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.
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:
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.