U.S. hospitals strategize to combat medical tourism
CHICAGO—Medical tourism—a term coined to describe going to a foreign country to have a procedure done more inexpensively than in one’s own country—is a thriving business. But U.S. hospitals are catching onto the trend and are beginning to create their own “destination programs.”

“If you’re not talking about medical tourism with your physicians, you need to. It’s taking away your volume,” said Tina R. Brinton, RN, a partner with Cenergy, a consulting firm specializing in physician-hospital alliances.

Brinton spoke on Friday at the annual meeting of the American College of Cardiovascular Administrators (ACVP) held in Chicago.

The trend started with trips for dental and cosmetic procedures, and has recently branched out to include cardiac and other surgical procedures. Singapore, in 2005, welcomed 400,000 patients from all over the world who paid cash to have elective medical procedures performed.

Most people pay out-of-pocket, but some payers, such as Blue Cross and United Health, have recently begun to foot the bill, according to Brinton. Savings per case can run between $20,000 and $45,000. Even some U.S. employers, such as Boeing, are taking a serious look at medical tourism as an option for their employees, she added.

A quick search on the Internet reveals several international hospitals offering their services, in very transparent detail. Bypass surgery: $8,500. Angioplasty: $13,000. Price includes all travel assistance including airfare and internal transfers by car; initial consult with surgeon; cost of implants; air conditioned private room with cable TV, DVD player and wireless Internet access; post-procedure consultation; and daily updates via email to your family and primary care physician.

“How many hospitals do you know that offer private rooms?” Brinton asked rhetorically.

There are 130 Joint Commission accredited international facilities on four continents and 60 more facilities seeking JC accreditation, she said. All physicians are U.S. board certified and many facilities seek to align themselves with prestigious U.S. medical schools such as Harvard and Johns Hopkins. Those two esteemed institutions, along with The Cleveland Clinic, are currently working with officials in Dubai to build a world-class medical center destination.

How can U.S. hospitals recoup these lost dollars or, even better, create a whole new stream of revenue? By creating their own destination packages.

Swedish Medical Center in Seattle has created such a program in an effort to attract patients from China and Japan. It also hopes to attract local patients who might otherwise travel abroad.

The key element to creating a “destination cardiovascular program” is not necessarily geography. Hospitals need only focus on price, quality, service and coordination, Brinton said.

“These programs can be used to differentiate your facility from your competitors,” she said.

When setting the price—one price, paid in cash—hospitals need to look at the cost of the service (pre- and post-operative care as well), travel, and hotel arrangements for guests or spouse. They should also offer financing options. The price should include everything. And the margin should be slightly more than usual, Brinton advised.

Rooms should be private, somewhat larger than usual to accommodate guests or spouse, and include amenities like refrigerators and computers with wireless access.

Coordinating the patient’s destination event has to be seamless from the initial schedule through the return home. Essentially, hospitals need an event coordinator and would do well to hire from a pool of travel agents, hostesses or concierges.

An indication of the importance of seamless care management is the trend for hospitals to employ care coordinators for their regular PCI patients. Care coordinators manage a certain number of patients. Each patient has one spokesperson through whom all pre- and post-operative management details are filtered, according to Brinton. 

“This is an example of hospitals taking one element of the destination program and using it as a differentiating factor,” she said.

Quality and attention to service should already exist in the hospital, making it easier to execute a destination package. Brinton suggests that hospitals publish quality indicators on their web site. Facilities also might want to align themselves with other prestigious institutions as a differentiating factor. 

Marketing the destination package is important and the web is the first place that medical tourists will look, Brinton said. Hospitals can also try to enlist sponsors such as restaurants, theaters, spas and other hospitality-focused businesses that can be part of the package. 

She recommends targeting particular employers: small- to medium-sized employers and those who are self-insured. Underinsured people with high deductibles can also be targeted.

Creating a destination program takes about 90 days to implement. After that, it’s ready to go, she said.