Editor’s Note: Based in Raleigh, N.C., IndUShealth recently released a patient experience study. Using data gathered over the past five years, the study highlights key aspects of the care experience and the motivations of the American retail and corporate patients that the company has coordinated care for at a network of hospitals in India.  Company founder and CEO Rajesh Rao spoke to us about the study, as well as how the nature of IndUShealth’s business has evolved over the past five years.   Part One of this conversation can be viewed here.   MTT: Given that 95 percent of the patients you work with need first-time passports, you’re clearing a lot of hurdles to get someone to commit to, first, surgery, and then surgery on the other side of the world. What are the key motivators for these individuals? RR: From what we’ve observed, the principal motivator is that people go because of dire circumstance. They’re physically impaired by their condition, and they don’t have the money at hand to pay the deductible. As you might expect, people just put off getting care. Their condition worsens and the cost of care keeps going up. Now when a company does their research and offers coverage that includes the ability to travel without deductible, provides first-dollar care, and offers the chance to travel with a companion, well, then the chance to get care outweighs any apprehension about travel. Now that’s just the people we ultimately end up talking or working with. I’m not sure how the conversation goes with those we don’t see. But clearly, we see more people saying they’re nervous but willing to give it a try.  In fact, utilization is higher than we initially predicted. The way it usually works is a company makes the offering and we see a few people step up and take it. The first patients then come back with a superior medical outcome than they could have received at home and talk about their positive experience. That gives other employees comfort to see that medical travel offers the quality of care they want and, of course, the savings.   MTT: I’m curious, do you have any sense of how your American patient data compares to non-American patients traveling to same facilities for care? RR: I haven’t had the need or opportunity to look at any data related to patients from other countries so I don’t know the answer to that, though I suspect it may be similar. It would also be interesting to see similar statistical data from other providers to determine the extent of the value-add provided by our carefully crafted vetting and risk management process.   MTT: What’s your process for providing feedback to hospitals? RR: We most definitely circle back with them on each experience and discuss any problem areas. What’s interesting is how the nature of the problems has changed over the years. Early on, problems tended to be around more circumstances where a facility may have had a third shift nurse that didn’t quite respond in the same way as other nurses had. That’s changed. There’s an expected level of consistency across all fronts that is apparent. Other issues arise as the nature of procedures change. For example, the nature of the need of a bariatric patient is quite different than, say, a patient getting a hip replaced. As unique issues emerge, we make sure to respond so that all patient experiences are as positive as possible. All of the hospitals are very interested in working with us to ensure that. What’s also interesting is that patient expectations have changed along with our patient demographics. Retail patients tend to do their homework and know what to expect. Especially the early adopters…they understand they can get good outcomes, but also that there  are some obstacles to navigate. Plus, they seem to have a different expectation of travel abroad. They know that it isn’t always clockwork. Now, patients from the corporate side have more of a ‘we don’t know any better just make it work approach.’ They’re far less tolerant of small issues because they are not equipped to be more tolerant…for the most part they’re not experienced world travelers. This typically emerges in the outside-the-hospital experiences. For example, if a couple is to take a sightseeing tour and their guide is running late, they’re not very tolerant. It’s not the idealized American Disney experience.  They seem to focus more on what the experience is not, rather than what it truly is. But the good news is that their excellent medical treatment and outcomes tend to be the memorable highlight of their experience, and they come back to their workplace as powerful advocates and brand ambassadors.       About Rajesh Rao With more than twenty years of experience in the creation and growth of successful entrepreneurial businesses, Rajesh Rao provides IndUShealth a critical combination of operational, financial and systems management skills. Mr. Rao began his career as a software engineer at IBM, later joining the founding team at Post Software International, where he ultimately became Director of Research and Development. Post Software became an established worldwide leader in retail systems automation and was acquired by Fujitsu ICL. Subsequently, Mr. Rao co-founded and served as CEO of Empower Corporation, an innovative enterprise e-learning software company that served several large multinational companies. Empower eventually became MindLever, which was acquired by Centra Software (Nasdaq: CTRA). Mr. Rao continued as General Manager at Centra prior to co-founding IndUShealth. Having faced ever-increasing costs of providing health benefits to employees in his previous companies, Mr. Rao decided to dedicate his time and resources to the pursuit of viable alternatives. He believed that the leveling of the global playing field would result in effective cross-border solutions with the potential to substantially reduce healthcare expenditures. As Co-Founder and CEO, Mr. Rao has been instrumental in building IndUShealth into a dominant player in the US, which has helped the “medical tourism” trend mature and evolve to an entirely new level.  He enjoys being able to innovate and work with others to further expand IndUShealth’s offerings and broaden its scope of influence. Mr. Rao is recognized as an industry leader and is often asked to speak to audiences at meetings and conferences. He has been featured in several news articles, as well as in TV and radio interviews. In June 2006, Mr. Rao appeared as an expert witness before the US Senate Subcommittee on Aging, extolling the advantages of employer-sponsored medical travel, and sparking a national debate over insurers’ and corporations’ roles in medical tourism.  He was also invited to speak at a National Academies seminar that explored the potential role of medical tourism in providing a suitable alternative for Americans. He holds Bachelor’s degrees in Electrical Engineering and Computer Science from North Carolina State University.