Medical Travel Goes Local

Cora Nucci, for HealthLeaders Media , December 13, 2010
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Medical travel, so often depicted in film and television as overseas quests for black market organ transplants and hush-hush rhytidectomies in luxurious warm-weather climes, is having a mainstream moment.

To be sure, there is an active market for international medical travel, but the real story is what's happening domestically, as employers get creative to rein in soaring healthcare costs for their employees.
"The next big thing won't be everyone going to India ? it will be employer plans, health plans, and insurers making selective deals with small networks and providers to get more leverage," says Devon Herrick, PhD, a senior fellow with the National Center for Policy Analysis. The big push is coming from self-funded health plans that relish paying, by one estimate, 30% to 50% less  for certain procedures than a typical provider network.

Lowe's is one such self-insurer. The home improvement supplies retailer made headlines last winter when it announced that it would offer 100,000 employees and their dependents in the United States who are participating in the company's self-insured insurance plan financial incentives to travel to the Cleveland Clinic for nine different cardiac procedures. The three-year deal covers fixed prices by ICD-9 code with provisions for outliers, says Bob Ihrie, senior vice president of employee rewards and benefits at Lowe's.  

Employees who opt for the benefit pay no deductible. All travel, hotel, living expenses, and medical services rendered in Cleveland are paid by Lowe's. Tests before and after the trip, however, are covered by the regular plan and may be subject to deductibles.

The Cleveland option is voluntary and, Ihrie says, popular. When Lowe's was evaluating the program, it projected there could be as many as 125 people in the first year who might need serious cardiac surgery.  A calculation was made that if 10 participated in the first year, "it would be a home run." At the five-month mark, 16 surgeries were completed, five were scheduled, and nine candidates for surgery were in the qualification process. One of every three eligible employees is choosing to travel for heart surgery, says a clearly pleased Ihrie.

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