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© 2014 Medical Travel Today

Medical Travel Today is a publication of CPR Strategic Marketing Communications, a public relations firm based near New York City that specializes in healthcare and life sciences, with an international clientele. CPR, its Partners, and clients are at the nexus of where medical travel is today, and where it will be tomorrow.

Laura Carabello

Laura Carabello

Managing Editor
Megan Kennedy

Table of Contents

From the Editor

From the Editor: This week in Medical Travel Today, Laura Carabello

News in Review

Courage, Leadership, Investment Needed to Effectively Push Medical Tourism Here, Experts Say

Graphic: Medical Tourism Figures

Low Medical Costs Make Asia Top for Medical Tourists

Medical Tourism to touch US$ 6 billion by 2018: PHD Chamber

Center to Promote Medical Tourism

Medical Tourism Convention Opens in the Best City for Tourism in Korea

90 Days or Less for Medical Tourism

The Patients' Guide to Treatment Abroad: New Independent Guide Published


John Olsen, M.D., chair, AAAHC International


Suzanne Taylor, former Vice President, HealthSmart

Industry News

Medical Tourism Amongst Key Factors Driving Huge Growth in Malaysian Healthcare Market by 2020, says GlobalData

Dominican Republic among Top Medical Tourism Destinations

Going The Distance: Domestic Medical Travel Steerage Programs

Las Vegas debuts its medical travel video. A "must see" production.

Seven Good Reasons to go Abroad for Medical Care

What You Really Need to Know About Travel Vaccines

Who and Where Are The Uninsured Consumers?

World's Largest Self-Insurance/ART Event Coming to Phoenix!

SIIA Panel Discussion: Domestic Medical Travel - Opportunities and Challenges for Self-Insured Employers

Help Save a Life and Support MatchingDonors

Upcoming Events

Hospital Management Asia 2014

Medical Fair Asia 2014

8th Annual Global Spa & Wellness Summit

10th International Health Asia Exhibition & Conferences 2014

10th International Exposition and Conference for Medical Tourism, Spa & Health


7th World Medical Tourism & Global Healthcare Congress

34th Annual SIIA National Educational Conference & Expo

International Medical Forum and Spa & Wellness: Healthcare Travel Expo

Mexico Summit on Medical & Wellness Tourism Business

Health Tourism Expo Turkey

Medical Asia

IHC Forum West 2014

Arab Health Exhibition & Congress

Moscow Medical and Health Tourism Congress

Medical Fair India

12th Annual World Health Care Congress 2015

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Volume 8, Issue 5

Dear Colleagues:

Established in 1979, the Accreditation Association for Ambulatory Health Care (AAAHC) is a leader in developing Standards to advance and promote patient safety, quality care and value for ambulatory healthcare through peer-based accreditation processes, education and research.

In 2010, AAAHC launched AAAHC International to assist providers in other countries who seek to offer ambulatory healthcare services consistent with the Standards of AAAHC-accredited U.S. organizations.

John Olsen, M.D., chair, AAAHC International, discusses the international organization's overall accreditation approach, which provides educational, on-the-ground training and consultation for facilities ranging from small ambulatory centers, outpatient facilities, oncology centers and small hospitals, as well as where AAAHC International is headed in the future.

For the growing number of readers who are interested in the U.S. domestic medical travel space, I am pleased to report that the Self Insurance Institute of America has invited me to chair a panel on the subject at the annual meeting: www.siia.org/national.

Date: October 5-7, 2014 
Location: JW Marriott Desert Ridge Resort, Phoenix, AZ

The SIIA National Conference & Expo is the world's largest event focused exclusively on the self-insurance/alternative risk transfer marketplace, typically attracting more than 1,700 attendees from throughout the United States and from a growing number of countries around the world. The program features more than 40 educational sessions designed to help employers and their business partners identify and maximize the value of self-insurance solutions.

For additional details about SIIA and the medical travel panel, read the article entitled, "SIIA Panel Discussion: Domestic Medical Travel - Opportunities and Challenges for Self-Insured Employers," below.

With the growing interest in medical/surgical travel options, we'd like to hear from your provider organization - ACO, health/hospital system, free standing surgi-center, community hospital - why you believe that your facility or organization is a Center of Excellence that can serve the needs of employers and payers throughout the United States. 

What distinguishes your service offering in terms of cost, patient experience and satisfaction, outcomes or other quality indicators?  Send us your descriptor, including photos or charts, and we will evaluate for publication in this newsletter.

Please be in touch and let me know how you are surviving and thriving in this emerging marketplace. 

Laura Carabello
Editor and Publisher
Medical Travel Today




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SPOTLIGHT: John Olsen, M.D., chair, AAAHC International



About John Olsen, M.D.
Dr. John Olsen is a Health Services executive with 23 years of transformational domestic and international leadership experience in public, government, private healthcare industries, and senior military roles. He has managed care and network development expertise with entitlement and self-insured product lines, and is an accomplished speaker, BOD member and team-builder -- battlefield and board-room tested.

About Accreditation Association for Ambulatory Health Care (AAAHC)
Our parent organization, AAAHC, is a private, non-profit organization formed in 1979. (Incidentally, this is our 35th anniversary.) We are the leader in developing Standards to advance and promote patient safety, quality care and value for ambulatory healthcare through peer-based accreditation processes, education and research. A certificate of accreditation is awarded to organizations that are found to be in compliance with AAAHC Standards.

AAAHC currently accredits almost 6,000 organizations in a wide variety of ambulatory health care settings including ambulatory surgery centers, community health centers, medical and dental group practices, medical home practices and managed care organizations, as well as Indian and student health centers, among others. We are also the official accrediting organization for the U.S. Air Force and the U.S. Coast Guard. With a single focus on the ambulatory care community, AAAHC offers organizations a cost-effective, flexible and collaborative approach to accreditation.

About Accreditation Association for Ambulatory Health Care International (AAAHCI)
AAAHC International was established in 2010 to help providers in other countries who seek to offer ambulatory healthcare services consistent with the Standards of AAAHC-accredited U.S. organizations. Similar to the process in America, non-U.S. facilities benefit from a rigorous, peer-based evaluation and onsite, interactive, consultative approach designed to meet AAAHC International Standards. AAAHC International also addresses the many differences in various countries that relate to their specific healthcare delivery systems, and offers culturally relevant responses to the differing local social and economic environments.

Medical Travel Today (MTT): What is the focus of the Accreditation Association for Ambulatory Health Care International (AAAHCI)?

John Olsen (JO): AAAHCI works with a spectrum of international facilities, from small ambulatory, outpatient facilities and oncology centers to hospitals (less than 100 beds). Through its accreditation processes and program, AAAHCI assists these institutions in preparing their environment and training their staff in a culture that maintains focus on patient safety and quality in the healthcare market place.

It is important to mention that AAAHCI does not impact the individual decision-making processes of physicians or nurses based on their clinical expertise.

MTT: What types of facilities does AAAHCI serve?

JO: In Latin America, where we made our first significant impact, we target a lot of smaller hospitals that range from roughly 50 to 100 beds.

As we enter different markets throughout Central and South America, we are finding that smaller hospitals have a very strong interest in accreditation. This is a development that, frankly, we had not predicted. In light of the hospital interest, we have adapted and enhanced our accreditation program accordingly to accommodate that customer segment.

Of course, we maintain a very strong interest in the ambulatory surgery centers, as well, which are somewhat harder to find in Latin America than in the United States.

MTT: How does AAAHCI differ from Joint Commission International?

JO: Our approach provides educational, on-the-ground training and consultation - much less of the audit profile that many individuals associate with the Joint Commission, stateside and internationally.

Again, following the mission of our parent organization, we believe that education and onsite, collaborative interaction between surveyor and staff allow greater growth for both the customer and the surveyors.

In the future, our intention is to nurture and develop increasing participation by host nation personnel in training roles and the actual conducting of the surveys, rather than using an American team. We have already introduced this concept in Peru.

MTT: How is the cost of international accreditation calculated?

JO: Internationally, the pricing system is much different than in the United States.

Generally, cost is based upon the size of the setting and number of surveyors needed, as well as the number of days that surveyors are on the ground.

MTT: AAAHC, the parent organization, planted its roots in the U.S. market, correct?

JO: Absolutely.

But as far back as 2004, the Accreditation Association for Ambulatory Healthcare, the U.S. parent company, began exploratory initiatives by forming an international task force, but quickly realized there were already hospital accreditors like Joint Commission International out there.

We were very familiar with an assortment of ambulatory outpatient settings right here in the United States, and we sculpted the program based on the U.S. marketplace. But as I said earlier, what we had predicted as a market, and what has become our market, is much more heavily weighted to small hospitals versus ambulatory and outpatient settings - although we have many of those types of medical and dental settings already accredited in Costa Rica and Peru, with a lot more showing great interest in pursuing AAAHCI accreditation.

At our most recent Board meeting we discussed this extensively and decided to revise and adapt our set of Standards to better reflect what a small hospital accreditation program would seek in accreditation. The timing for this was perfect, as it fell during the routine updating and refinement of our core International Standards Handbook. For example, our new Standards will increasingly focus on emergency room, maternity and occupational health services - all primary components that make up smaller hospitals.

MTT: How does accreditation help an institution connect with the market?

JO: Regardless of location, accreditation raises the bar of quality and safety, and from an ideological standpoint, when one facility proves that it's raised the bar, others are moved to follow.

From a more pragmatic perspective, if individuals are unfamiliar with a certain facility or healthcare environment, AAAHCI accreditation provides reassurance and peace of mind.

MTT: Do you look at outcomes, infection rates and patient satisfaction?

JO: Yes, those are all individual Standards, and in fact, we dedicate an entire chapter to safety and infection prevention in our second edition, Accreditation Handbook.

Of course, given that our mission of accreditation is based on quality and safety, we dedicated a single chapter to quality and quality studies, many of which are internal to the institution we visit. The sophistication of quality studies has increased dramatically over the last decade in the United States. We imagine this same curve will occur internationally as institutions begin to reframe the importance of developing a culture of quality and safety as a routine environment for healthcare delivery.

The way we teach internal quality studies and, if possible, external benchmark studies, is with a focus on measurable outcomes - highly quantitative outcomes more so than highly qualitative outcomes. Our international teams realize that quality programs are in various stages of development throughout the region and within the facilities and view this as one of the greatest opportunities for our program. Training on quality is often a major component of a pre-assessment survey or the actual survey itself.

Similar to any standards set by an accreditor, we also consider how satisfaction is gauged, measured, and what changes are put in place to improve patient satisfaction if such opportunities exist.

MTT: If hospitals do not meet the expectations necessary to become accredited, are they given a chance to remediate and re-apply?

JO: Yes, of course.

Occasionally the accreditation committee awards a less than three-year accreditation or a three-year accreditation with a focused follow-up to emphasize specific aspects needing improvement in order to receive full terms of accreditation.

Focused follow-ups occur within a certain time frame, one where AAAHCI teams will go back and review the aforementioned aspect(s) that need more attention. If the issue has been addressed, a three-year accreditation is granted. We have been fortunate to date: all facility revisits have resulted in full accreditation due to their remedial efforts on the focused concerns.

MTT: What percentage of the hospitals or institutions surveyed by AAAHCI earned the full three-year accreditation on the first go around?

JO: I don't have an exact number, but I do know that there hasn't been any facility that has completely failed a survey.

Similar to what we find in the U.S. program, internationally we have had several institutions that required an interim visit and focused review following their initial accreditation survey. The focused reviews almost universally occur within the first six months following the survey. With many of these international facilities, we actually go in and do pre-assessment surveys. This may consist of a facility visit six months before an actual survey where we engage in granular discussions that prompt better performance. This is such a great environment, one in which the surveyors learn of the local challenges hospitals face, while hospital staff receive focused education and training opportunities on what will be looked at during the accreditation survey.

Personally, I have been on two pre-assessment surveys - both with small hospitals in Peru. Our days were spent on the details of the Standards, as well as how to fulfill the Standards.

A pre-assessment really helps both organizations - the facility and the accreditor - to become more aware of each other's challenges and expectations.

For example, here in the United States, there are often great similarities among geographically separated facilities. Institutions in Wyoming and North Carolina are compelled by similar forces of performance despite their separation, resulting in similar environments of care and expectations by their patients. But internationally, we often see much greater differences in the healthcare environment - sometimes with those differences separated by only a few kilometers between an inner-city hospital and one in the suburbs.

Again, a pre-assessment gives us a really local flavor of what to expect.

MTT: How many hospitals outside the United States have you surveyed?

JO: We are in the range of around two dozen small hospitals, mostly located in Central and South America that are either accredited, in the process of applying for accreditation, or seeking reaccreditation.

MTT: Are you going to market this program beyond Central and South America?

JO: Currently, our approach is circumscribed by the caveat that we are young, limited and budget-conscious.

We have chosen locations such as Peru and Costa Rica because they are easier to access and more affordable to get our surveyors there. We realize that by our measured approach, we can offer a better price point to our customer and make the cost of accreditation more attractive to a wider audience.

In the near future, we will begin to look at Colombia and Mexico, as well.

Of course, we have incredible interest globally - Australasia, Europe, the Mideast and Africa - but the complexity, in terms of location, for a small organization like ours will be much more challenging.

We want to grow within our bandwidth.



Interview: Suzanne Taylor, former Vice President, HealthSmart

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?"

Industry News

Medical Tourism Amongst Key Factors Driving Huge Growth in Malaysian Healthcare Market by 2020, says GlobalData

Healthcare.globaldata.com-Medical tourism, easy regulatory guidelines, a lack of strict price regulation and an increasing elderly population will be the main contributors to the rapid rise in Malaysia's healthcare market value by 2020, according to research and consulting firm GlobalData.

The company's latest report* states that these factors, as well as the fact that Malaysia is not dependent on imported branded products, will provide the necessary impetus for the market growth, which the Malaysian Organization of Pharmaceutical Industries estimates will increase to approximately $3.7 billion by 2020.

Joshua Owide, GlobalData's director of Healthcare Industry Dynamics, says: "Malaysia has been a hotbed for medical tourism over the past few years, with increasing numbers of foreign patients visiting the country for treatment. This growth has been supported by government policies, such as tax exemption for hospitals.

"The implementation of a National Health Insurance System, which, pending parliamentary approval, will lead to universal healthcare coverage, is expected to be another driver of Malaysia's pharmaceutical market. Currently, the lack of universal healthcare insurance is forcing people to purchase medicine from the open market, resulting in high out-of-pocket expenditure."
GlobalData states that government initiatives aimed at increasing investment in the pharmaceutical industry, including Entry Point Projects and National Key Economic Areas, have so far been successful.

Owide concludes: "While reforms, such as free outpatient registration for the elderly, will impose a financial and logistical burden on Malaysia's healthcare system, they will also stimulate growth by the end of the forecast period."

*CountryFocus: Healthcare, Regulatory and Reimbursement Landscape - Malaysia

This report provides an overview of Malaysia's pharmaceutical and medical device markets, comprising market size, segmentation, and key drivers and barriers. It also provides profiles and SWOT analyses of the major players in Malaysia's pharmaceutical market, a review of the reimbursement and regulatory landscape, and an overview of the opportunities for, and challenges to, growth in the Malaysian healthcare market.

This report was built using data and information sourced from proprietary databases, primary and secondary research, and in-house analysis conducted by GlobalData's team of industry experts.

For guidelines on how to cite GlobalData, please see: http://www.globaldata.com/QuotingGlobalData.aspx

GlobalData is a leading global research and consulting firm offering advanced analytics to help clients make better, more informed decisions every day. Our research and analysis is based on the expert knowledge of over 700 qualified business analysts and 25,000 interviews conducted with industry insiders every year, enabling us to offer the most relevant, reliable and actionable strategic business intelligence available for a wide range of industries.

For more information, please contact our Press Office on +44 (0)1204 543 537 or at pr@globaldata.com.
Gain access to our latest press releases and expert analysis on developments in your industry. Subscribe to our RSS feed for the Healthcare sector, or connect with us on:Facebook | LinkedIn | Twitter

To view the original article click here.

Industry News

Dominican Republic among Top Medical Tourism Destinations

Dominicantoday.com- Americans, especially Costa Rican Americans living in the United States, choose to go to Mexico, the Dominican Republic and Costa Rica for complex medical procedures, dental works and aesthetic surgery.

According to a report published by thecostaricanews.com, Costa Ricans living in the United States have an advantage over Americans who do not speak the Spanish language and are also familiar with the culture of those countries.

The Dominican Republic, known for the best beaches in the world, takes advantage of its natural beauty to draw medical tourists to the exclusive medical institutions for various medical procedures.

The reasonable prices of the whole medical trip is 50 percent less than having surgery in the States, the report says. Medical tourists come to the country for dentistry, orthopedic, cardiology and cosmetic surgery.

For more information please refer to the Costa Rican News here: thecostaricanews.com/top-three-medical-tourism-destinations-for-costa-rican-americans/21173.

To view the original article click here.

Industry News

Going The Distance: Domestic Medical Travel Steerage Programs
by Laura Carabello, Founder and Principal, CPR, and Publisher of Medical Travel Today and U.S. Domestic Medical Travel™

TheIHCC.com-The fast-growth phenomenon of U.S. domestic medical travel - inter-state to Centers of Excellence throughout the country - is capturing the attention of employers, payers, third party administrators, insurance companies and other intermediaries throughout the country. With the influence of health care reform, the significant shift toward cost-containment and patient-centric care, employers now put enormous stock in preventive health care programs and options that offer quality, transparency and value. 

COEs range from high-profile hospitals and health systems to physician-owned surgi-centers specializing in specific procedures such as orthopedic and cardiac care. Retail giants Wal-Mart Stores Inc., Boeing, Lowe's and PepsiCo -- to name a few - offer domestic medical programs for a number of reasons: 

  • Baby Boomers are aging, raising the necessity for knee, hip, spine and heart-related surgeries
  • Surgery costs account for a substantial percent of total health care spend
  • Complex, high-cost surgeries are infrequent, but consume disproportionately high resources
  • COEs have demonstrated promising results in avoiding unnecessary procedures

This last point is especially important given that as much as one-third of surgeries may be medically questionable or unnecessary, according to a Consumers Medical Resource study. This includes surgical procedures for seven complicated and serious medical diseases such as breast cancer, heart disease and prostate cancer. 

Benefits of Domestic Medical Travel

The success of domestic medical travel programs relies upon transparent pricing and quality measures, which can vary widely across hospitals and regions. Companies are able to negotiate bundled, fixed-rate prices that are generally 20 to 50 percent below rates charged through traditional insurance plans. This savings enable them to a) waive co-pays or offer cash incentives, b) cover the full cost of travel for the patient and caregiver and c) still save on procedure costs. 

Providing access to COEs helps employers reverse a costly trend in which plan members typically make decisions about surgery guided solely by their physician. Studies show that when patients engage with highly specific, detailed information on their diagnosis, prognosis and treatment options, they make informed medical decisions that lead to healthier, and more personally satisfying, outcomes. Given the ability to understand their options and actively participate in surgical decisions, plan members can play a role in cutting the costs of surgery.

Shifting high-cost procedures to COEs can also help plan members avoid unnecessary risk associated with overtreatment, while enabling employers to receive significantly better value at lower cost. 

Another benefit of COEs: avoiding costs related to complications. For years, hospitals have been rewarded for medical complications with the ability to bill for the additional services provided - while employers have paid a high price for mediocre outcomes. One study shows that the average surgical complication generates an additional $13,000 in revenue for the hospital. 

Despite the many benefits of domestic medical travel, companies may encounter reluctance from executives and plan members. Therefore, it's important to develop steerage programs to inform them about strategies for leveraging the domestic medical travel opportunity.

Steerage Programs

Factors that impact the success of a COE program include employee willingness to travel, the role of incentives, ease of travel, waived co-pays and deductibles, and coverage of all travel costs. Steerage programs can be implemented to: 

  • Help employees fully understand all of the benefits
  • Establish top-down commitment to the benefit offering
  • Share the experience of other employers of similar size that have introduced the benefit
  • Arrange programs for spouses/traveling companions

The use of incentives is key, and many employers arrange complementary programs for spouses/traveling companions, eliminating co-pays and deductibles, and going the extra distance by providing some "pocket money" to cover the cost of meals, gas, tolls and other expenses.

The purpose of a steerage program is to spread the word that travel to COEs is in the employee's best interest -- and dispel any negative perceptions or confusion. Emphasis should be placed on a commitment to high-quality care, less cost for employees and access to alternative sites for surgery. COE programs are of special value to those living in rural communities with limited access to high-quality care.

A steerage program also addresses obstacles. For example, when Lowe's asked its benefit administrator to develop ways for workers to determine the best hospitals for cost and quality, the insurer dragged its feet for years, and Lowe's ended up doing the research. 

Las Vegas: Wellness Destination

After a hospital stay, many patients and companions choose to remain in the host city for a period of time before going home. An extended stay represents additional tourism revenues to the local economy and further stimulates job creation. The influx of visitors drives revenue for the COE, hotels, restaurants, shopping malls, museums, local attractions or points of interest, entertainment venues, sports events, airports and transportation services.

Las Vegas is a pioneer in this field and is making a huge play in the domestic medical travel arena. The Las Vegas Convention and Visitors Authority has taken a multi-faceted approach by focusing on hosting health care meetings and medical meetings, such as bio-skills training and continuing medical education for doctors, nurses and other health care professionals. 

In November, LVCVA will feature its hotels, spas, accommodations and specialized accommodations for corporate medical travelers and others interested in Las Vegas as a medical/wellness destination at the City Healthcare Consumerism™ FORUM West. Their goal is to promote the concept that Las Vegas is a medical and wellness travel destination. 

Top reasons to choose Las Vegas for medical travel include:

Comprehensive Medical Care: 16 hospitals, nearly 3,500 patient beds and access to a world-class collection of renowned medical experts.

Specialty Areas of Medicine: Medical providers who excel in unique specialties such as brain health, executive physicals, age management medicine, reproductive/fertility medicine, cosmetic surgery, bariatric surgery, and dental treatments and cosmetic dentistry.

Medical Services for Executives: A variety of services designed for executive business travelers, as well as their guests, including comprehensive executive physicals, age management services, dental treatments and cosmetic dentistry services.

Continuing Medical Education: An array of unique medical laboratory meeting facilities for hands-on bio-skills labs and surgical training, as well as a clinical simulation center and specialized continuing medical and dental education training facilities.

Physician Expertise: Diverse community of dedicated physicians, dentists and other practitioners representing numerous ethnicities, cultures and religions, representing exceptional training from institutions around the country and the world.

Hospital Accreditation: Acute-care hospitals in Southern Nevada are accredited by the Joint Commission. 

Hospital Facilities: Technology infrastructure has reached nearly $1 billion on construction of new facilities and major facility expansions and renovations, allowing hospitals to offer the latest state-of-the-art surgical care in the areas of cardiology, orthopedics, and emergency and trauma services.

Electronic Medical Records: $19.6 million grant to construct and operate a statewide broadband network for the purpose of improving patient care by eliminating technology disparities between rural and urban areas through telemedicine and health information exchange. 

Nevada Biotechnology: Generates $281 million in value output, employs 654 people and creates $58 million in household income, with new biotechnology research being conducted to address the use of proteins to regenerate blood vessels, skin and other tissues. 

Leading Global Spa Trends: World's top global spa trends, including culturally diverse treatments and services (Japanese stone beds, Turkish hammams, Shio salt rooms and Ayurvedic treatments, acupuncture and Moroccan rhassoul); healthy foot treatments and gait analysis; ice and cold therapies (arctic ice room, cedar wood saunas, laconium rooms, tea rooms); and massage and reflexology (pre- and postnatal massage).

Visitors with Disabilities: More accessible guest rooms than any other city in the country, with hotels offering rooms with roll-in showers, transfer showers, tubs with built-in or portable seats and lifts for swimming pools. 

Air Service: More than 900 flights per day and nonstop services from 120+ U.S. cities, with McCarran International Airport conveniently located just one mile from Las Vegas Boulevard. 
Weather: Averages 320 days of sunshine per year and averages less than five inches of precipitation annually, which is particularly beneficial for medical travelers. 

Licensing: Nevada physicians must pass stringent licensing requirements and comprehensive investigation programs. 

Academic Institutions: Academic institutions of higher education providing medical, nursing, dental and pharmacology education to ensure that the future of medicine remains stable. 

Accommodations: More than 150,000 rooms, averaging nightly room rates of $107. 

Dining: World-class chefs offering great food for every culinary taste, including vegan, superfood and farm-to-table choices.

Wellness Spas: More than 50 of the world's finest wellness spas and thousands of wellness treatments. 

Transportation: Close proximity of Las Vegas hotels, in many cases, eliminating the need for transportation as visitors can walk to many destinations, or use car rentals, buses, taxis, shuttles and the country's first automated monorail. 

Pools: Year-round sunshine allows for year-round swimming. 

In collaboration with the multi-disciplinary, not-for-profit health care organization Las Vegas HEALS, the City of Las Vegas plans to span its economic developing agencies, medical schools and the University of Las Vegas for the development of a strategic plan for the community to look at the development of medical tourism in the community. Part of this involves price transparency and packaged pricing, and bundling of medical services. 

Some health care providers in Las Vegas are already on board and offer package programs with transparent pricing. Others are still in the development process. A number of hotels have taken the lead as well, and have begun incorporating wellness technologies and amenities into their rooms:

  • The Stay Well Room Product at MGM has worked with the Cleveland Clinic and a company called Delos Living to integrate wellness technology.
  • M Resort has a new room called the Experience Room, which is basically a room that comes with wellness amenities. They also offer a Vitamin C-infused shower head and other types of aroma therapy and enhancements that create more of a wellness environment.
  • The Hilton Grand Vacations has a new medical traveler's discount program.
  • Trump International Hotel Resorts and Spas in Las Vegas offers Trump Wellness, which includes everything from an early morning boot camp for organized workouts to complete spa treatments -- all designed around a wellness and preventative health experience.

Las Vegas' city-wide effort is designed to target the traditional medical surgical traveler and the wellness preventative traveler, serving as a pioneer in what is likely to become a boom industry as more employers and their employees recognize and embrace the substantial advantages of domestic medical travel.

The End Result

Many companies have watched the big retailers begin offering domestic medical travel to COEs, and have taken their own first steps in exploring this benefit offering. As more employers adopt domestic medical travel, they will be motivated more by cost control, while moving toward paying for quality care - rather than simply paying per service. 

Domestic medical travel can play a critical role in mitigating the high cost of unnecessary surgery. Utilizing robust health data, employers can identify plan members who are on the path to major surgery -- and who would benefit from learning more about the surgery, as well as less invasive but equally effective options. 

As an innovative approach to health care, domestic medical travel helps to reduce financial risk for employer organizations of all sizes, while a relationship with a COE empowers them to anticipate costs and take positive, proactive action. Steerage programs are critical for getting a domestic medical travel program off the ground. They should be designed to inform and enlighten a company from the top down, with a focus on keeping employees healthy and productive for the company's long-term sustainability. 

About the Author

Laura Carabello has been an entrepreneur and a strategy consultant in both domestic and international businesses related to health care and technology since 1985. She is the publisher/managing editor of Medical Travel Today, the authoritative, online business-to-business international newsletter of the medical tourism industry, as well as US Domestic Medical Travel, the newsletter dedicated to U.S. intra-state and inbound medical travel. In 2011, Carabello published Medical Travel Today: Opinions and Perspectives on an Industry in the Making

To read the original article click here.

Industry News


Join employers, brokers, health plans, TPA's, consultants and solution providers to LEARN, CONNECT and SHARE over HealthCare Consumerism trends, challenges and solutions at the 4th Annual 2014 IHC FORUM West.
As a benefit to our partnership with IHC, MEDICAL TRAVEL TODAY would like to extend to you a complimentary registration FREE of charge*


This offer expires September 15, 2014 so Register TODAY!

  • Learn next steps and best practices in HealthCare Consumerism
  • Compliance issues with health care law in 2015 and beyond
  • Access latest health and benefit innovations and trends
  • Look into real time open enrollment statistics


  • Analyze benefit models, including defined contribution and exchanges
  • Network with your peers and other industry stakeholders
  • See what others are doing to empower and engage employees
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Industry News

Las Vegas debuts its medical travel video. A "must see" production.


Industry News

Seven Good Reasons to go Abroad for Medical Care
by Vitals

Surgery, healthcare, dental treatment and medications are often cheaper in other countries - much cheaper. Consider that a hip replacement costs about $40,000 on average in the United States. The same procedure costs only $7,780 in Spain. In fact, the Medical Tourism Association says that most patients save 90 percent of the cost by traveling abroad.

Read the full story here: 7 Reasons To Consider Medical Tourism

Industry News

What You Really Need to Know About Travel Vaccines
by Vitals

When my husband and I were planning a trip to South Africa, we visited a travel clinic to find out which vaccinations and other health precautions are recommended. For travel to South Africa, we received the recommended vaccination against yellow fever and were prescribed anti-malaria medication to be taken at a specific time in advance of our trip. We were also given boosters to bring us up-to-date on our routine vaccinations.

Read the full story here: Travel Vaccines: Which Ones Do You Need?

Industry News

Who and Where Are The Uninsured Consumers?
by Dina Overland

Fiercehealthpayer.com- Almost 14 percent of the American adult population remains uninsured since open enrollment closed three months ago, according to the Health Reform Monitoring Survey from the Urban Institute. The survey parsed out various characteristics of the remaining uninsured, which can help insurers target their outreach and education efforts as they focus on the 2015 enrollment period.

To view the original article click here.


Industry News

World's Largest Self-Insurance/ART Event Coming to Phoenix!

The Self-Insurance Institute of America (SIIA) today announced the program for its National Educational Conference & Expo, scheduled for October 5-7, 2014, at the J.W. Marriott Desert Ridge Resort & Spa in Phoenix. The event typically attracts more than 1,700 attendees from throughout the United States and from a growing number of countries around the world.

Detailed event information, including registration forms, can be accessed on-line at www.siia.org, or by calling 800/851-7789. Sign up today and take advantage of discounted early bird registration fees and secure your room at the host hotel. NOTE: This hotel is a SIIA member favorite and always sells out early, so please keep this in mind as you make your arrangements.

The program features more than 40 educational sessions designed to help employers and their business partners identify and maximize the value of self-insurance solutions.

We'll cover self-insured group health plans from every angle, including plan design and cost containment, financial risk transfer, broker involvement and healthcare reform compliance. Extra content has been incorporated this year that should be of specific interest to TPA executives and their key management teams. And you won't want to miss our panel discussion sessions featuring top thought leaders talking about the future of the self-insurance marketplace.

Another focus will be stop-loss captive programs (also known as employee benefit group captives). An increasing number of smaller and mid-sized employers have been considering self-insured group health plans and stop-loss captive programs can help facilitate this transition. SIIA has become the recognized industry leader in this fast-growing captive insurance market niche and the session speakers for this topic area will be many of the industry's top experts.

Also within the Alternative Risk Transfer track, additional sessions will focus on Enterprise Risk Captives, also known as 831(b) captives, which have become an increasingly popular self-insurance solution for many companies.

Given the rapidly involving business and regulatory environment for group workers' compensation self-insured funds (SIGs), we have incorporated a series of roundtable sessions where SIG leaders from around the country will provide a unique opportunity to share perspectives on how their organization should be positioning themselves for future success. These SIG-focused roundtables will be supplemented by additional timely sessions of interest to both groups and individual workers' compensation self-insurers.

Rounding out the program will be some sessions addressing key self-insured issues, including healthcare reform compliance requirements, for companies with global operations and/or workforces, giving the conference an added international flavor.

This top notch educational program will be supplemented with quality networking events, including an exhibit hall with more than 150 companies showcasing a wide variety of innovative products and services designed specifically for self-insured entities. If you are searching for a self-insurance business partner, they will be waiting for you at this event. For more information about exhibiting and sponsorship opportunities, please contact Justin Miller at 800/851-7789, or jmiller@siia.org.

Your can get a head start on your networking by participating in the conference golf tournament the morning of Sunday, October 5. And then cap things off with an incredible social event on the closing night of Tuesday, October 7, so be sure that you make your travel arrangements accordingly.

New to Self-Insurance/Alternative Risk Transfer? SIIA Welcomes You!....While the conference will be packed with industry experts and many advanced-level educational sessions, SIIA warmly welcomes those who are new to self-insurance/alternative risk transfer and want to learn the basics. To help you get started, we have scheduled "beginner" sessions immediately before Sunday night's welcome reception to help you more fully participate in the overall event. Additionally, for employers (non-industry service providers) considering self-insurance, you can take advantage of a highly discounted registration fee.

If self-insurance is important to you in any way, this is simply a must-attend event. We look forward to seeing you in Phoenix.

Register Now: www.siia.org/national

Industry News

SIIA Panel Discussion: Domestic Medical Travel - Opportunities and Challenges for Self-Insured Employers

Description: While international medical travel has been highly publicized over the past several years, domestic medical travel has been more quietly gaining traction among a growing number self-insured employers. This panel discussion will explore the latest trends in domestic medical travel and what employers need to consider when evaluating whether to incorporate this strategy as part of their health plans.

Moderator: Laura Carabello
Editor and Publisher:  National and International Newsletters
U.S. Domestic Medical Travel:  www.USDomesticMedicalTravel.com
Medical Travel Today:  www.MedicalTravelToday.com
Panelists: Ruth Coleman, CEO, Health Design Plus
G. Keith Smith, M.D., CEO, Surgery Center of Oklahoma
Olivia Ross, Senior Manager, Employers Centers of Excellence Network,
Pacific Business Group on Health

About Ruth Coleman

Prior to founding Health Design Plus in 1988, Ms. Ruth Coleman had almost 20 years of experience in HMO and hospital management, patient care, and nursing education. Her experience includes several executive HMO and hospital management positions with responsibility for network development, utilization management, customer service, quality management, marketing, strategic planning, and operations. Coleman used this breadth of managed care and care delivery experience to create an organization that provides high quality management for employer sponsored health benefit plans.

Her experience, expertise and leadership have guided Health Design Plus through incredible growth, recognized by numerous awards, including the prestigious Inc. 500 and eleven consecutive years as part of the Weatherhead 100, along with being named one of the Top Ten Women Business Owners in Northeast Ohio, and a finalist for the Ernst and Young Entrepreneur of the Year Award.

About G. Keith Smith, M.D.

G. Keith Smith, M.D., is a board-certified anesthesiologist in private practice since 1990. In 1997, he co-founded The Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City, Okla., owned by 40 of the top physicians and surgeons in central Oklahoma. Dr. Smith serves as the medical director, CEO and managing partner while maintaining an active anesthesia practice.

In 2009, Dr. Smith launched a website displaying all-inclusive pricing for various surgical procedures, a move that has gained him and the facility national and even international attention. Many Canadians and uninsured Americans have been treated at his facility, taking advantage of the low and transparent pricing available.
Operation of this free-market medical practice, arguably the only one of its kind in the U.S., has gained the endorsement of policymakers and legislators nationally. More and more self-funded insurance plans are taking advantage of Dr. Smith's pricing model, resulting in significant savings to their employee health plans. His hope is for as many facilities as possible to adopt a transparent pricing model, a move he believes will lower costs for all and improve quality of care.

The Surgery Center of Oklahoma is a 32,535 square-foot, state-of-the-art multispecialty facility in Oklahoma City, owned and operated by approximately 40 of the top surgeons and anesthesiologists in central Oklahoma.

If you have a high deductible or are part of a self-insured plan at a large company, you owe it to yourself or your business to take a look at our facility and pricing which is listed on the site. If you are considering a trip to a foreign country to have your surgery, you should look here first. Finally, if you have no insurance at all, this facility will provide quality and pricing that we believe are unmatched.

It is no secret to anyone that the pricing of surgical services is at the top of the list of problems in our dysfunctional healthcare system. Bureaucracy at the insurance and hospital levels, cost shifting and the absence of free market principles are among the culprits for what has caused surgical care in the U.S. to be cost-prohibitive. As more and more patients find themselves paying more out-of-pocket, it is clear that something must change. We believe that a very different approach is necessary, one involving transparent and direct pricing.

Transparent, direct package pricing means the patient knows exactly what the cost of the service will be upfront.

About Olivia Ross

Olivia Ross is Senior Manager with the PBGH New Initiatives team. Her projects include management of the Employers Centers of Excellence Network, which is a multi-purchaser (employer) collaborative established by PBGH as part of its commitment to improving the quality and affordability of health care. Additionally, Olivia participates in several on-going projects focused on changing physician and hospital financial incentives to ensure high-quality health care delivery, while also containing costs.

Olivia joined PBGH in 2012 after four years at the Feinberg School of Medicine Center for Healthcare Studies at Northwestern University. She initially served as Project Coordinator for several programs working with the Chicago Pediatric Patient Safety Consortium to advance patient safety through improved clinician communication and teamwork. Olivia's activities included conducting failure modes effects analysis (FMEA) risk assessments, training and evaluation of clinician handoffs and directing nearly 50 in situ simulations across six local hospitals

Olivia was then recruited to serve as the Research Project Manager of the newly formed Northwestern University Transplantation Outcomes Research Collaborative (NUTORC). In addition to managing patient safety projects, she supported strategic planning and oversaw the day-to-day operation of a group tasked with creating innovative health services and outcomes research in organ transplantation.

Olivia holds a Master in Public Health (MPH) from UCLA, and an MBA from the Kellogg School of Management at Northwestern University.

Industry News

Help Save a Life and Support MatchingDonors
100 percent of all donations on MatchingDonors.com go to help people get organ transplants on MatchingDonors.com.

MatchingDonors is a 501c3 nonprofit organization and the nation's largest online living organ donor organization finding living organ donors for people needing organ transplants.  In conjunction with various health organizations throughout the United States we have created a very successful Public Service Announcement campaign to help people recognize that they can save lives by being a living organ donor, to encourage them to register as an altruistic living organ donor, and to make them realize they can help save the lives of people needing organ transplants by donating other things. This MatchingDonors Living Organ Donor Initiative program has already saved thousands of lives.

Industry News


Upcoming Events

Medical Fair Asia 2014


September 9-11, 2014 - Suntec Singapore, Singapore
To learn more or to register click here.

8th Annual Global Spa & Wellness Summit


September 10-12, 2014 - Four Seasons Resort Marrakech, Marrakech, Morocco
To learn more or to register click here.

10th International Health Asia Exhibition & Conferences 2014


September 16-18, 2014 - Karachi Expo Center, Karachi, Pakistan
To learn more or to register click here.

10th International Exposition and Conference for Medical Tourism, Spa & Health


September 16-19, 2014 - Moscow, Russia
To learn more or to register click here.


September 20-21, 2014 - Tishinka Exhibition Centre, Moscow, Russia
To learn more or to register click here.

7th World Medical Tourism & Global Healthcare Congress

September 20-24, 2014 - Gaylord National Resort & Convention Center, Washington D.C.
To learn more or to register click here.

34th Annual SIIA National Educational Conference & Expo

October 5-7, 2014 - J.W. Marriott Desert Ridge Resort & Spa, Phoenix, AZ
To learn more or to register click here.

IMF International Medical Forum and Spa & Wellness: Healthcare Travel Expo


October 14-16, 2014 - EC KyivExpoPlaza, Kyiv, Ukraine
To learn more or to register click here.

Mexico Summit on Medical & Wellness Tourism Business


October 22-24, 2014 - Reynosa, Mexico
To learn more or to register click here.

Health Tourism Expo Turkey


October 23-25, 2014 - Istanbul, Turkey
To learn more or to register click here.

Medical Asia


November 5-7, 2014 - Bangkok International Trade & Exhibition Center, Bangkok, Thailand
To learn more or to register click here.

IHC Forum West 2014


December 4-5, 2014 - Red Rock Resort, Las Vegas, Nevada
To learn more or to register click here.

Arab Health Exhibition & Congress


January 26-29, 2015 - Dubai International Convention & Exhibition Centre, Dubai, UAE
To learn more or to register click here.

Moscow Medical and Health Tourism Congress


March 18-21, 2015 - Moscow Expocenter, Moscow, Russia
To learn more or to register click here.

Medical Fair India


March 21-23, 2015 - Pragati Maidan, New Delhi, India
To learn more or to register click here.

12th Annual World Health Care Congress 2015


March 23-25, 2015 - Marriott Wardman Park, Washington, D.C.
To learn more or to register click here.


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Medical Travel Today: Opinions and Perspectives on an Industry in the Making

Medical Travel Today - the authoritative newsletter for the worldwide medical travel industry - is pleased to announce publication of a new book, "Medical Travel Today: Opinions and Perspectives on an Industry in the Making."

Featuring 40 of the newsletter's most compelling interviews from the first five years of publication, the volume chronicles the explosive growth of international medical tourism as witnessed and experienced by some of the key stakeholders and players. A must-read for anyone interested or involved in the industry.

News in Review

Courage, Leadership, Investment Needed to Effectively Push Medical Tourism Here, Experts Say
Vegasinc.com-When people fly out of town for medical care, they often go abroad for low-cost surgery or head to such world-class centers as the Mayo Clinic for care they can't get at home.

Graphic: Medical Tourism Figures
Thenational.ae-Dubai Healthcare City surveys respondents from its 120 medical facilities.

Low Medical Costs Make Asia Top for Medical Tourists
Ttgasia.com-ASIA is claiming top spots as medical tourism destinations, according to the PHD Chamber's Medical and Wellness Tourism Report for 2013 with the first five places going to Singapore, Thailand, Malaysia, India and South Korea respectively.

Medical Tourism to touch US$ 6 billion by 2018: PHD Chamber
Newstodaynet.com- Even though India has yet to develop a fully dedicated website for marketing its existing super medical facilities to tour operators and medical facilitators, the Indian medical tourism industry is still anticipated to reach a value of US$ 6 billion by 2018, boosting the number of medical tourists arrivals in India to a projected level of 4 lakh in next four years.

Center to Promote Medical Tourism
Business-standard.com - The union tourism ministry has finalized fresh guidelines to promote the "untapped" market in medical tourism, an official said.

Medical Tourism Convention Opens in the Best City for Tourism in Korea
Businesskorea.co.kr-To transform Busan into a medical tourism hub, improve its competitiveness in the global medical tourism industry, and attract foreign patients, the City of Busan announced that the 2014 Busan International Medical Tourism Convention will open at BEXCO from Sept. 12 - 14, 2014.

90 Days or Less for Medical Tourism
Virtual-strategy.com- It takes 90 days or less for medical tourism consumers to make their buying decision. The factors that influence their health travel option can be enhanced.

The Patients' Guide to Treatment Abroad: New Independent Guide Published
Treatmentabroad.com-With many patients considering medical, dental or cosmetic treatments overseas due to long NHS waiting lists or high costs of private healthcare in the U.K., a new independent guide, published this week, aims to give them the information they need to make informed choices.


Do you know of any available job openings relative to the medical travel industry? We encourage readers to submit any available, relevant job opportunities along with its descriptions and requirements for fellow readers and industry professionals to consider. All submissions are appreciated.


Editor's Note: The information in Medical Travel Today is believed to be accurate, but in some instances, may represent opinion or judgment. The newsletter's providers do not guarantee the accuracy or completeness of any of the information and shall not be liable for any loss or damage caused - directly or indirectly - by or from the information. All information should be considered a supplement to - and not a substitute for - the care provided by a licensed healthcare provider or other appropriate expert. The appearance of advertising in this newsletter should in no way be interpreted as a product or service endorsement by the newsletter's providers.