procedures that were performed by neurosurgeons. Medical travel was happening then, and I am sure it is growing today with changes in technology. Now, individuals are traveling to different Centers of Excellence nationwide, whether it is for transplants or for other high cost procedures, experimental procedures, new technology treatments, clinical trials, etc. MTT: Inbound medical travel to the United States is growing. Do you think it is more around the globalization of healthcare rather than focusing on medical travel? ST: I think it could be. When I was with the neuro services that were provided at my hospital, we had a couple of surgeons who were one of five in the world that could perform certain procedures. Patients who needed their particular expertise found a way to seek treatment from these surgeons. If Brazil has the best plastic surgery in the country, who wouldn’t want to go to San Paulo if they could afford it to receive the best plastic surgery ever? From my perspective, I might be more willing as a consumer to look at traveling for treatment in the United States rather than to travel outside of the country for a transplant-I am not sure I’d want to do that. There are still stigmas as far as not understanding how well the medical care is in a foreign facility. I don’t worry as much about the doctors in foreign countries, as there are ways to check on the quality of the doctor and verify their training. My concern as a consumer is, “Would I receive the same standard of care as I would expect to receive at an American hospital?”

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