Transcript Document

International Plan of Mystery:
What Self-Insured Employers Need to Know About Global Health Care Programs
PRESENTED BY
Victor Lazzaro, Jr.
Tom Emerick
David Hom
Chief Executive Officer
President, Emerick Consulting Former VP Strategic Initiatives
BridgeHealth International, Inc. Former VP Global Benefits
Pitney Bowes
Wal-Mart Stores, Inc.
October 6, 2008
Presentation
Overview
Medical Travel and BridgeHealth
Overview of Medical Travel
Who is BridgeHealth?
Destinations, Network, Procedures
Care Coordination
The Advantage to Employers
Examples
What Could It Have Done For Us?
US vs. “Peer” Countries
Decision Example: Hip
Sample Design & Savings
Myths and Realities
Experience as Mythical Patient
Popular Myths
Witnessed Realities
Conclusions
Discussion
Open Discussion
Medical Travel
&
BridgeHealth
The Trusted Bridge to World-Class Healthcare™
Overview of
Medical Travel
One 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 Travel
A 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:
•
•
•
•
•
Quality Care
Broad Network and Service Offering
Transparent, Cost-Effective Plans
Safety
Premium Experience
•
•
•
•
•
Flexible Benefit Design
Simplified Billing
Financial Stability
Deep Healthcare Experience
Solid Infrastructure
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.
BridgeHealth…
…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
Destinations
BridgeHealth 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.
Network
Just 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 Procedures
BridgeHealth 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:
•
•
•
•
•
•
•
•
Cardiology
Cardiothoracic
Chemical Dependency
CyberKnife® (cancer)
Dental
Detox/Rehab
ENT
Executive Health
Physicals
•
•
•
•
•
•
•
•
Gastroenterology
General Surgery
Gynecology
Internal Medicine
Neurosurgery
Oncology (selective)
Ophthalmology
Orthopedics
•
•
•
•
•
•
Pain Management
Pediatrics
Plastic and
Reconstructive Surgery
Urology Male/Female
Vascular
Weight Loss/Obesity Surgery
Care Coordination
Travel 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 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?
The Trusted Bridge to World-Class Healthcare™
US Healthcare Spending
vs. “Peer” Countries
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
“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 Replacement
Hospital A
Hospital B
Hospital C
Local US
Hospital
$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)
4.5
4.1
4.9
4.7
$500
Waived
Waived
$5000
$0
$1500
$3000
$0
$4500
$6500
$8000
-$5000
Underlying Cost of Procedure,
including Airfare and Hotel
Patient Satisfaction Score (5 point
scale)
Impact to Employee*
Patient co-payment and
deductible
Incentive paid by ER by EE
Net benefit to employee
with variable incentive
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 & Savings
Hypothetical Company Example:
Current
Insurance
International
Insurance
Benefit
$0
$41,000
$1,000
waived
80/20
waived
$5,000
waived
Travel Incentive
n/a
$3,000
Travel costs, air & hotel
n/a
$4,000
Partner air
n/a
$2,000
Savings to Employer*
Deductible
Coinsurance
Max. out of pocket
Additional Benefits:
* 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.
Pros & Cons
Pro’s
Employees requesting it
Lower cost
Good quality
Con’s
Due diligence required
Controls important
Myths & Realities
The Trusted Bridge to World-Class Healthcare™
My Experience as a
Mythical Patient
• Spent 2 days in Mexico to “feel” the experience
as 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
Myth 1: Medical Care is
Not Quality Focused
• 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 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
• 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 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 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
Conclusions
• 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
Discussion
The Trusted Bridge to World-Class Healthcare™
Contact Information
www.BridgeHealthInternational.com
The Trusted Bridge to World-Class Healthcare™
Victor Lazzaro, Jr.
Chief Executive Officer
BridgeHealth International, Inc.
[email protected]
O: 303.457.5725
C: 303.358.0300
Tom Emerick
President, Emerick Consulting
Former VP Global Benefits, Wal-Mart Stores, Inc.
[email protected]
O: (479) 957-4902
David Hom
Former VP Strategic Initiatives, Pitney Bowes
[email protected]
O: (203) 685-6790