Tag Archives: healthcare price transparency

Former VP of Anthem Blue Cross Blue Shield Joins MedVoy

MedVoy announced today that they have added Lew Emanuelson to its advisory board to support and develop strategies for the employer benefit marketplace. MedVoy will now have an additional 32 years of specialized insurance experience in underwriting, sales and consulting for group health insurance plans and insurance brokerages in order to provide invaluable insight into the increasingly complex insurance vertical. It will enable MedVoy’s partners to draw from a new pipeline of patients to increase revenue streams, while also fulfilling MedVoy’s mission of connecting patients to domestic and international healthcare providers that administer the highest quality of care and accessibility at an affordable cost.

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The New Normal in Global Healthcare Referrals

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The model for global healthcare referrals has changed. In the old model, patients went to their doctor who referred them to another doctor or surgeon for care. These days, patients find their own surgeon and request a “reverse referral” asking the consultant to get the necessary information from a primary care doctor at home to assure continuity of care. Using transfer of electronic medical records, health information exchanges and telemedicine, patients now drive the process with increasing disintermediation of healthcare professionals.

BOTTOM LINE: The globalized, interconnected healthcare infrastructure is putting more power in the hands of patients to make choices about the value of care they receive.

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Mommy Makeovers at MedVoy

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You may be wondering… what exactly is a “mommy makeover”?

Pregnancy takes a toll of a woman’s figure and a mommy makeover is designed to help restore the pre-baby body. Women gain an average of 25 to 35 pounds during pregnancy and unfortunately, there are changes to the body, such as stretching of the stomach and fatty tissues stored in the hips and abdomen which is difficult, if not impossible, to lose through diet and exercise alone. A mommy makeover combines a variety of cosmetic surgery, such as tummy tuck, butt lift, breast lift/augmentation, liposuction, cellulite removal and other treatments. As every woman is different, these are customized to each woman’s needs.

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Five things will need to happen before medical travel gets real

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Despite the research reports, eco-devo white papers, industry analyses and industry marketing hype, medical travel/medical tourism is still an early stage industry looking for the right formula for success.

In my view, five things will need to happen before medical tourism and global healthcare referrals get real traction: 1) the creation of a sustainable business model, 2)global healthcare IT connectivity and integration, 3) a physician generated global healthcare referral network, 4) a global regulatory, legal and socioeconomic ecosystem, and 5) patient awareness and acceptance.

The creation of a sustainable business model
Industry players including payors, providers, partners and facilitators are still looking for the the most successful way to make a profit and scale the business. With an eye towards what happened when Expedia disrupted the travel agency business, participants understand that margins for travel arrangement services are thin and that there is high price elasticity for global medical care. Few have found the magic key that fits the lock that opens the doors to profits. Payors and employers are hesitant to accept the value proposition without a better way to reduce their risk and demonstrate tangible, meaningful cost savings to their insureds and employees.

Global healthcare IT connectivity and integration

The US national healthcare information architecture is evolving. Eventually, the network will be a portal to the world and will allow for seemless, secure, confidential transfer of personal health information thus assuring some continuity of care and quality improvement. Similarly, it will take a while for health information systems to evolve in host countries that can talk to non-host systems. Short term solutions, like personal health records or mobile health applications, might fill the void temporarily.

A physician generated global healthcare referral network

Most medical tourism models connect patients to healthcare facilities, bypassing doctors in the initial stages. Doctors will get in the game when the model feels better, and they have the resources and ability to make referrals to consultants directly, like they do now. Since MedVoy was founded by an American doctor, MedVoy connects patients directly to doctors which is unlike other facilitators. Given the rise of international members, professional medical societies should be more proactive in building global referral networks, rather than seeing them as threats to existing domestic members.

A global regulatory, legal and socioeconomic ecosystem

The barriers to adoption and penetration of medical travel are many and include liability, reimbursement, quality assurance and impediments to continuity of care. As healthcare goes global, so will the rules and regulations that facilitate or obstruct its use. How about a World Trade Organization Treaty on Medical Travel?

Patient awareness and acceptance

According to the most recent polls, 50% of consumers understand the meaning of the term “medical tourism”, leaving home for care. Social network buzz and media stories find the medical travel story sexy, particularly given all the noise about escalating healthcare costs and consumers, employers and payors are hungry for more information. Moving patients from awareness to intention to decision to action, however, will take more time and use innovative marketing approaches directed towards granular market segments.

Global medical travel is projected to be a $1B industry by 2012. While the bones are in place, it will take more time to add the flesh. Until then, to quote Karl Mauldin, people won’t leave home without it.

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Healthcare Open Enrollment Period

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It’s that time of year again… open enrollment for your health benefit plans. Most Americans are frustrated because their healthcare care bill is increasing… yet again… and this is exacerbated by the global recession and the confusion surrounding healthcare reform. Colorado is projected to see a healthcare increase of 14.4% in 2010 – slightly higher than other states due to the large number of small businesses in the state.

Large employers with 100 or more employees will often receive utilization and cost data and are in a much better position to manage their health care cost through aggressive plan management strategies and tactics. Small employers (and individuals) generally do not receive utilization and cost data plus often rely on the pooling of risk since they have a higher probability of costing the system more than the dollars they contribute through premium payments – since “everybody pays for a few”.

The misperception in healthcare is that cost and pricing for the same clinical procedure is relatively the same from provider to provider yet clinical costs vary significantly from zip code to zip code, state to state, and country to country.

Domestic and international medical tourism introduces transparency and helps to lower healthcare cost. There are scores of articles on lowering your out-of-pocket healthcare cost in 2011 that may help marginally. However, MedVoy is in a position to help individuals, employers and employees save real money on healthcare – contact us for details.

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The next wave in medical tourism

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As anyone following this industry knows, medical tourism is evolving rapidly. Some of the biggest changes are:

1. Movement from an emphasis on “tourism” to “medical”, with some questioning whether the term “medical tourism”should be abandoned in favor of descriptors like “global and domestic healthcare facilitation or aggregation”
2. A shift from international travel to US domestic referral to an ever expanding base of “centers of excellence”
3. Domestic price and quality transparency leading to value comparisons
4. Global competition forcing US providers to lower their charges
5. An emphasis on regional referral networks rather than long distance networks
6. Increasing IT interconnectedness because of HITECH incentives in the US
7. Increasing telehealth and mobile health options
8. Industry consolidation and elimination of marginal players
9. Higher barriers to entry as companies develop difficult to build networks
10. Initial attempts at costing the true benefits of various business models.

BOTTOM LINE: Buckle your seats belts. We’re in for a rough ride.

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Medical Spa MD Interview with MedVoy Cofounder, CMO, President

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MedVoy’s Chief Medical Officer, Cofounder and President, Dr. Arlen Meyers, was recently interviewed by Medical Spa MD.

In this interview, Dr. Meyers defines medical tourism as “leaving home for care. It can be inbound, (someone from Mexico coming to the US), outbound (leaving the home country to go to another country) or domestic. There are local, regional, national and international medical tourism clusters developing throughout the United States and around the world.

It is estimated that global medical tourism is a $100B global industry expected to grow significantly over the next few years. While no one can know for certain the effects of the recent US healthcare reform bill, rising costs, lack of supply of physicians and the demand for technologies and treatments continue to expand and fuel the growth of the industry.

The most common procedures sought by patients considering medical tourism are cosmetic surgery and dentistry, bariatric surgery, IVF and short stay procedures in urology, orthopedics, ENT and ophthalmology. That said, because of the onerous costs of some procedures in the US, patients are seeking life-saving cardiac surgery in India, proton beam irradiation in South Korea and living donor liver transplants in Asia.

The entire interview may be found here.

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Top 10 Medical Tourism Trends

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It’s time for new year’s lists. Here are my Top 10 Medical Tourism trends for the new year.

1. Global healthcare information exchanges
2. Commoditization of healthcare and the disintermediation of professionals
3. eBay mechanism to auction global healthcare services
4. Erosion and redefinition of professionalism and ethics
5. New heatlhcare insurance products designed to empower patients
6. Changes in global healthcare workforce
7. Global quality and price information exchanges and growth of domestic medical tourism
8. Growth of programs offering MBA’s in medical tourism
9. Evolution of medical toursm nurses and advocates
10. Electronic markets offering unused healthcare capacity.

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Medical tourism:Hype or Hope

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The US healthcare debate has focused a lot of attention on cost, price transparency and quality. As a result, medical tourism has garnered a lot of attention in the media and the press. When the fog clears,however, it is still unclear how much healthcare reform will impact whether Americans will go out of country for care. A few things seem clear, though.

First, the initial outbound medical tourism growth predictions seem overinflated. The numbers of patients leaving the US seems significantly less than originally stated. Major consulting firms are revising their growth projections downward.

Second, there continues to be low barriers to entry with providers, service providers and consultants scrambling to secure a dominant place in the market.

Finally, as I’ve written before, a crucial tipping point for outbound medical tourism will happen when referring physicians begin to trust overseas consultants. That will take a while.

In the meantime, innovators and early adoptors will continue to view medical tourism as a viable alternative, particularly when faced with the choice of getting something done at a price they can afford, versus not being able to get it done at all in the US because of high cost. The early majority will join later.

arlen.meyers@medvoy.com

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Domestic medical tourism: Old wine in a new bottle?

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People are now calling referring patients to someone in the same country domestic medical tourism. Doctors call it an out-of-area referral. Whether the consulting physician is located in a place recognized for excellence in diagnosing or treating a particular illness, like National Jewish Hospital (Denver) for pulmonary care or MD Anderson Hospital (Houston) for cancer care, the usual model involves one provider referrring the patient to another provider. The referring provider takes responsiblity for sending the appropriate records and reassuming care for post treatment issues when the patient returns home.

Domestic medical tourism implies something different. First, patients armed with information provided by the Internet or medical tourism facilitators, are requesting care without necessarily seeking the referral or “permission” of their provider at home. Second, given improving price transparency, in part a response to the transparency of foreign providers, patients can shop for value, something their insurance providers are encouraging by covering some or all of the out of network charges. Finally, when patients return home, they may have trouble finding someone to care for them is they have had treatment, particularly sugery, somewhere else.

Domestic medical tourism will evolve as quality and outcomes data and prices become less opaque and as interstate insurance cooperatives or other insurance models make it easier for patients to go to the best place for care regardless of location.

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