THIS WEEK IN U.S. DOMESTIC MEDICAL TRAVEL™
Volume 2, Issue 2
Nobody can take issue with the fact that education, information, networking opportunities, resources and access to quality services will propel this industry forward.
We can all benefit from learning the perspectives of Carol Berry, CEO, Health Care Administrators Association (HCAA) who is committed to delivering this level of service. For 35 years, HCAA has supported the advocacy, networking and educational needs of third-party administrators (TPAs), insurance carriers, managing general underwriters, audit firms, physician hospital organizations, medical managers, brokers/agents/consultants, human resource managers and other healthcare affiliated organizations in order to advance industry goals.
And judging from the growth of the HCAA, she is succeeding. In this issue, Berry shares her thoughts and concerns on the concept of employers - large, mid-size and small - to offer employees a domestic medical travel benefit to access high-quality, cost-effective care.
I am pleased to announce that About.com has published my byline entitled: "Medical Travel: Access to Savings and Quality Healthcare." This piece addresses the growing trend of employers adopting an innovative new approach to high-quality, cost-effective healthcare: medical travel. To read the article, click here.
Additionally, my UK colleague Keith Pollard at IMTJ has posted a blog which addresses an issue often raised about the value of one trade association. Please read the blog here: http://www.imtj.com/blog/mta-when-will-hype-and-misinformation-stop/.
Editor's Note: I am pleased to report that the Self Insurance Institute of America has invited me to chair a panel on employer direct contracting during its annual meeting: www.siia.org/national.
Panel: Employer Direct Contracting: Game-Changing Medical Travel Trend
Date: October 19, 2015
Time: 10:15 a.m. - 11:30 a.m.
Location: Marriott Marquis, Washington D.C.
The SIIA National Conference & Expo is the world's largest event focused exclusively on the self-insurance/alternative risk transfer marketplace, typically attracting more than 1,700 attendees from throughout the United States and from a growing number of countries around the world. The program features more than 40 educational sessions designed to help employers and their business partners identify and maximize the value of self-insurance solutions.
For additional details about SIIA and the upcoming panel, read the announcement entitled, "SIIA Panel Discussion: Employer Direct Contracting: Game-Changing Medical Travel Trend," below.
We're hearing from many hospitals, independent surgi-centers and provider groups that want to be better positioned to serve self-funded employers offering medical/surgical travel options. If you have a good story to tell us, please be in touch! We want to boost opportunities for Centers of Excellence nationwide.
What distinguishes your service offering in terms of cost, patient experience and satisfaction, outcomes, or other quality indicators.
Send us your descriptor, including photos or charts, and we will evaluate for publication in this newsletter.
"Rising health insurance premiums, lack of transparency and increased awareness of how varied medical costs and quality vary dramatically between hospitals and across regions, have pushed consumers right into the arms of international and domestic medical travel. The growing industry provides the perfect solution for patients to receive the high-quality, cost-effective care that they need AND rightfully deserve!" - Laura Carabello, Executive Editor& Publisher, Medical Travel Today & U.S. Domestic Medical Travel.
READERS: I invite you to send quotes relevant to domestic medical travel to firstname.lastname@example.org to be featured in upcoming issues of U.S. Domestic Medical Travel.
Thank you for your interest in this exciting, growing market space. Please be in touch with your comments and editorial contributions, which can be sent directly to: editor@USDomesticMedicalTravel.com.
Editor and Publisher
SPOTLIGHT: Carol Berry, CEO, Health Care Administrators Association (HCAA)
Health Care Administrators Association
6155 Lockhurst Drive
Woodland Hills, CA 91367-1203
About Carol Berry
In her position as HCAA CEO, Berry is responsible for the promotion of third-party administrators (TPAs) and others within the self-funded industry, as well as driving implementation strategies to achieve HCAA's short- and long-term strategic initiatives. With guidance from the Board of Directors, she extends awareness of self-funding, promotes educational forums, engages and grows membership, and directs advocacy efforts. She is responsible for supporting the efforts of HCAA's board to maintain and enhance current relationships with sister organizations and for creating new relationships that bring value to HCAA. She also provides strategic direction for HCAA's association management company. Berry reports to HCAA's executive committee.
She brings extensive experience in the healthcare and software industries, providing corporate leadership, operations consulting, product positioning and strategic planning. She has held successful executive positions in self-funding, managed care, managed behavioral health, and group medical insurance companies. She served as HCAA's president (2001-2002) and was awarded the HCAA designation of a Certified Self-Funding Specialist® (CSFS®) in July 2009.
Specialties: self-funding, healthcare, insurance, claims, benefit administration, strategy, operations, contracts, networks, information technology.
About Health Care Administrators Association
The Health Care Administrators Association is the nation's most prominent nonprofit trade association that supports the advocacy, networking and educational needs of third-party administrators (TPAs), insurance carriers, managing general underwriters, audit firms, physician hospital organizations, medical managers, brokers/agents/consultants, human resource managers and other healthcare affiliated organizations. For nearly 35 years, HCAA has taken a leadership role in legislative advocacy, working to increase its influence with policymakers and other stakeholders in order to transform the self-funding industry and expand its role within healthcare.
For more information, visit www.hcaa.org, or connect with us at @HCAAinfo, HCAA LinkedIn or HCAA YouTube.
U.S. Domestic Medical Travel (USDMT): How does Health Care Administrators Association (HCAA) differ from other associations in the market?
Carol Berry (CB): In comparison to other associations in the market, HCAA places heavy focus on the needs of TPAs and, of course, our supporting affiliate partners.
HCAA provides the education, information, networking opportunities, resources and access to quality services that this industry needs to move forward.
Traditionally, other industry partnering associations have done a great job at addressing lobbying and regulatory support issues. In turn, HCAA has supported their efforts and has carried out its mission by disseminating that information to our interested stakeholders.
We like to consider HCAA and its partners as symbiotic, with each organization contributing in its way to the greater good of the industry.
USDMT: Is HCAA comprised of large, mid-size and/or small employer members?
CB: Our membership is expansive and diverse. Our TPA members serve the gamut of self-funded employers from the very small to the traditional jumbo employers. Our membership includes TPAs from almost every state. We also have a few international members that have joined to learn more about U.S. healthcare delivery.
USDMT: Is a domestic medical travel benefit advantageous to employers of all sizes?
CB: I think a domestic medical travel benefit is probably more practical to offer for larger employers because they have the ability to spread costs and risks much further than smaller employers. That said, where the employer is located and the workforce that serves it can have a great effect on the choice of benefits, provider networks used and the opportunity to use the medical travel benefits. The most important thing for an employer to do is to craft their benefit plan with the broker and their chosen stop loss carrier or managing general underwriter (MGU), so that benefits are aligned with all the contracts and the best possible outcomes occur for both the patient and the employer.
USDMT: Do you agree that all consumers should have access to high-quality, cost-effective care regardless of what size employer they work for?
CB: Absolutely! I wish everyone could have that access, but this is not always the case. I believe that our member TPAs, in partnership with the broker community, provide the best networks available to employers for their benefit plans. So I believe that they provide access to high-quality providers. Providing access to "cost-effective care" may be more problematic. Our industry cannot control the costs that providers charge. Medical costs remain a problem for us all. Employers have only so much to spend on benefits. That is why in many cases there are "in-network" and "out-of-network" benefit plans, where the employee is given more choice, but with the choice comes more cost out of their pocket. The term "cost-effective" then becomes a personal and economic decision for the patient. Someday there will be greater transparency. Once that happens, and we can see the true costs for medical services, we be able to make those cost-effective decisions.
As a medical services consumer, I recognize the value of domestic medical travel in developing more access to cost-effective care. My concern is that not everybody can afford to travel for care, and if they can afford to travel for care, they may not be able to afford to bring a companion along for comfort, reassurance and/or aftercare.
USDMT: If the opportunity at one Center of Excellence is 40 percent less expensive than another, a number of employers will eliminate deductibles and copays, and in some cases pay for a patient's family member to travel.
I think it is important to mention that cost is not the only incentive for patients to travel - some facilities are touting better outcomes, as well.
CB: The good news with that is, the more publicity that gets out there regarding medical services pricing and quality statistics, the quicker this industry can grow.
Right now, I believe the facts are under-published.
USDMT: The demand for transparency is very apparent among consumers, which leads me to my next topic: bundled pricing.
Do you think bundled rates in foreign hospitals would be well-received by consumers?
CB: If a foreign facility employed renowned doctors that were providing high-quality, cost-effective care, I believe consumers would be attracted to bundled rates.
I am fortunate enough to be located in Los Angeles, and have access to wonderful medical care. But if I was faced with a catastrophic diagnosis, I too would look for a specialty Center of Excellence.
And that is what medical travel is all about!
SPOTLIGHT: Richard Lungen, Membership Chair, HealthCare Executive Group (HCEG)
About Richard Lungen, Membership Chair, HCEG and Managing Member, Leverage Health
Richard founded Leverage Health following 16 years of leadership experience within the managed care, life and health insurance, and overall healthcare service industries, as a means to deliver best-practice solutions from leading service companies to healthcare payers. Since founding Leverage Health, the firm has experienced year after year growth in sales, referencable clients and Portfolio Companies, and has developed an expanded team of healthcare professionals.
About HealthCare Executive Group
The HealthCare Executive Group is a national network of select healthcare executives and thought leaders, who navigate the tactical and strategic issues facing organizations today and provide a platform that promotes healthcare innovation and the development of life-long relationships. Originally the Managed Care Executive Group (MCEG), The HealthCare Executive Group (HCEG), was founded in 1988 by healthcare executives looking for a forum where the open exchange of ideas, opportunities for collaboration, and transformational dialogue could freely ensue.
U.S. Domestic Medical Travel (USDMT): Describe your professional history and involvement in medical travel.
Richard Lungen (RL): Currently, I serve as a Board Member of the newly launched HealthCare Executive Group (HCEG).
By way of background, I am the founder and executive of Leverage Health - a business development firm supporting emerging vendors that provide services to the payer, provider and employer marketplace.
Roughly six years ago, I became actively involved in the medical travel space, which was imminent due to my background in the PPO market where individuals are constantly searching for high-quality care at an affordable rate.
Around this time, the Centers of Excellence (COEs) industry seemed to have solved one set of problems, but I was on a separate mission to uncover whether or not individuals would travel for a multitude of procedures, both domestically and abroad.
USDMT: Where is the future of medical travel headed - domestic or abroad?
RL: The international market is real, but the domestic space is undoubtedly set up for success.
At this point, the domestic market is much more convenient - there's no language barrier, currency exchange, or confusion with follow-up care. Simply put, it is just more comfortable.
Again, there are detailed statistics indicating that patients are willing to travel internationally for knee, hip and shoulder replacements.
It is important to recognize that international patients specifically travel to the U.S. for care, as well.
USDMT: Are international patients discouraged from seeking treatment in the U.S. due to the high cost of care?
RL: Not necessarily. If you visit the Mayo Clinic, you will notice there are clocks from around the world in their lobby - and for good reason!
Regardless of the price of U.S. healthcare, we are a premier destination for treatment and will continue to be recognized as one for years to come.
USDMT: Does the implementation of the Affordable Care Act (ACA) drive interest in this space?
RL: Absolutely. For example, look at the exchange offerings - there is a significant demand for high-quality care at the right price. With the right benefit plan, consumers will have an increased incentive to travel.
Of course, as government benefits for the "65 and under" market begin to parallel the "65 and older" market, there will be added incentives for higher quality care - similar to the Star Program in Medicare.
On the employer side, the concept of medical travel has been attractive for many years as a solution to retain employees and control costs.
Now, with a more rigid focus on care, quality and price - the employer market is a faster adopter of medical travel because it helps reduce their personal healthcare spend.
The ACA and exchange trends are yet just another accelerator of the medical travel industry.
USDMT: Tell our readers why Managed Care Executive Group (MCEG) re-launched into the Healthcare Executive Group?
RL: At this point, the healthcare industry is very dynamic, and with the evolving roles of organizations within the industry, it prompted HCEG to broaden its membership base. We welcomed new executives from across the spectrum to help provide a more comprehensive view and approach to industry-wide innovation and transformation.
By simply moving the company from managed care to healthcare, we can invite other stakeholders to our organization as members, not just attendees, including providers and payers.
USDMT: Has the re-launch generated any pushback?
RL: We have received all positive feedback and are very excited about the future of HCEG.
As previously mentioned, our Board is now comprised of new members who each bring a fresh perspective to HCEG. Additionally, our annual event is approaching quickly, and will encompass different types of participants from providers, retailers and other stakeholders who previously did not attend.
As we speak, we have launched our education initiatives -- which include webinars, virtual panels and white papers - all centered on our proprietary HCEG Top 10. With our membership participation, HCEG has created a Top 10 Trends list to guide the strategic direction of the business. We are also developing the agenda for our 2015 HCEG Annual Forum. The theme, "Healthcare Revolution Required - Inquire Within," promises to be relevant and timely for all stakeholders in the industry.
USDMT: What specific challenges are organizations facing today?
RL: Today, the challenges are relatively consistent among payers, providers and industry stakeholders.
For example, HCEG members are currently faced with how to:
- Place the right products, at the right price, on the market
- Implement administrative and operational functionality to support employers and members as the market becomes geared toward consumers
- Ensure access to the appropriate tools and technologies to satisfy providers with respect to contracting value-based healthcare
USDMT: Is there anything else you'd like to share with our readers?
RL: HealthCare Executive Group is a lot more than an association - it is a community of thought leaders that discuss important matters, including medical travel, to help make a difference.
HCEG is actively monitoring how our payers, providers and stakeholders can work toward positioning consumers at the forefront of high-quality, cost-effective care.
Domestic Medical Travel: Benefits Option Offers Health and Financial Wellness
by Laura Carabello, Founder and Principal, CPR Strategic Marketing Communications
This article originally appeared in HR.BLR.com (http://hr.blr.com/), a Business & Legal Resources (BLR) website that provides compliance information, training and best practices for HR professionals.
Given the financial and legal pressures on businesses today, healthcare reform has prompted many employers to re-examine their responsibilities to protect not only their employees' health and wellness, but also their financial status.
With budgets and pocketbooks having taken a severe hit from mounting healthcare costs, HR and benefits executives are challenged to help companies avoid substantial monetary penalties for noncompliance under the reform's new regulations, and seek strategies to curb staggering healthcare costs.
In this environment, medical travel-leaving one's home state or region to travel to a Center for Excellence (COE) for high quality, more affordable surgical procedures or episodes of treatment-is quickly becoming a benefit option for many of the nation's leading companies.
While there are no authoritative statistics regarding employer adoption of domestic medical travel programs, it is estimated that 15% of the nation's 50 largest employers are offering this benefit option.
Significantly, top U.S. companies, including Wal-Mart, Lowe's, Jet Blue, and others, have begun offering U.S. domestic medical travel programs to their employees, covering the medical treatment and expenses, as well as expenses for a required caregiver. This sends a strong message to businesses of every size that medical travel is a viable strategy for cutting healthcare costs.
A key driver of medical travel is the increased demand for outpatient surgery. The number of outpatient procedures done in the U.S. tripled between 1999 and 2005. Advanced medical technology has allowed patients to go home just hours after a procedure, rather than several days. According to experts, outpatient surgeries account for about 75% of medical travel procedures, in part, because the out-of-pocket payments are relatively high in the U.S.
What is particularly interesting is that many employers get a taste for the quality and cost savings of a domestic surgery travel program, and soon migrate to international medical travel where the savings are even more significant.
The statistics on international medical travel are more clearly defined. About one million Americans sought medical treatment abroad in 2014, compared to about 750,000 in 2013, according to AARP Magazine. Experts expect this trend to increase 25% to 35% per year, with particular emphasis on procedures not traditionally covered by employer insurance such-as dental or cosmetic work.
Keep in mind that medical liability laws vary significantly among countries. Patients who are considering elective surgery abroad should not assume that they will be afforded the same legal protections against medical negligence as they receive in the United States. This legal issue is one reason that domestic medical travel is receiving growing interest from employers.
Domestic medical travel
U.S. domestic travel is the practice of traveling out of one's hometown or home state to a care provider or COE located in another part of the country. Domestic medical travel has also spawned a new breed of health management companies that gives employers access to the country's top hospitals and doctors-at a predictable cost.
The select hospitals involved in these programs must adhere to strict benchmarks for:
- Positive outcomes
- Low hospital-acquired infection rates
- High patient satisfaction
- Advanced staff training and skills
- Thorough patient data capture and other factors
Doctor's costs, hospital expenses, and fees are part of a single, transparent price.
Employers, especially large, high-profile companies, are increasingly exercising their options to pursue domestic medical travel, and employees are quickly becoming willing travelers in greater waves. The path toward better outcomes and cost-efficiencies represents high value for all parties.
While large employers have dominated the domestic medical travel marketplace, many midsize, and small employers, are growing more receptive to this concept, and aggregating their purchasing power through coalitions and other multiple employer welfare arrangements (MEWAs).
Employers of all sizes build in incentive programs to prompt workforce uptake of the benefit, including waiving copays and deductibles, and covering both patient and companion/caregiver travel expenses. One of the drivers is the documented track record of a COE to achieve better results for specific procedures, mitigating complications, redo's, and re-admissions-which can be very expensive in terms of hard costs, time lost from work, and the health of employees.
Several organizations and purchasing coalitions are helping to guide employers in their selection process. For example, The Pacific Business Group on Health (PBGH) brings employers together with the aim of improving the quality of healthcare while moderating healthcare costs. PBGH's 60 member-companies provide healthcare coverage to 10 million Americans and their dependents, providing employers with a wide array of services that range from advising on relationships with carriers, supporting projects that accelerate price and quality transparency, and advocating for policy initiatives.
One of the organization's key members, Wal-Mart, launched a COE travel surgery program for cardiac and spine, and suggested that this type of program could have a stronger impact moving the market if multiple employers joined together. Since then, PBGH has learned that employers want a travel surgery program that offers high quality surgical care at affordable rates, not just an arrangement that provides the "best deal."
Employers that sign on with PBGH's Employers Centers of Excellence Network (ECEN) can expect to receive a complete return on investment within 2 years-and significant savings thereafter. In addition to the competitive bundled rates, the bulk of savings opportunity is the result of the higher quality of care.
Optimizing the opportunity
While quality of care has traditionally been the primary deciding factor in choosing a hospital or physician for a specific treatment or procedure, the cost of healthcare has become an increasingly important factor for consideration. As patients have been asked to pay a greater proportion of the cost of their care-through higher copays, deductibles, and other plan cost-sharing features-they are becoming more comfortable with the notion of leaving home to access better care that costs less out-of-pocket than seeking care locally.
Having access to geographically-specific healthcare cost information will also be key to empowering patients to make more informed decisions regarding whether to travel for care and how to plan for it financially. Additionally, all stakeholders will benefit from price transparency and bundled pricing.
Enormous variation in healthcare prices exists across the country. For example, one hospital might bill $40,000 to remove a gallbladder using minimally invasive surgery, while another hospital might charge $91,000, according to the New York Times.
Prices can also vary within each state. For example, the median cost for a common inpatient heart procedure in southeastern Wisconsin ranges from a high of $178,647 at Waukesha Memorial Hospital to a low of $105,119 at Wheaton Franciscan All Saints in Racine, according to Business Journal.
By only signing contracts with providers priced in the low range, but who also demonstrate good outcomes, employers can lower the cost of providing healthcare without compromising quality.
Bundled payment, also known as episode-based payment or packaged pricing, is defined as the reimbursement of healthcare providers based on expected costs for clinically defined episodes of care. Providers are paid a single fee for a set of evidenced-based services related to a diagnosis, with payments typically linked to outcomes, as well as other quality measures.
As plan members take on a greater share of their own healthcare costs, they are beginning to distinguish between low prices and high quality. At the same time, employers are playing a more aggressive role by contracting directly with healthcare providers and COEs in order to find the best value for their employees, and opting for bundled, fixed price procedures.
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.
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EdisonHealth Adds Connecticut Joint Replacement Institute to its Elite Network of Medical Destinations of Excellence
The EdisonHealth Network is pleased to announce that the Connecticut Joint Replacement Institute (CJRI) at Saint Francis Hospital and Medical Center in Hartford, Connecticut, has been added to its Network of medical destinations of excellence.
CJRI joins Virginia Mason Medical Center in Seattle, Washington, and Mercy Hospital Springfield in Springfield, Missouri, as one of EdisonHealth's Network destinations for joint replacements. CJRI is nationally recognized by Consumer Reports as a top five hospital in the nation for total hip and total knee replacements, and the only hospital recognized in both categories.
"The Connecticut Joint Replacement Institute is well-suited for our network," comments Rick Chelko, co-founder of EdisonHealth. "CJRI's operating model, quality and patient safety programs, and track record of outstanding clinical outcomes are consistent with our emphasis on proper diagnoses, appropriate treatment and great outcomes."
"The Connecticut Joint Replacement Institute is excited to partner with EdisonHealth in offering high-value orthopedic services to members of contracting employer-sponsored health plans. This new and innovative model will allow consumers to access one of the premier joint replacement centers in the United States," according to Steven Schutzer, M.D., medical director of the Connecticut Joint Replacement Institute.
Modeled after co-founder Tom Emerick's work with Wal-Mart and other major corporations, EdisonHealth also provides members of contracting health plans with access to spine, heart, valve, transplant, and cancer care at some of the highest-performing clinics and health systems in the United States. These EdisonHealth Network medical centers are committed to team-based, accountable approaches to evaluate and treat patients - ensuring they receive high- quality and appropriate care. By focusing on the limited, but growing, number of patients with these high-cost and often mistreated conditions, EdisonHealth is able to deliver tremendous value to these individuals and health plan sponsors.
"Knee and hip replacements have rapidly become big profit drivers for hospitals. We need to make sure people get to the right team to be diagnosed properly and treated appropriately," states Tom Emerick, one of Forbes' 13 Unsung Heroes Changing Healthcare. "CJRI will enable us to more easily get patients in the Northeast the care they need."
To learn more about the EdisonHealth Network LLC, call 866 982-7988 or visit www.edisonhealth.net.
About The EdisonHealth Network LLC
EdisonHealth provides members of contracting health plans with access to joint replacements, heart, valve, spine, cancer and transplant care at some of the highest-performing clinics and health systems in the United States. The service is offered to organizations with 5,000 or more employees, as well as smaller groups through third party "aggregators." Participating employers and health plans also receive a suite of care coordination, claims payment, performance reporting and related services. EdisonHealth recently received the Validation Institute's "seal of approval" for its integrity and proven performance with respect to reporting outcomes, contractual promises and other claims. For more information, visit www.edisonhealth.net.
About Connecticut Joint Replacement Institute
The Connecticut Joint Replacement Institute has performed more than 20,000 joint replacement procedures since 2007, making CJRI the highest volume and most experienced joint replacement center in Connecticut and amongst the largest in the United States. CJRI records some of the lowest postoperative complication rates nationally and is ranked in the 99th percentile in the state for patient satisfaction. For more information, visit www.saintfranciscare.com/cjri.
New World Medical Network Announces an All-Inclusive-of Travel-for-Two CyberKnife® Cancer Treatment Program at Southeast Georgia Health System
As third-party administrators, stop loss, captives and self-insured companies all look for ways to provide quality care for less cost, New World offers another solution specifically for cancer care as part of the high quality program at Southeast Georgia Health System.
"We are excited to partner with the Southeast Georgia Health System with this state-of-the-art Cyberknife® Treatment offering. Together, with our all-inclusive one price healthcare (TM) offering, the self-insured marketplace will know exactly what they are paying for care before their members receive treatment," shares Terry Johnson, chief operating officer for New World Medical Network (TM) (New World).
"Southeast Georgia Health System is one of less than 250 CyberKnife programs world-wide that provides access to the world's first and only robotic radiosurgery system designed to treat tumors throughout the body non-invasively," says president and CEO of Southeast Georgia Health System Gary R. Colberg, FACHE. "We are proud to be able to make available our services to those outside our region through our partnership with New World Medical Network."
Southeast Georgia Health System is a not-for-profit, tobacco-free health system comprised of two acute care hospitals, two long-term care facilities, three immediate care centers, and five family medicine centers, and employs more than 115 providers working in 20 different medical specialties at more than 40 locations. The Health System has multiple outpatient specialty care centers, including the only CyberKnife® Center in the region and one of only four in Georgia, a Cancer Care Center accredited by the American College of Surgeons Commission on Cancer, and designation of Centers of Excellence in: Breast Care and Joint Replacement. In 2013, the Camden Campus was named the 2013 Small Hospital of the Year by the Georgia Alliance of Community Hospitals, and was also recognized as a 2013 Top Performer on Key Quality Measures® by The Joint Commission, the leading accreditor of healthcare organizations in the United States. In 2015, the Brunswick Campus was rated High Performing in Hip Replacement in the U.S. News & World Report. For more information, call 855-ASK-SGHS (855-275-7447) or visit sghs.org.
New World Medical Tourism LLC (New World) is run by experienced healthcare and insurance professionals and caters to the self-insured marketplace -- TPAs, companies, municipalities, and unions - with its one-cost, all-inclusive approach to non-emergent medical procedures and surgeries called "One Price Healthcare" (TM) The New World Medical Network consists of high quality, accredited medical facilities within the United States, often saving organizations 50 percent off average U.S. costs. The program attaches to an existing health plan, achieved with a simple amendment to the plan document, so there is no need for Open Enrollment or a delay in Savings; the program can be implemented at any time. Companies, municipalities and unions can call directly to 1-800-475-PATIENT (7284) to talk with a salesperson and receive a comprehensive savings analysis specific to their company and demographics, or visit newworldmedicalnetwork.com.
New World Medical Network
+1 (631) 909-8538
New World Medical Network
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Top 10 Causes of Workplace Injuries: How Medical Tourism Can Save Employers Money
by Richard Krasner
Merrell: "...Can you see a role of medical tourism in workers' compensation injury?"
Ludwick: "I could, if it were a long-term issue. Many workers' comp issues are emergent,
so that would take out the medical tourism aspect. However, if it was a long-range issue, I
could see us involving workmen's comp issues into that, or problems."
Lazzaro: "I would support that. I don't know the incidence, for example, of some of the
orthopedic procedures that are non-emergent, such as knee or hip replacement, which would
fall under workmen's comp. But theoretically, a case could be made for that..."
Merrell: "I was thinking about it in terms of the chronic back injury and the repetitive action
injuries and hernia that are in the workers' compensation area. An acute injury on the job
would probably not be at issue but a work-associated problem with a potentially surgical
solution might be a matter for medical tourism."
You may recognize the above quoted dialogue from my white paper on medical tourism and workers' comp. I am reprinting it here because I came across a report from the Liberty Mutual Research Institute for Safety that highlighted the top ten causes and direct costs of the most disabling workplace injuries in 2012. My thanks goes to Jim Mecham, Continuing Education Director and Return-to-Work Software Developer at OCCUPRO, for bringing this to my attention through his post on LinkedIn.
The report, the 2014 Liberty Mutual Workplace Safety Index is based on information from Liberty Mutual, the U.S. Bureau of Labor Statistics (BLS), and the National Academy of Social Insurance. The Index provides statistics for injuries that occurred in 2012, which is the most recent year for which data was available.
The Index showed that the most disabling injuries and illnesses had a direct workers' comp cost of $59.58 billion, which translates to over a billion dollars a week spent by business on the most disabling injuries.
The following chart indicates what those ten injuries are, the percentage of each type of injury, and the direct cost.
Source: Bing Images
The top five causes were:
- Overexertion involving outside source
- Falls on same level
- Struck by object or equipment
- Falls to lower level
- Other exertions or bodily reactions
Overexertion accounted for 25.3 percent of injuries, and is further identified as being caused by lifting, pushing, pulling, holding, carrying, or throwing, and cost businesses $15.1 billion in direct costs.
Falls to same level accounted for 15.4 percent of injuries, costing $9.19 billion.
Struck by object or equipment injuries accounted for 8.9% of injuries and cost $5.3 billion.
Falls to lower level accounted for 8.6% and cost $5.12 billion.
Other exertions and bodily reactions accounted for 7.2 percent of injuries and cost $4.27 billion. This includes injuries resulting from bending, crawling, reaching, twisting, climbing, stepping, kneeling, sitting, standing, or walking.
The second group of five injury causes accounted for 18.4 percent of the direct total cost of injuries. These were:
- Roadway incidents involving motorized land vehicles - 5.3 percent, $3.18 billion;
- Slip or trip without fall - 3.6 percent, $2.17 billion;
- Caught in/compressed by equipment - 5 percent, $2.1 billion;
- Repetitive motions involving micro-tasks - 3.1 percent, $1.84 billion;
- Struck against object or equipment - 2.9 percent, $1.76 billion
These ten injuries comprised 83.8 percent of the total cost burden for disabling work-related injuries in 2012.
What does this all mean?
For the employer, it means a lot, especially in terms of dollars and cents that can be avoided if there are proper safety programs in place to lessen the frequency and severity of these injuries. However, accidents do occur, and while safety programs do work, they don't always live up to the promise; nor do workers ever follow safety rules. Therefore, when these injuries occur, it would be wise for an employer to find a less expensive way to deal with the injury than expensive surgeries at home.
For the workers' comp industry, it means that you are not doing a very good job of saving your client's money, or you are doing a great job making money for yourselves and other workers' comp service providers.
And finally, for the medical tourism industry, it means you have some work to do to go out and get this business and prove to the American employers, insurance companies and injured workers that when any of these types of injuries occur, you can provide them with the best care and the lowest cost. As I said in my presentation in Reynosa, Mexico, last November, "[the] Medical Tourism industry must take [the] lead and go after the market; the market will not come to you".
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Interested in Improving Your Health and Well-being? Newly Published Book, An Illustrated Guide to Personal Health, Will Provide You With A Step-By-Step Guide!
Tom Emerick has just published on Amazon a new book called An Illustrated Guide to Personal Health, co-authored by Roberts H. Woods, Ph.D., an excellent researcher and professor at University of Nevada, Las Vegas. This book is aimed at showing consumers how they can improve their health and well-being in ways doctors really can't. The authors contend that medicine simply cannot deal with major risk factors. They address 40 of those in this book, although a little irreverently at times.
Here is a synopsis written by their editor:
Health issues are an inescapable part of life-but by preparing for them, you can fend them off longer and handle them better when they do arise.
Offering eye-opening insight in a surprisingly lighthearted way, An Illustrated Guide to Personal Health teaches you how to manage your own health rather than depend on doctors and medicine-which often only narrowly address your overall well-being.
Skirting the typical fitness and dietary solutions, this guide provides 40 common-sense practices you can incorporate into your regular routine to improve your resilience, reduce your stress, and ensure you will live healthier and happier for many years to come. With unexpected chapter titles like "Give Your Fork a Rest," "Let Kids Play in the Dirt," and "Don't Take Multivitamins," this self-help manual sets itself apart from the typical tips most health books offer, while still supporting its collection of timeless and innovative directives with citations from the medical field.
Health, wellness and happiness go hand in hand-and only you can form the habits that will ensure you experience all three. Start learning how to improve your life today.
If you're interested in purchasing An Illustrated Guide to Personal Health. Just click here.
SIIA Panel Discussion: Employer Direct Contracting: Game-Changing Medical Travel Trend
Panel: Employer Direct Contracting: Game-Changing Medical Travel Trend
Date: October 19th, 2015
Time: 10:15am - 11:30am
Location: Marriott Marquis, Washington D.C.
Description: With the sticker-shock of health reforms resonating in the employer community, business leaders are seeking solutions that not only lower costs, but also ensure quality. While there are a few pioneers in the large business category that have tested the waters to execute direct contracting arrangements with targeted Centers of Excellence (COEs) (e.g. Wal-Mart, Lowe's, Boeing) the vast majority of large employers are now contemplating these arrangements in the year ahead. Furthermore, virtually all of the mid-size and small employers are also receptive to this concept and may aggregate their purchasing power through coalitions and other multiple employer welfare arrangements (MEWAs). A panel of experts will discuss the latest trends in this area.
Moderator: Laura Carabello
Editor and Publisher: National and International Newsletters
U.S. Domestic Medical Travel: www.USDomesticMedicalTravel.com
Medical Travel Today: www.MedicalTravelToday.com
Cheryl DeMars, CEO, The Alliance
Trisha M. Frick-Hall, MS RN, Assistant Director, Managed Care Contracting, Office of Managed Care, John Hopkins Healthcare LLC
David LaMarche, MBA, Administrative Director, Finance, Virginia Mason Medical Center
To learn more about the upcoming panel and/or event, please visit: www.siia.org/national.
U.S. News Names Massachusetts General Hospital Best in the Nation
Boston hospital leads publication's list of top-ranked hospitals for 2015-2016
by Joanne Finnegan
Fiercehealthcare.com-Massachusetts General Hospital in Boston is the best hospital in the country, according to the latest rankings released by U.S. News & World Report.
To view the original article click here.
AHIP: How insurers can improve price transparency tools
by Dina Overland
Fiercehealthpayer.com-Insurers have launched more price transparency initiatives to empower their members to become more engaged in and make more informed choices about their healthcare, according to a new issue brief from America's Health Insurance Plans (AHIP).
To view the original article click here.
A First for Cleveland Clinic, ShurTech: Company Gets On-Site Medical Care
Cleveland.com-The breakthrough innovations of American healthcare are often associated with prestigious universities and sleek research labs where white-jacketed scientists push the boundaries of what's possible.
To view the original article in its entirety, click here.
Technology Key to CVS' Disruption of the Healthcare Industry
by Dan Bowman
FiercehealthIT.com-For many patients, access and affordability often are the most important determinants as to where, when and how they will receive care.
To view the original article click here.
UAW May Form Co-Op to Negotiate Directly With Providers
Union, automakers confront dramatically increasing healthcare costs
by Ron Shinkman
Fiercehealthfinance.com-Faced with rapidly rising costs for their healthcare, automotive workers may form a special cooperative to negotiate with providers directly for services, Crain's Detroit Business has reported.
To view the original article click here
Q2: Big Five Insurers Report Better-Than-Expected Earnings
by Dina Overland
Fiercehealthpayer.com-The biggest for-profit health insurers continue to benefit from a low utilization trend among consumers, as most reported better-than-expected second-quarter earnings.
To view the original article click here.
Despite Negative Reputation, Doc-Owned Hospitals Don't Cherry-Pick the Healthiest Patients
by Zack Budryk
Fiercehealthcare.com-Physician-owned hospitals have a reputation for hijacking the lion's share of desirable patients at the expense of other providers--but it is largely undeserved, according to a new study published in the British Medical Journal.
To view the original article click here.
NETWORKING JUST GOT EASIER: SEE BELOW TO LEARN HOW
Help Save a Life and Support MatchingDonors
100 percent of all donations on MatchingDonors.com go to help people get organ transplants on MatchingDonors.com.
MatchingDonors is a 501c3 nonprofit organization and the nation's largest online living organ donor organization finding living organ donors for people needing organ transplants. In conjunction with various health organizations throughout the United States we have created a very successful Public Service Announcement campaign to help people recognize that they can save lives by being a living organ donor, to encourage them to register as an altruistic living organ donor, and to make them realize they can help save the lives of people needing organ transplants by donating other things. This MatchingDonors Living Organ Donor Initiative program has already saved thousands of lives.
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