Domestic medical travel is taking off for surgery deals Updated 7/9/ :46 AM Comments 168 Recommend 21 Save Print

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1 Cars Auto Financing Ev ent Tickets Jobs Real Estate Online Degrees Business Opportunities Shopping Search How do I find it? Subscribe to paper Money Home News Trav el Money Sports Lif e Tech Weather Markets Economy Companies/Execs Personal Finance Taxes Media Cars Real Estate Small Business Jobs Become a member o TODAY comm Log in Become W h GET A QUOTE: Enter symbol(s) or Keywords Domestic medical travel is taking off for surgery deals Updated 7/9/ :46 AM Comments Save Print Enlarge By Eileen Blass, USA TODAY Anthony Reynolds, 50, of Greenwood, Del., went to Cleveland last month for heart surgery. Lowe's has an agreement with the Cleveland Clinic and waived his $5,000 in deductibles. By Julie Appleby, Kaiser Health News When John McNally needed a knee-replacement operation, his employ er, Alpha Coal West, of f ered to pay his trav el expenses if he would hav e the surgery in Fort Collins, Colo., a f iv e-hour driv e f rom his home near Gillette, Wy o. The Colorado surgery center had data showing good results with such operations, and it charged f ar less than the hospital in Gillette. Despite f eeling "ev ery bump on the way back," McNally was so pleased with the outcome of the operation that he returned to Colorado a f ew months later to hav e his other knee done. Share Yahoo! Buzz Add to Mixx Facebook Twitter More Subscribe myyahoo igoogle More Featured video iphone fix? Apple: Free cases to alleviate iphone 4 problems. Dolphin steals show Raw video: Jumps out of tank in Japan park. Quake DC-area woken up by minor earthquake. More: Video Forget about trav eling to Thailand or India f or low-cost surgery. More employ ers and insurers are of f ering f inancial incentiv es to encourage workers like McNally to consider "domestic medical trav el." By steering workers to f acilities with high-quality care and lower prices, employ ers say they can reduce their costs 20% to 40% more than enough to cov er the trav el expenses. A lot is at stake. Hospital care accounts f or more than one-third of the nation's $2.5 trillion annual health spending tab. And spending on hospital care which rose nearly 6% last y ear is expected to accelerate, gov ernment data show, driv en both by increased use and rising prices. Employ ers with domestic trav el programs say they sav e money in part by negotiating a single rate, which includes f ees f or surgeons, anesthesiologists and all medical care up until the patient is discharged. "This is one of our way s of try ing to bend the cost curv e," say s Bob Ihrie, senior v ice president in charge of employ ee programs at Lowe's. The national home-improv ement retailer has a three-y ear deal with the Clev eland Clinic to send willing employ ees and their dependents there who need treatments such as open-heart surgeries, v alv e repairs and pacemakers. Lowe's, which like most large employ ers is self -insured, may add orthopedic surgeries to its trav el program, Ihrie say s. Four other large employ ers including an airline and a bank are in a coalition with Lowe's that may soon announce similar agreements with medical prov iders, he say s. Lower costs, better care If domestic medical trav el catches on, particularly among large employ ers, it could help driv e down costs and improv e the quality of care, Ihrie say s. Colorado Health Plans Find a Cheap Plan w/ Full Cov erage! Ads by Google

2 It could shake up the hospital industry by f ostering "a truly national competition," say s consultant Jim Unland of the Health Capital Group in Chicago. The mov e by Lowe's along with growing interest in domestic medical trav el by other employ ers comes amid scrutiny of the role hospital prices and their market clout play in rising health insurance premiums, along with wider awareness that medical costs and quality can v ary dramatically between hospitals and across regions. Employ ers and insurers hav e long sent patients to "centers of excellence" f or organ transplants and other complex procedures. But domestic trav el is mov ing bey ond that to of f er more ty pes of medical care, including back and cardiac-by pass surgeries, and ev en relativ ely minor treatments, such as repairs to knee cartilage. Some companies are ev en prov iding f inancial incentiv es to workers. Among the f irms promoting domestic trav el: Alpha Coal West, McNally 's employ er, say s its medical costs hav e remained f lat ev en as spending nationwide has risen since its 2001 decision to of f er medical trav el to its Wy oming workers and their f amilies. A div ision of Alpha Natural Resources, the nation's third largest coal-mining f irm, Alpha Coal of f ers trav el to Fort Collins; Billings, Mont.; Rochester, Minn.; and Houston f or medical care related to orthopedic problems, cancer and other dif f icult diseases. BridgeHealth Medical, based in Greenwood Village, Colo., began of f ering domestic trav el programs to small and midsize employ ers last y ear. The f irm links workers to a network of about 20 hospitals and surgical centers in the U.S., where it has negotiated prices f or orthopedic, cardiac and other ty pes of surgery. The Health Serv ices Coalition, a group of 24 employ ers and unions in Las Vegas, warned in May that its member organizations might send some of their 260,000-plus employ ees and dependents to hospitals in Utah or Calif ornia unless local hospitals prov ide plans to improv e quality of care and reduce costs. Still, the domestic trav el mov ement f aces challenges. It could backf ire, Unland say s, if employ ers and insurers f ocus solely on cost, rather than quality. While most programs are v oluntary, large f inancial incentiv es can blur the line between choice and necessity. Medical prov iders hav e balked at making their discounts public. And it isn't clear how many workers are willing to trav el long distances, particularly those with y oung children. "Nev er mind sending them to India, they don't ev en want to go to Oklahoma," say s Rick Baker, president and CEO of North American Surgery, a Vancouv er, Canada-based f irm that negotiates discounted surgeries in the USA f or indiv iduals who don't hav e health insurance. While uninsured people are willing to trav el, workers with insurance are less likely to hop on an airplane, he say s. Get Instant Health Quotes Online. colorado.gohealthinsurance.com Heart Valv e Replacement New Approach; Less Inv asiv e; Less Pain and Scarring; Faster Recov ery! e Plans f or Small Business UnitedHealthcare s plans can help y ou recruit the right employ ees. UHC.com/Business What's this? Search hundreds of franchises and business opportunities to find the one that is right for you. Find a franchise: Select Category Select Investment Quick Request Form: Request information from your favorite franchises and business opportunities. Click here Some insurers not on board Insurers also can be reluctant to encourage domestic trav el. Lowe's Ihrie say s he asked the insurers who administer benef its f or his f irm's 125,000 employ ees to dev elop way s f or workers to determine the best hospitals f or cost and quality. Years went by without the insurers taking action. "So we went out and did it ourselv es." So did Alpha Coal. It hired retired surgeon Dav id Crowder to research options outside its local area f or some ty pes of care, say s Michael Peelish, executiv e v ice president at Alpha Natural Resources. Using data f rom Health Grades, a publicly traded hospital-ratings f irm, and other sources, Crowder looked into the quality of care at f acilities around the country. "It was really about looking f or the best in breed," Crowder say s. Alpha negotiated rates f or specif ic treatments with medical centers on Crowder's list, including Orthopaedic & Spine Center of the Rockies in Fort Collins, where McNally went. Alpha Coal's insurance program reduces co-insurance pay ments f rom 20% to 10% f or workers willing to trav el. It also cov ers hotel and trav el costs f or employ ees and their spouses or partners. "I would hav e probably been in a wheelchair by now if I hadn't done the surgeries," say s McNally, a welder who returned to work f or two y ears af ter his surgeries in He is now retired and has no problem with his company sav ing money on his care. Sav ings result not only f rom lower prices but f rom f ewer complications with procedures done at high-quality centers, Crowder say s. Some f ollow-up care, including phy sical therapy, is prov ided in Gillette. In f act, all the trav el-f or-surgery programs of f er emergency f ollow-up care f or patients. If any worker who trav els f or surgery has a complication or other urgent problem af ter returning home, that treatment is prov ided at the local hospital and cov ered under the company 's regular insurance plan, the companies say. In Lowe's case, the company negotiated f lat-rate f ees with the Clev eland Clinic f or complex cardiac procedures. Lowe's is not charged extra if a patient is re-admitted to the clinic f or care resulting f rom the surgery. But Lowe's agreed to make additional pay ments f or patients whose medical needs are so complex that they exceed normal ranges, such as a patient who might hav e multiple problems. Ev en those cases show sav ings, Ihrie say s. Already, one Lowe's employ ee had three complex heart procedures while hospitalized under the new program, Ihrie say s. Lowe's asked benef it f irm Mercer to calculate the cost of those procedures if they were done under the company 's standard insurance plan. Mercer estimated $531,000. Under the agreement with the Clev eland Clinic, Lowe's paid $469,000, Ihrie said. Less costly for employees, too To encourage workers to use the program, Lowe's waiv es deductibles and cov ers their trav el and hotel costs. Those sav ings made the decision a no-brainer f or Tony Rey nolds, an eight-y ear employ ee based in Dov er,

3 Del., who needed mitral-v alv e surgery. Rey nolds, 50, knew the company would waiv e $5,000 in deductibles and he'd sav e in other out-of -pocket costs if he went to Clev eland, and that Lowe's would cov er trav el costs f or him and his wif e. Rey nolds, who had his surgery last week, has been discharged f rom the hospital, is stay ing at a local hotel, and is scheduled to f ly home Thursday. Simpler treatments are also cov ered under some work-based trav el programs. Barry Yontz, 58, a sales manager in Rockton, Ill., f lew to Southern Calif ornia f or outpatient arthroscopic surgery to repair cartilage in his knee. BridgeHealth arranged the trip. Ev en af ter pay ing f or trav el and hotel costs f or him and his wif e, the insurance company "sav ed almost $3,000" compared with a similar surgery he had the prev ious y ear near home, Yontz say s. Nationwide, it's hard to quantif y how many employ ers are embracing domestic medical trav el or how much money they 're sav ing, say s Paul Keckley, executiv e director of the Deloitte Center f or Health Solutions, who has studied medical trav el extensiv ely. Employ ers who are going to send patients "hundreds or thousands of miles" f or care need to ev aluate whether "the outcomes are truly, dramatically better," say s consultant Peter Hay es with Health Care Solutions in Scarborough, Maine, whose clients include employ ers, drug companies and other industry play ers. Most major metropolitan areas hav e an "outstanding hospital" nearby, say s Victor Lazzaro, CEO of BridgeHealth. "Their outcomes are f abulous, and they hav e excess capacity." Domestic trav el is "slowly catching on," say s Hay es, whose last job was heading employ ee benef its f or supermarket chain Hannaf ord Bros. in Scarborough. Three y ears ago, the company began of f ering its 27,000 workers the option of going ov erseas f or some expensiv e surgeries. No one went because local hospitals lowered their prices in response. Still, insurers are reluctant to of f er trav el incentiv es because "it really angers the (local) prov ider community " to send patients elsewhere f or care, Hay es say s. James Caillouette, co-owner and surgeon at the Newport Orthopedic Institute in Newport Beach, Calif., say s doctors and hospitals had better get ov er their anger and embrace the new model. Two y ears ago, the center began signing f lat-rate prices with domestic trav el companies. "That's where health care is heading," Caillouette say s. "We're no longer going to be paid piecemeal." Kaiser Health News is an editorially independent news service and a program of the Kaiser Family Foundation, a non-partisan health care policy organization. Neither KFF nor KHN is affiliated with Kaiser Permanente. You might also be interested in: Backlash grows against full-body scanners in airports (USATODAY.com in Travel) 4-time Texas lotto winner rich with money, mystery (USATODAY.com in News) Chevy Volt fuel-economy forecast of 230 mpg now dead; actual number TBD (USATODAY.com in Drive On) Insurers test health plans that stress patient choices (USATODAY.com in Money) Selected for you by a sponsor: Ex-Drug Lord Rick Ross Sues Rapper Rick Ross (Billboard.com) Yahoo! Buzz Mixx Posted 7/6/2010 9:19 PM Updated 7/9/ :46 AM Save Print To report corrections and clarifications, contact Standards Editor Brent Jones. For publication consideration in the newspaper, send comments to letters@usatoday.com. Include name, phone number, city and state for verification. To view our corrections, go to corrections.usatoday.com. Guidelines: You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. Read more. You must be logged in to leave a comment. Log in Register Submit Post this comment to Facebook? Comments: (168)

4 Showing: Newest first New: Most recommended! MediBid (0 friends, send message) wrote: 1d 8h ago MediBid is a website that is designed JUST f or this issue. Companies and Health Benef it Administrators as well as indiv idual people can use MediBid f or domestic and international medical tourism. It's a site that lets y ou take control by giv ing y ou a choice f rom thousands of phy sicians with upf ront pricing unique to ev ery indiv idual request f or care. 4 Report Abuse jimmydmd (0 friends, send message) wrote: 7/9/2010 8:29:51 PM THIS IS GREAT NEWS, ALL PATIENTS WILL BE FLOWN TO CLEVELAND AND I WILL GET TO SLEEP. THANK YOU Report Abuse toddm7878 (0 friends, send message) wrote: 7/8/2010 3:28:14 PM Actually it is Medicare and Medicaid that underpay hospitals. I could cite numerous sources but here are just two. One f rom the American Hospital Association. -f igures-show-rise-in-gov ernmentunderpay ments-c harity -care/ /09medicunderpay ment.pdf I know this comes across as unf ortunate but it is the dirty little secret that Obama and liberals don't want y ou to know. It is f act. Not opinion. 2 Report Abuse The_Libertarian (0 friends, send message) wrote: 7/8/2010 9:16:55 AM Many politicians and a public that is eager to place blame hav e latched on to the belief that "America needs af f ordable health insurance". On the surf ace, this sounds correct, but it is actually quite f ar f rom the truth. What Americans need is af f ordable health care - insurers are only the middlemen. If we hav e af f ordable health care, then af f ordable insurance will f ollow. We must f irst address the high cost of care in our country. Unf ortunatly PPACA does absolutely nothing to address the cost of care. A signif icant portion of the American public has adopted an entitlement mentality and ref uses to accept responsibility f or their own liv es. It is neither y our gov ernment's nor y our employ er's obligation to take care of y ou. You are responsible f or y ourself. Employ er f unded (or subsidized) health insurance is an employ ee benef it that employ ers began prov iding in response to union demands. Non-union employ ers began to prov ide this cov erage in an ef f ort to attract and retain the most qualif ied employ ees. It has nev er been the employ er's obligation to prov ide employ ees with any thing other than a saf e work env ironment and a pay check f or the work that was perf ormed. Wake up and take care of y ourself. If y ou need health insurance, stop waiting f or Obama or y our boss to giv e it to y ou. Go get it y ourself. Priv ate health insurance is not limited to group insurance such as many people obtain through their employ ers. It is also av ailable as an indiv idual or f amily policy through hundreds of health plans throughout the country. These health plans of f er many dif f erent options at a wide range of prices. If y ou are not insured and y ou desire protection f rom catastrophic f inancial loss in the ev ent of a medical problem, then it is y our responsibility to obtain protection. There are cov erage options to f it almost any budget. Report Abuse angry.veteran (167 friends, send message) wrote: 7/7/ :38:53 PM The_Libertarian (0 f riends, send message) wrote: 1h 57m ago According to the Center f or Medicare & Medicaid Serv ices, the estimated cost of insuring the 33 million uninsured indiv iduals under the Patient Protection and Af f ordable Care Act (aka Obama-care, health care ref orm, or the end of the world as we know it - depending on who is talking) will be $930 BILLION in The cost f or insuring each of these uninsured people comes out to $28,182 per person. Our current health care expenditures av erage only $8,160 per person (a total of $2.5 trillion). Under the present health care pay ment model where priv ate insurance pay s f or about 60% of all health care expenses, the cost of health program administration is 7% of the total expenditure. With the gov ernment's inv olv ement, the cost rises dramatically. If the av erage expenditure is $8,160 f or those currently insured and the cost of insuring an additional 33 million people is $20,800 per person, what is driv ing the signif icant additional cost. Most of that additional cost comes f rom the additional bureaucracy that must be created to support PPACA. Those who would claim that the cost of administering healthcare through the gov ernment will be

5 lower than the cost of administration under priv ate insurance must hav e missed a f ew math classes. The numbers I hav e cited are f rom the U.S. Department of Health and Human Serv ices and their Center f or Medicare and Medicaid Serv ices (CMS). I maintain that to rely on the gov ernment to deliv er serv ices that a f ree market is capable of deliv ering with greater ef f iciency is sheer f olly. This is a f oolish experiment that the taxpay ing citizens of our country cannot af f ord Very nice. Now all we hav e to do is conv ince more employ ers to of f er a health insurance benef it so we can av oid the current plan. Only problem is, more and more employ ers are dropping out. Hell, we can't ev en manage to get sick day s out of many of them, nev er mind health insurance. The only part y ou missed was how we will expand the priv ately sponsored health care plans. 2 Report Abuse doctor pangloss (62 friends, send message) wrote: 7/7/2010 9:27:30 PM I just returned f rom Haiti and a v isit with a Voodoo witch doctor who cured my chronic toe itch by pouring chicken blood all ov er it. Cost about $2.50 f or the consultation and procedure. Report Abuse The_Libertarian (0 friends, send message) wrote: 7/7/2010 8:37:44 PM According to the Center f or Medicare & Medicaid Serv ices, the estimated cost of insuring the 33 million uninsured indiv iduals under the Patient Protection and Af f ordable Care Act (aka Obama-care, health care ref orm, or the end of the world as we know it - depending on who is talking) will be $930 BILLION in The cost f or insuring each of these uninsured people comes out to $28,182 per person. Our current health care expenditures av erage only $8,160 per person (a total of $2.5 trillion). Under the present health care pay ment model where priv ate insurance pay s f or about 60% of all health care expenses, the cost of health program administration is 7% of the total expenditure. With the gov ernment's inv olv ement, the cost rises dramatically. If the av erage expenditure is $8,160 f or those currently insured and the cost of insuring an additional 33 million people is $20,800 per person, what is driv ing the signif icant additional cost. Most of that additional cost comes f rom the additional bureaucracy that must be created to support PPACA. Those who would claim that the cost of administering healthcare through the gov ernment will be lower than the cost of administration under priv ate insurance must hav e missed a f ew math classes. The numbers I hav e cited are f rom the U.S. Department of Health and Human Serv ices and their Center f or Medicare and Medicaid Serv ices (CMS). I maintain that to rely on the gov ernment to deliv er serv ices that a f ree market is capable of deliv ering with greater ef f iciency is sheer f olly. This is a f oolish experiment that the taxpay ing citizens of our country cannot af f ord. 1 Report Abuse jimoo02144 (22 friends, send message) wrote: 7/7/2010 7:50:24 PM cbscribe (0 f riends, send message) wrote: 3h ago Our Pres has been quoted that the health care ref orm bill is a mirror image of the Mass plan. So how is that working out? --- Hav ing liv ed in Mass f or the past 7 y ears, it is working pretty well. Near 100% cov erage f or adults at minimal increase in costs to the residents. 2 Report Abuse More comments on this story: Next AARP Medicare Supplement Insurance Plans insured by UnitedHealthcare Insurance Company. AARPHealthCare.com Ads by Google

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