International Plan of Mystery:What Self-Insured Employers Need to Know About Global Health Care Programs
International Plan of Mystery:What Self-Insured Employers Need to Know About Global Health Care Programs
PRESENTED BY
Victor Lazzaro, Jr.Chief Executive Officer
BridgeHealth International, Inc.
Tom EmerickPresident, Emerick Consulting
Former VP Global BenefitsWal-Mart Stores, Inc.
David HomFormer VP Strategic Initiatives
Pitney Bowes
October 6, 2008
PresentationOverview
PresentationOverview
Medical Travel and BridgeHealth
Overview of Medical Travel
Who is BridgeHealth?
Destinations, Network, Procedures
Care Coordination
The Advantage to Employers
Examples
Myths and Realities
Experience as Mythical Patient
Popular Myths
Witnessed Realities
Conclusions
What Could It Have Done For Us?
US vs. “Peer” Countries
Decision Example: Hip
Sample Design & Savings
Discussion
Open Discussion
Medical Travel&
BridgeHealth
Medical Travel&
BridgeHealth
The Trusted Bridge to World-Class Healthcare™
Overview of Medical TravelOverview of
Medical TravelOne of the newest, most innovative options for U.S. employers, health plans, third party administrators, and other health benefits administrators.
Significant savings
Innovative health benefit design
Ensures high quality, cost effective medical care
Transparent costs
Complements consumer-driven programs
Overview of Medical TravelOverview of
Medical TravelA recent Deloitte study put the number of Americans traveling in 2007 at 750k, and a staggering 15M by 2016
Many players have entered the space on the B2C level, but few qualified on the B2B arena
Top criteria to consider:
• Flexible Benefit Design• Simplified Billing• Financial Stability• Deep Healthcare Experience• Solid Infrastructure
• Quality Care• Broad Network and Service Offering• Transparent, Cost-Effective Plans• Safety• Premium Experience
Who is BridgeHealth?Who is BridgeHealth?
BridgeHealth International, Inc.
(BridgeHealth) …is the premier
service provider in the burgeoning
medical travel industry—a real
company with infrastructure,
expertise, growth capital and
industry-specific experience.
…maintains an international
network of physicians and
accredited hospitals and clinics
…offers significant savings
…provides a turnkey solution
…has sent many Americans
abroad for medical travel
BridgeHealth…BridgeHealth…
DestinationsDestinationsBridgeHealth International has selected centers of excellence in the following countries: Brazil, China, Costa Rica, Hong Kong, India, Mexico, Panama, Singapore, South Korea, Taiwan, Thailand, and Turkey.
Additional locations in Europe and elsewhere are under evaluation.
NetworkNetworkJust two examples of the high quality network are:• Wockhardt Hospital in Bangalore, India –
affiliated with Harvard• Punta Pacifica Hospital in Panama – affiliated
with Johns Hopkins
Aftercare Network• Our Travel Care Coordinators work individually
as needed plus:• Over 160 locations in the U.S. for any follow up
that their usual physicians might not take.
Pre Travel care and consultation
The same network is available for discussion and medical review as needed prior to travel
Suite of ProceduresSuite of ProceduresBridgeHealth provides prospective patients an all-inclusive, transparent pricing plan which includes: surgery/procedure costs, airfare, lodging, transfers and a 24/7 concierge service.
A suite of medical and dental procedures are available, including:• Gastroenterology• General Surgery• Gynecology• Internal Medicine• Neurosurgery• Oncology (selective)• Ophthalmology• Orthopedics
• Cardiology• Cardiothoracic• Chemical Dependency• CyberKnife® (cancer)• Dental• Detox/Rehab• ENT• Executive Health
Physicals
• Pain Management• Pediatrics• Plastic and
Reconstructive Surgery• Urology Male/Female• Vascular• Weight Loss/Obesity Surgery
Care CoordinationCare CoordinationTravel Care Coordinators work with client and their needs
All U.S. information is treated in HIPAA compliant manner
Coordination of Pre travel medical records are made for client to host country hospital and physician
Pre travel telephone and/or email consultation with client and their host country physician can be arranged
Full outcomes data prior to travel is available to client
Care CoordinationCare Coordination
Post procedure medical records are translated as needed and coordination arranged for the client for their medical records to get to their U.S. physicians
Any after care needs can be coordinated
Client satisfaction surveys are done
Client outcomes are tracked and monitored
What Could It Have Done
For Us?
What Could It Have Done
For Us?
The Trusted Bridge to World-Class Healthcare™
Health Care Per Capita Spending (2003)
GDP %
U.S. $5,711 15.2
Switzerland $3,847 11.5
Canada $2,998 9.9
U.K. $2,317 7.8
Japan $2,249 8
Source: OECD Health Data 2006
US Healthcare Spending vs. “Peer” Countries
US Healthcare Spending vs. “Peer” Countries
“One fifth of all countries exceed U.S. in life expectancy.”
“Americans are living longer, but not as long as people in
41 other countries.”
“The U.S. health care system ranks last compared with five other nations on measures of quality, access, efficiency, equity, and Outcomes.”
Example: Decision for Hip ReplacementExample: Decision for Hip Replacement
Hospital A Hospital B Hospital C Local US Hospital
Underlying Cost of Procedure, including Airfare and Hotel
$15,000 $12,000 $9,000 $50,000
Complication Rate for Procedure 0.5% 1.8% 1.1% 1.2%
Travel time from home (showing flight transfers required.)
4 hrs (0) 22 hrs (2) 30 hrs (1) 0.5 hrs (0)
Patient Satisfaction Score (5 point scale)
4.5 4.1 4.9 4.7
Impact to Employee*
Patient co-payment and
deductible
$500 Waived Waived $5000
Incentive paid by ER by EE $0 $1500 $3000 $0
Net benefit to employee with variable incentive
$4500 $6500 $8000 -$5000
Assumes a $5000 copay/coinsurance at a US hospital and a variable incentive paid by employer (ER) to employee (EE) based on provider selected.
Sample Benefit Design & SavingsSample Benefit
Design & SavingsHypothetical Company Example:
Current Insurance
International Insurance
Benefit
Savings to Employer* $0 $41,000
Deductible $1,000 waived
Coinsurance 80/20 waived
Max. out of pocket $5,000 waived
Additional Benefits:
Travel Incentive n/a $3,000
Travel costs, air & hotel n/a $4,000
Partner air n/a $2,000* Hip replacement done in Asia: U.S. cost ~ $50k, Int’l cost ~$9,000
Cost to the Employer: $14,000 ($5k OOP, + $9k incentives & costs)
Net Savings to Employer: $27,000.
Pro’s
Employees requesting it
Lower cost
Good quality
Con’s
Due diligence required
Controls important
Pros & ConsPros & Cons
Myths & RealitiesMyths & Realities
The Trusted Bridge to World-Class Healthcare™
• Spent 2 days in Mexico to “feel” the experienceas a patient
• Gained deep understanding of the process• Visited several hospitals as a patient• Visited a cosmetic surgical center• Saw it firsthand and had “bias” pre-visit
My Experience as aMythical Patient
My Experience as aMythical Patient
• Hospitals are state-of-the-art facilities– Many are newly built with an understanding of patient flow for expedited
care• Similar principles to just in time production
– Visually attractive– High touch service for patients
• English speaking coordinators and forms are in English
• Physicians are often US or western trained– Updated on newest procedures and technologies– Typically are English speaking
• Nursing Staff are trained to handle US patients– Recent graduates with up to date training– English speaking
Myth 1: Medical Care isNot Quality Focused
Myth 1: Medical Care isNot Quality Focused
Myth 2: Only Cosmetic or Excluded Benefits
Myth 2: Only Cosmetic or Excluded Benefits
• This is shifting to mainstream care for other conditions such as– Cardiovascular – Pain– Hips and Knees– Optical surgeries
• Cosmetic surgeries will continue to grow due to the aging of the US population
• Dental care will expand
Myth 3: Patients Won’t Go Outside the US for Care
Myth 3: Patients Won’t Go Outside the US for Care• Access to additional services will continue to be
important • Options or choices will remain important to patients• Individual insurance premiums will continue to
increase at high levels• Growth of high deductible plans will continue to grow• Growth of ethnic populations will continue and
willingness to go their home country for care will continue
Myth 4: Medical Travel Won’t Be SustainableMyth 4: Medical Travel Won’t Be Sustainable
• Supply side growth will continue– Hospital beds designated to medical travel will continue to grow – Physician availability for multiple specialties will grow
• Demand side will grow significantly– Patient volume will grow
• Under or Un Insured• Ethnic Population growth in the US
– Employers will begin to adopt these programs as an additional choice for employees
– Health plans will need to get active as this will serve as a growth engine for members
Myth 5: Malpractice and Liability Barriers PersistMyth 5: Malpractice and Liability Barriers Persist• Demand side of health care will force innovative
financing of health care malpractice for returning patients in the US
• Liability coverage will likely move to shared captives by hospitals and other systems or companies
• Intake processes to manage patients will need to be automated and to improve to manage expectations
ConclusionsConclusions
• Growth industry• Venture capital is now entering this market to drive
adoption and sustainability• Health plans will see the need to invest• Employers who have specific needs will use these
services • Employees will demand services over time
DiscussionDiscussion
The Trusted Bridge to World-Class Healthcare™
Contact InformationContact Informationwww.BridgeHealthInternational.comThe Trusted Bridge to World-Class Healthcare™
Victor Lazzaro, Jr.Chief Executive Officer
BridgeHealth International, [email protected]
O: 303.457.5725C: 303.358.0300
Tom EmerickPresident, Emerick Consulting
Former VP Global Benefits, Wal-Mart Stores, [email protected]
O: (479) 957-4902
David HomFormer VP Strategic Initiatives, Pitney Bowes
[email protected]: (203) 685-6790