Medical tourism was once made up of patients from developing countries traveling to places like the United States to receive medical care that wasn’t available in their homeland. But over the past decade, medical tourism has shifted dramatically. Now a large segment of medical tourists are those from developed countries opting for the much lower prices of medical procedures offered across the borders. In fact, a 2009 Gallup poll found that 40 percent of Americans would be happy to go overseas for treatment if the price was better and the quality of care was comparable to what they would receive in the U.S.
Medical tourism is most common among those who need cosmetic surgery, dentistry or heart surgery, according to the CDC. It is also becoming increasingly common for those who need medical care not yet approved in the United States, such as stem cell procedures or certain fertility treatments. According to Patients Beyond Borders, the most popular medical tourist destinations outside the U.S. include Brazil, Costa Rica, India, Korea, Malaysia, Mexico, Singapore, Taiwan, Thailand and Turkey.
As health care costs continue to rise in the U.S., the influx of patients to medical tourism destinations is expected to increase. Deloitte projects that medical tourism travel will increase by 35 percent annually in coming years. Besides the substantial savings offered by medical tourism — in some cases as much as 70 to 80 percent — there is the added bonus of a vacation for the patient. With such clear incentives for obtaining medical care outside of the country, what can U.S. doctors do to keep more patients here?
Medical tourism within the U.S.
For those who don’t want to pull out the passport, comparing prices at various U.S. destinations could prove to be the incentive that keeps them nearby — but in order for that to happen, price transparency is a key factor. As pointed out in the TIME magazine article “Bitter Pill” by Steven Brill, the lack of transparency in healthcare costs can lead to significant confusion, and those costs can vary wildly from one hospital to another, even in the same geographic location.
“The lack of price transparency in America is a persistent and national concern,” said Dr. John Maa, president of the Northern California Chapter of the American College of Surgeons. “Increasing competitiveness and efficiency in the American healthcare markets could be achieved by price transparency. That would weaken the need for medical tourism even further, and catalyze increased health reform. Price transparency would have many benefits beyond keeping patients ‘at home’ in the US, and is one area that the Affordable Care Act did not specifically address, and should be considered as healthcare delivery system reform evolves further in America.”
Some facilities have caught on to the fact that patients want to shop around. The Orthopedic Surgery Center of Orange County is a good example of a facility that makes costs clear up-front. Gabrielle White, R.N., the executive director of ambulatory services and network development, believes it makes a difference. “Even our local patients access this and they really appreciate knowing the total cost of care before the surgery,” she said. “We also post our quality and satisfaction data as price is only one part of medical care.”
Streamlining care for better patient satisfaction
For those who want to get their care in the United States, asking for pricing up-front might be one way to narrow down the options between a wide selection of provides and facilities. Offering a “bundled bill” that includes one clear fee is common among medical tourism destinations, a practice that U.S. hospitals could emulate in order to make staying home more attractive.
“It would help to at least know the facility price up front,” White pointed out. “To go a step further, the price could include the professional providers most commonly involved in the specific procedure. Depending upon the treatment, there can be at least three professional providers involved in care who have their own billing and this is where it gets complicated for patients, when they don’t understand where all the bills are coming from.”
But even with clear price transparency, holding down medical costs is necessary to compete against overseas medical providers. For instance, implant prices in France are routinely one-fifth the cost of implants in the United States. Working to bring down the costs of implants and procedures, streamlining the final bill and offering patients the option of choosing a particular facility or doctor across the country through transparency of healthcare costs could go a long way toward convincing more Americans to take their medical vacation close to home rather than across an ocean.
Shannon Lee is a contributing writer for HIT Consultant
