Jim Krampen, Co-Founder, Principal and Executive

Seven Corners Inc. recently launched a new insurance product specifically for medical tourism patients. A first-of-its-kind policy, the product provides patients with coverage for medical complications and any other medical issue that may arise pre- or post-procedure (excluding pre-existing conditions).

Medical Travel Today spoke to Jim Krampen, one of the co-founders of Seven Corners to learn more about how the product was developed, how it works, and why medical tour operators are calling it a "godsend."

Medical Travel Today (MTT): Please provide some background on yourself and the founding of Seven Corners.

Jim Krampen (JK): Seven Corners was founded in 1993 by me and Justin Tysdal. Prior to that, we both worked for another local international insurance firm.
At that time, international travel insurance was very much a commodity product. The only difference was customer service, which was something clients didn’t really get to experience unless they had a claim.

Justin and I  thought we could “build a better mousetrap.” We felt that if we put an emphasis on customer service and client focus we would be offering something better, something different than what was being provided in the industry The thing about insurance is that when you buy it, you're paying for a service you can't see, touch, or feel. It's all about trust. Honestly, you're paying for something you're hoping you never have to use.

So we decided to show our customer service to people up front and build that trust with them before they became insured clients. That included being responsive, caring, and always having a live person answer the phone. That was our approach then, and it's still our approach today. When a customer calls us they don't get a phone tree. Not even at three in the morning. They get a live operator who responds to their needs.

When we started we had one simple travel insurance plan for non-U.S. citizens visiting the United States. This covered them for any acute illness or injury incurred during their stay here. We expanded quickly to offer more travel programs for inbound and outbound groups. Student groups and missionaries were a big part of that early expansion.
In 2001 we launched a trip cancellation product, principally for the cruise and tour market. We also have a government division through which we provide worldwide benefits administration for government agencies. All active Peace Corps members and every AmeriCorps member is a client. We also provide benefits administration for exchange students for  the U.S. Department of State’s Accident Sickness Program For Exchanges (ASPE).

MTT: When and how did you first become aware of the need for a supplemental medical travel insurance product?

JK: There was an article in the December 2006 issue of Business Insurance Magazine. It was a brief piece on medical tourism that caught my interest. Then in March 2007 I started getting Google alerts on medical tourism. From that point on I was reading eight to 10 articles or blogs a day on medical tourism.

A year ago I approached some of our underwriters, including Lloyds of London and AIG Accident and Health Division, to develop an insurance program for medical tourism patients. We brought with us the research from our actuaries and a plan for building and administrating the product.  We have such a good longstanding relationship with these groups and our other underwriters (Nationwide, Fairmont Specialty, and Virginia Surety) that they trusted our data and assumptions and gave us the go-ahead.

MTT: Why would a consumer need your product? What does it cover that a medical tour provider does not?

JK: The research we did shows that 65 percent of the people using medical tour facilitators are going for elective, cosmetic, or dental surgeries. These are things that are not covered under any medical plans. In order to do this, they must generally pre-pay 50 percent for their treatment before they go.

What we do is cover them in two unique ways. First, let's say you're getting a breast augmentation for $5,000.  You pay the required $2,500 upfront. Now, if the week before the trip you have a car accident, there's a hurricane, or for whatever eligible reason you can't make it, regular trip insurance covers the cost of the trip -- airfare, hotel, etc. However, the money paid to the medical center would not be covered. Our policy covers that.
Currently all insurance products exclude travel to be treated for medical conditions. We do not exclude that. That is the purpose of your trip so it should be insurable.

Second, let's say you get your surgery, then within 60 days after that, no matter where you are in the world or if you've returned home, you experience a medical complication, we will arrange and pay to get that medical complication treated.

The truth is that if you're on the operating table for a cosmetic procedure and have a stroke, the contract with the medical facility only covers you for the services you signed up for. Any complications that arise, you've got to pay for those out-of-pocket.  Our policy would pay for the complication that occurs in or shortly after surgery.

Our policy covers you for acute illness and injuries or anything that's non-pre-existing. That includes an appendectomy or being hit by a bus and breaking your arm.

MTT: Who was involved in the creation of the offering?

JK: In May 2008 we contacted 12 medical tour providers—all U.S.-based—and interviewed them. I asked them each eight questions from an insurance perspective to gauge what benefits would be most important to the medical tourist. Through that, they offered me really good information on why people don't travel for medical care -- the "what if" point that keeps them from making the leap. And what we found was that the "no guarantees" aspect was the biggest obstacle.

When I explained to them what I was thinking, they immediately recognized how this could assist them in their sales. So we took the data gathered in the interviews/surveys and matched it with our own actuarial information to come up  with the Seven Corners Medical Tourism Insurance plan.

At this point what I'm doing is contacting those same folks to say "here's the promised insurance plan." A number of them are looking at actually embedding it into their offering, which means the cost of the insurance would be provided as part of the entire package.  This gives the medical tour operator a unique selling point and a meaningful differentiator.

Other operators are talking about including it as a retail offering on their site -- a sort of "click here" if you'd like to add this to your package. We're also open to having them simply refer people to us.

MTT: How do you anticipate the product being accessed, for what need, and on what data is that prediction based?

JK: Recognizing that my data collection method is very unscientific, what I found is that U.S. medical travelers are going for:
- 65 percent dental and cosmetic
- 10 to15 percent  knee and hip, carpal tunnel, and lumbar
- 10 percent bariatric (Mexico)
- 5 to 10 percent infertility
- 5 to 10 percent cardiac

In reality, travel for cardiac is very rare. Not a lot of people in need of heart surgery sign up for long plane flights. However, this area does offer the biggest cost savings, and it gets a lot of media attention. It's a much better story than a nose job, but it doesn't really represent what's driving people to travel for care. 

MTT: What has the reception for the product been thus far?

JK: My favorite quote from a medical tour operator so far is: "This is a godsend to the medical tourism industry." Another said, "I don't know how you did this, but it’s what the industry needs."

People recognize that this will significantly help medical tour operators. It alleviates that one last concern their clients may have.

About Jim Krampen
James Krampen, executive officer and co-founder of Seven Corners, brings nearly 20 years of underwriting and reinsurance expertise to his role at the company. In this capacity, he offers extensive depth and breadth of knowledge and experience in the areas of underwriting custom group insurance programs, expatriate medical insurance programs, and private label expatriate plans. In addition to serving as a resource to the Seven Corners leadership team, Mr. Krampen also works directly with clients to design customized insurance programs.

As a well-respected authority on international expatriate medical insurance, Mr. Krampen has been called to testify as an expert witness in many court cases and legal proceedings. Prior to co-founding Seven Corners, he worked for various international underwriting and brokerage companies providing expatriate medical insurance to individuals and groups.

Mr. Krampen holds a bachelor’s degree from Purdue University in Lafayette, Ind. He is a member of the Self Insured Institute of American (SIIA) and serves on the Travel Medical and Legal/Compliance committees for the United States Travel Insurance Association (UStiA).

SPOTLIGHT: Razia Hashmi M.D., M.P.H., Anthem National Accounts

Dr. Razia Hashmi, CMO for National Accounts, Anthem Blue Cross & Blue Shield

Last week it was announced that Anthem Blue Cross & Blue Shield of Wisconsin, a subsidiary of WellPoint Inc., would be the latest insurance company to step into the medical tourism arena.

Beginning in January, the insurance company will allow employees at Serigraph Inc., a Wisconsin-based graphics company, to travel to India for certain elective surgeries.

Medical Travel Today spoke to Dr. Razia Hashmi, vice president and CMO for Anthem’s national accounts about this new endeavor.

Medical Travel Today (MTT): Can you tell me how and when you first began considering offering a medical travel benefit and how you came to select Serigraph as your "beta" account?

Dr. Hashmi (RH): We've actually been following the trend for some time. It's for obvious reasons, very intriguing. Over the past year and a half we've looked for potential partners and have had conversations with several medical tour groups to obtain information which could be used to base our decision.

As the same time, we started to explore what segments of our client base might be interested. Our clients were, of course, also interested in health solutions that provide better or equal quality at a lower cost.

In the past year we noticed an increase in employers asking about medical travel as an option. It's now a frequent question in Request For Proposals (RFPs) and client conversations. I believe all the recent media attention contributed to that.

As for how we chose Serigraph, the truth is they chose us.

They were already a customer of ours, and they had been looking for ways to improve the value of their benefit offerings.   They knew we were working on something in the medical travel area, and they said they'd like to be part of the pilot.

We consider Serigraph an early adopter of innovations in benefit management in many ways. For example, we work with them in Wisconsin on a program they call MedSave through which they provide their employees comparative cost information for domestic medical tourism. For example, if an employee needs a procedure, they share with them how much it costs to get the procedure at various locations in the state.

MTT: Are you exploring the benefit with other employer groups at this time?

RH: We are in conversations with several other groups, and there's certainly a lot of interest out there. We will evaluate further expansion of the pilot once we have some experience with this. We want to ensure we have a program that works smoothly and delivers high member satisfaction along with high quality and value.

MTT: What parameters will you use to evaluate the benefit and in what sort of timeframe?

RH: Depending on the volume it may take us a while to evaluate the full impact of the pilot. We don't expect a huge volume right out of the gate. There are a number of parameters that will be used to evaluate success. One parameter will be the uptake and its impact on the client’s health benefits strategy. What kind of consumer is using medical tourism and does this information allow us to segment the consumer population and their needs? What makes them choose this option? What's unique about this segment?  And of course we'll be evaluating the standard parameters: clinical outcomes, quality of care metrics, patient satisfaction, and even family satisfaction. The ease of care with which patients can access and receive what they need will also be evaluated.

MTT: What were the guidelines you used to determine which procedures would be covered?

RH: We use the same process that others use. We selected a subset of elective procedures for which types of care can be provided safely in the international setting. We further narrowed the list by evaluating the potential for enhanced value through lower cost and equal or better quality. We also followed the American Medical Association’s guidelines very carefully to select procedures.

The basic guidelines for the pilot are:

1. The procedure is elective in nature
2. The patient is able to travel
3. The surgery is commonly performed at the referral hospital with demonstrable quality outcomes
4. Local follow-up care upon return home can be arranged
5. The patient can safely return home post procedure

MTT: How did you determine what facilities patients could access?

RH: All hospital systems in WellPoint's program will be accredited by the Joint Commission International (JCI).  JCI accreditation standards are based on international consensus standards and set uniform, achievable expectations for structures, processes and outcomes for hospitals. Serigraph employees will be able to visit the Apollo Health Systems hospitals in either Bangalore or New Delhi.  We are also exploring further expansion to include other countries.

MTT: What kind of interest have you and Serigraph received from employees since the announcement?

RH: The pilot won't officially roll out until January so we don't have numbers just yet. They're currently holding their open enrollment meetings. Check back with us in January or so. 

MTT: Are you or Serigraph doing anything to educate the employee population about medical travel?

RH: Yes, we've talked up-front a great deal about the importance of education and how best to partner with Serigraph on employee education. Obviously Serigaph is a critical first resource, and we're working to make sure they have the appropriate information and resources to offer employees and help them understand the option.

One of the key points we'll be communicating is the fact that patients will have a dedicated case manager to coordinate all steps of the medical tourism process; all medical arrangements are handled for the member, and all travel arrangements are booked and paid for, for both the patient and a travel companion.  The case manager will also make arrangements for any necessary post-operative care for the member’s return to the United States.

We are working with two vendors who will assist in this process.  Our case managers will work with Healthbase to: make the necessary travel arrangements, including securing passports and/or visas for members and their travel companions; schedule the medical procedure; facilitate transfer of the medical records; and arrange for the member to speak with the international provider.   

We are also working with Mondial Assistance, which has existing relationships with these international hospitals.

About Dr. Razia Hashmi

Dr. Razia Hashmi is CMO for National Accounts. She leads the National Clinical team in the development and execution of our clinical strategy that focuses on integration as well as consumerism and transparency of our services and products for our company’s largest customers. Prior to this role, Dr. Hashmi was RVP, medical director in Health Care Management (HCM) for the Northeast region. In that role, she provided leadership for medical management, clinical quality improvement, network management, sales support, and cost of quality care programs. She previously held the medical director role in HCM servicing the Connecticut market specifically, as well as various clinical leadership roles during her eight years at CIGNA, and her three years as medical director for Phillips Family Practice Beth Israel Medical Center in New York City.

Dr. Hashmi received her medical degree from Jawaharlal Institute of Post-Graduate Medical Education and Research in Pondicherry, India. She is board certified in Family Practice and Geriatrics. Additionally, she has completed fellowships in Infectious Diseases and Urban Family Medicine as well as a master’s in Public Health (MPH) in Health Services Management from Columbia University’s School of Public Health, New York. She is a member of the Academy of Family Physicians and the American Medical Association.

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PERSPECTIVES:

An American Physician as an International Patient 

Dr. Michael Horowitz, Medical Insights International

When Dr. Michael Horowitz, founder and CEO of Medical Insights International, traveled to Singapore last March for a medical travel conference, he had no idea he would be leaving with a new appreciation for the patient experience -- and without his appendix. Dr. Horowitz, who arrived in Singapore on a Monday and felt fine throughout most of the week, began to feel fatigued Thursday night. During a hospital tour hosted by the conference on Friday he began to take a turn for the worse.

Feeling as if he had the ‘flu,’ he returned to his hotel and fell asleep for 12 hours. Late Friday night he woke with some mild abdominal discomfort.

“At that point,” says Dr. Horowitz, “I realized I was getting sicker and needed to go to hospital. I decided to pack my suitcase but found my efforts exhausting. In short order, I was drenched in sweat, my heart and respiratory rates were up, and I needed to rest every few minutes.”

By the time Saturday morning rolled around, Dr. Horowitz was packed and ready to check out and head to the hospital.

“Because of my contacts and experience in Singapore, I already knew where I wanted to go—Mount Elizabeth Hospital. Unlike most consumers, I was very, very fortunate in that respect. I was able to make the choice of where to receive care,” says Dr. Horowitz.

Upon checkout from the hotel, Dr. Horowitz climbed into a cab and went directly to the hospital.

“Here’s where the experience began to deviate from the traditional American emergency room trip,” notes Dr. Horowitz. “I went into the main lobby of the hospital. With just one look at me they took me to a treatment room where I was seen immediately by an emergency room doctor. They were very thorough and fast. I was then quickly moved to radiology.

I’d say between the time I walked in the door until my CT scan was completed and evaluated took less than 90 minutes. It was really impressive.”

Shortly after the CT, a surgeon met with Dr. Horowitz and informed him that he had a perforated appendix with an abscess.  Surgery was required promptly.

“This is when you’d think one would start to get a bit nervous about being in a foreign country, on the other side of the world. But the truth is, I felt totally comfortable with the facility I was in. It never occurred to me to go anywhere else or to try to travel home. Now, as a physician and one involved in medical travel, I have a very critical eye. Here, I was impressed.  The professionalism, the protocols followed, the communication level, the technology…they had it all.”

Dr. Horowitz underwent laparoscopic surgery that day. In some respects the procedure itself was the ultimate global medicine experience: Dr. Horowitz was an American in Singapore being operated on by a surgeon of Indian descent with post-grad training in Scotland, being cared for by a Canadian-trained anesthesiologist, and a head nurse trained in England.

But more than a mélange of nationalities, Dr. Horowitz’s experience was defined by the level of care.

“I can’t tell you how well cared for I felt throughout it all,” he says, adding an example of the type of attention he received.

“Early in the post-op period I simply had no appetite. They kept trying to get me to eat but I just couldn’t. But on the fifth day,” he says, “I suddenly had some appetite. And along with it a craving for shrimp Creole. Don’t ask me why, but that’s what I was craving. I mentioned it to the head nurse who asked me to explain what it was. She shook her head in confusion and left apologetically. She came back shortly with three chefs wearing big white hats in tow.”

Dr. Horowitz laughs recalling how he described the concept of shrimp Creole while the chefs busily took notes. The chefs then retreated to the kitchen only to return forty-five minutes later with something “really, really close to shrimp Creole. It was perfect. I had it two nights in a row. Beyond the chefs’ ability to pull together something great from a vague, description, the thing that was truly impressive was how hard the staff was working to find something that I could and would eat.” 

“And the care didn’t end after I left,” Dr. Horowitz continues. “Two weeks after I returned home, the floor nurses called to check on me. From Singapore! And I really should add that all the nurses were wonderful. They were well-trained intelligent, and very skillful. Because the patient-nurse census was better than we experience here, they had more time to take care of me. There were no nurses’ aides. With the exception of food service, all the care was done by the nurses.

“The other major difference in the domestic/foreign care experience was the billing,” says Dr. Horowitz. “Within a few days of discharge, they emailed me a PDF file of my bill. There it was, all my charges on one single sheet of paper with a lump sum, including professional fees, at the bottom.”

Dr. Horowitz submitted the bill to his insurance company.  After a fair amount of paperwork and a number of questions, they sent him a check. He was then able to pay the bill by credit card.

“As far as dealing with the hospital, the billing and collection process was very smooth,” says Dr. Horowitz. “In fact, it was frictionless.”

Another bright side to the billing experience was the actual cost.

According to Dr. Horowitz, the total bill for an 8-day stay, including all professional and surgical fees, medications, labs, CT scans, etc. was Singapore$ 26,774.75. Because he paid with a credit card, which incurs a higher exchange rate, his total USD cost was $20,252.30.

Lessons to be Learned

Looking back on the experience, Dr. Horowitz recognizes some particularly important issues for the medical tourism industry.

“I was fortunate by virtue of location and my existing knowledge. Most consumers are not that fortunate. That includes those who don’t have an emergency situation like I did,” says Dr. Horowtiz.

According to Dr. Horowitz, “It’s hard for consumer to separate high quality care facilities from the poor quality and, frankly, dangerous facilities. I think this is the biggest question and challenge for the industry. How do we provide information and comfort?

“For the consumer who needs or wants to go abroad, the questions are: Where do I go shop for information and care? Who is my guide? It’s really hard to be a shopper in this marketplace.

“What I think agencies need to do is identify and partner with hospitals that meet the highest standards—providers that they can stand behind. Of course finding those partners requires a lot of homework. There’s thorough vetting that needs to take place. Plus, they need to fully understand the concept of quality involving clinical issues and also service quality. Those two points need to be integrated.

“That said, agencies need to be careful. Not all claims that facilities and providers make are true.  Many hospitals in the world want to be medical travel destination. But not all are suitable. You just can’t have every facility in the world be world-class. 

Before attempting to enter the marketplace, the facilities need to look carefully at their mission, and decide if the international market fits into it. They have to decide if they’re really prepared to compete in the international market and if they’re prepared to make the changes and improvements that might be needed to compete with some very, very good hospitals around the globe.

“And agencies should feel very comfortable, and entitled, to ask about those processes before entering into a partnership,” says Dr. Horowitz. “That’s the only way we can feel confident that we’re giving consumers what they deserve: an experience like the one I had.”

Dr. Horowitz will be sharing more of his patient perspective story at the Healthcare Globalization Summit in Washington, D.C., on Monday, December 8, 2008, at 1:30 p.m.

Michael D. Horowitz, M.D., M.B.A.
Medical Insights International
www.medicalinsightsinternational.com
michael_horowitz@mac.com

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INDUSTRY NEWS

Consumer Health World Provides Platform for Launch of Companion Global Healthcare’s Medical Travel Insurance for Patients and Employers

Companion Global Healthcare selects Custom Assurance Placements to offer medical travel benefits

Arlington, VA – November 19, 2008 – Exemplifying the role of Consumer Health World (CHW) 2008, December 7-10, 2008, Arlington, Va., as a platform for positioning innovative healthcare solutions, Companion Global Healthcare will utilize CHW to formally announce its selection of Global Protective Solutions^SM, -- administered by Custom Assurance Placements, Ltd. and underwritten by certain underwriters at Lloyd’s of London -- to provide affordable specialty travel insurance with defined benefits for medical travelers.

Companion Global, offering health care choices to patients at accredited international medical facilities, will showcase plan features for individuals that include medical procedure coverage, flexible purchase options, travel companion coverage, and comprehensive travel accident coverage. It will also unveil insurance policy options for employers, helping companies meet their fiduciary responsibilities in medical travel.

“We selected GPS to provide these breakthrough programs based upon the company’s 28 years of experience in handling insurance issues related to international travel and its reputation for service excellence,” says David Boucher, president and CEO of Companion Global Healthcare, emphasizing the company’s dedication to providing access to healthcare services delivered exclusively at hospitals accredited by the Joint Commission International (JCI). “These policies mitigate the fear factor for medical travelers and answer employer needs for liability exposure related to medical travel. These coverage options raise the comfort level that stakeholders have been seeking.”

According to Tracy Simons, president of Columbia, S.C.-based Custom Assurance, “These insurance plans address the unintended consequences of medical travel, with benefits that can be tailored to each individual or group-specific need. They actually exceed the protection options available to patients opting for U.S-based care and include accidental death and dismemberment, medical expenses, disability, emergency evacuation, repatriation of mortal remains, additional travel expenses, meals and accommodations, family coordination, residence modification, loss of reproductive function, and more.”

With an emphasis on enlightened consumerism, globalization, and innovative technologies, CHW focuses on three critical areas that drive positive change in healthcare, each tailored to address the respective needs and concerns of employers, payers and providers, and international providers.

“The relationship between Companion Global Healthcare and GPS reflects a brand of advanced thinking that will be represented and explored at Consumer Health World,” says Skip Brickley, CEO of Transmarx, the nation’s leader in coordinating premiere health care conferences.

About Consumer Health World

Consumer Health World management is one of the country's premier conference and trade show producers with vertical industry expertise in advertising, marketing, healthcare, media, travel, financial services, entertainment, and sports. Consumer Health World management currently produces the following “Consumer Health World” events: The National Conference On Health Care Consumerism (www.nchconsumerism.com), The Health 3.0 Summit (www.health30summit.com), and The Health Care Globalization.

South Korea Joins Lucrative Practice of Inviting Medical Tourists to Its Hospitals

The New York Times recently published a piece on South Korea's efforts to lure medical tourist to the country. In addition to building a 370-acre complex of medical clinics and upscale apartments surrounded by 18-hole golf courses and scenic beaches, the government has revised immigration rules to allow foreign patients and their families to get long-term medical visas, and altered laws to permit local hospitals to form joint ventures with foreign hospitals. For the complete story, click here.

IMS Israel Opens Offices in Mongolia and Nigeria,
Establishes New Office and Partnership in Moscow

Expansion documents rise in medical travel

New York, NY/PETACH TIKVA, Israel – November 17, 2008 – As more patients are taking advantage of quality healthcare outside of their home countries and looking to Israel as a destination for quality, cost-effective care, International Medical Services, Global Ltd., is expanding its operations to 12 offices worldwide, including locations in Mongolia and Nigeria. IMS, a leading global healthcare firm specializing in medical tourism in Israel, is establishing new offices and partnerships in Moscow (Russian Federation) and maintaining offices the Ukraine and Kazakhstan, where there is little to no medical infrastructure but where citizens with financial capabilities are seeking better healthcare.

“Russia and Israel have abolished the need for visas, making it very appealing for IMS to establish a new office and partnership in Moscow to replace the previous one,” says Ira Nissel, founder and CEO of IMS. “Our global expansion gives patients in numerous locations throughout the world the opportunity to learn more about medical tourism in Israel and book their procedures.”

Austine Agbaje, IMS Nigeria, points out, “It isn’t always easy for patients in Nigeria to obtain the medical care they need. This partnership with IMS Israel makes first-rate care more accessible to patients, and at a lower cost.”

Urjgee Duuya, IMS Mongolia concurs: “Israel represents a highly attractive destination for residents of Mongolia to access exceptional medical care that is simply not available here.”

According to Nissel, “Our offices are now focused in regions where patients can afford to access top quality medical care but find that it is not available in their home countries. By establishing a local entity in each of these countries, IMS increases its market reach and expands its capabilities to channel many more patients to Israel.”

Nissel explains that most local citizens in these countries are more comfortable and confident with medical travel when their medical travel coordinator, such as IMS, has roots within the community.

IMS offers patients the chance to have a procedure done in one of 18 internationally renowned medical centers in Israel. Doctors and specialists at these medical centers are the best in their fields, including oncology, urology, orthopedics, in-vitro fertilization, and neurosurgery – to name a few. Elective procedures, including plastic surgery, are also available and best paired with vacations in some of Israel’s attractive resorts.

“Israel is fast becoming a highly sought-after destination among medical travelers worldwide,” adds Nissel. “Patients from every corner of the globe want to get the best medical care possible, and IMS makes it possible to access this level of care in Israel.”

About IMS

International Medical Services Global, Ltd. (IMS) specializes in uniquely customized medical travel to Israel. Founded in 2007 by Ira Nissel, CEO, IMS offers a full range of medical services to children and adults and provides a completely personalized treatment and travel experience. The company also aims to advance the image of Israel as a global leader in medical treatment, research, and technological development.

BridgeHealth Empowers Third Party Administrators with Innovative Strategies to Optimize Medical Travel Benefits

Denver, Colo. (November 18, 2008) – Third party administrators (TPAs) seeking fresh opportunities to be more competitive with their service offerings and capture increased market share welcome recommendations on medical travel from BridgeHealth International, Inc.

As the premier service provider in the medical travel industry, with a focus on serving businesses and individuals for the delivery of international medical care, BridgeHealth understands the unique needs of TPAs and tailor programs that make good business sense for specific markets and clientele.

“Medical travel is a strategic health benefit that improves access to care and significantly reduces health care spending,” says Victor Lazzaro, Jr., CEO of BridgeHealth. “As this option becomes increasingly popular among employees, BridgeHealth helps TPAs and employers meet the demand for high quality medical care and exceptional cost savings on acute care procedures, surgeries, and dental care. This is an opportunity for TPAs to differentiate their product offering, introduce cost savings, and improve client relationships.”

Lazzaro stresses the importance of selecting the best practice service partner, one that can provide the best global provider network, turnkey customer care, concierge services, and full data reporting (outcomes, savings, and claims) to assist in adoption and implementation. The optimal service provider must be able to demonstrate genuine health care experience, leadership, an emerging suite of vendors, and in-depth understanding of the health care continuum.

“In other words, avoid service providers that are little more than glorified travel agents,” advises Lazzaro. “A professional medical travel organization should incorporate patient advocacy and coordination services, with a dedication to ensuring patient satisfaction.”

TPAs should look for these qualities and capabilities when selecting a medical travel partner:

• A network that provides geographic choice, giving employers and employees more options for treatment and preferred destinations.
• A high regard for personal and medical safety in all provider locations—hospitals, outpatient facilities, and the destination country.
• Willingness to create customized solutions as well as streamlining administrative functions such as provider sourcing, scheduling, evaluation and contracting, coordinating with employees, and payment.
• An easy and understandable billing process that removes the undue administrative burden from employers.
• Financial viability to deliver on promises to businesses and individuals.
• Functioning staff of employees serving all areas of the medical travel company to meet the ongoing activities and reporting requirements.

“In this economic downturn, medical travel emerges as beacon for healthcare cost containment,” Lazzaro adds. “With the guidance and resources of a medical travel partner, TPAs can seize this opportunity and introduce an option that represents positive change.”

About BridgeHealth International, Inc.

BridgeHealth International, Inc. (BridgeHealth) is the premier service provider in the burgeoning medical travel industry, founded with a vision “to create a trusted bridge to the world of international healthcare.” BridgeHealth serves health plans, insurance carriers, employers, third party administrators, individuals accessing benefits via voluntary benefits plans, health and affinity card programs or Consumer Directed Health Care Plans (CDHP), and individual consumers seeking medical travel options. Visit www.bridgehealthinternational.com

Anthem Blue Cross and Blue Shield Introduces International Medical Tourism Pilot Program

WEST BEND, Wis., Nov 12, 2008 /PRNewswire via COMTEX/ -- Anthem Blue Cross and Blue Shield in Wisconsin (Anthem) today announced a new international medical tourism pilot product that will allow members to access benefits for certain common elective procedures at designated facilities in India. Beginning in January 2009, Anthem will pilot the program with Serigraph Inc., a Wisconsin-based global provider of printed decorating solutions.

Under the pilot program, Serigraph members planning to undergo certain procedures can enjoy access to an extended network of respected hospitals and health care providers in India. By electing to use the international benefit, members can receive care at accredited facilities at lower out-of-pocket costs for common non-emergency procedures that could result in thousands of dollars in total savings. The pilot program includes coverage of certain common non-emergency procedures, such as major joint replacement, upper and lower back fusion, and other procedures that have significant cost differences between domestic and international providers.

"Anthem Blue Cross and Blue Shield in Wisconsin is committed to finding innovative solutions to our nation's health care challenges, and we are continually evaluating new concepts," said Dr. Michael Jaeger, managing medical director for Anthem in Wisconsin. "Increasingly, our employer clients have expressed interest in accessing foreign providers as a means to reduce their claim expenditures because they see medical tourism as a promising option for improving access to affordable, quality health care.

"We're proud to partner with Serigraph, a leader in workplace benefits innovation, on this pilot and believe the plan design we've structured will not only empower members to be more involved in the care they receive, but also help employers better manage their health care costs."

Members who choose to access this international option will have a dedicated case manager who will coordinate all medical arrangements, including scheduling and concierge travel service. All travel arrangements will be booked and paid for, for both the member and a travel companion. The case manager will also help make arrangements for any necessary post-operative care upon the member's return to the United States.
All hospitals within the international program are accredited by the Joint Commission International, whose accreditation standards are based on international consensus standards and set uniform, achievable expectations for structures, processes, and outcomes for hospitals. The program also complies with American Medical Association (AMA) guidelines for medical tourism.

"The market for many products and services has gone global -- why not healthcare?" said Linda Buntrock, senior vice president at Serigraph. "It will be interesting to see the competition for customers in the market for medical services and how many employees in our medium-sized company take advantage of this opportunity once we have the program in place. We hope our employees choose to access the international medical tourism option, which has the potential to greatly benefit their household budgets by cutting down out-of-pocket costs while retaining their ability to receive quality care."

Seven Corners Announces First Insurance Program for International Medical Tourism

Indianapolis, Ind., (Nov. 11, 2008) – Seven Corners announces the launch of the first worldwide medical tourism insurance program that reduces travel-related and medical risks associated with patients electing to have surgical procedures abroad.

Medical tourism, the practice of traveling outside of a person’s home country to obtain health care services at a significantly reduced rate, is expected to multiply by 100 percent from 2007 to 2010, according to a study conducted by Deloitte. Medical tourists most often travel abroad to obtain elective procedures such as dental, Lasik, bariatric, lumbar/disc, knee/hip replacement, infertility and plastic surgeries. According to the study, costs for these procedures can be up to 90 percent less than what a person may pay in their home country.

“Medical tourism insurance is a natural progression of Seven Corners’ core competencies. We’re excited about introducing such an innovative and valuable product to the growing medical tourism industry,” said Jim Krampen, co-founder and executive officer of Seven Corners. “The support and confidence of our underwriters at Lloyd’s of London have allowed us to address the specific needs and concerns of the medical tourist.”

This insurance program can be embedded into packages offered through a network of qualified medical tourism facilitators, international surgical centers, or hospitals.

For a small percentage of the total cost of the trip and medical procedure(s), Seven Corners’ medical tourism insurance mitigates health risks and safeguards the patient’s financial investment. The package includes:

• Trip cancellation and interruption coverage for non-refundable, prepaid expenses, including the scheduled medical treatment
• Medical coverage for the patient and companion upon the occurrence of unexpected illness or accidental injury unrelated to the scheduled medical procedure
• Worldwide emergency medical evacuation and repatriation for any necessary medical condition
• Worldwide medical coverage for treatment of complications incurred from scheduled treatment abroad.

For more information, log on to www.SevenCorners.com/medicaltourism.

About Seven Corners
Seven Corners is one of the industry's most experienced providers of international medical and travel insurance policies for U.S. citizens traveling overseas or foreign nationals visiting the United States. The company created and maintains the industry's most comprehensive network of international health care providers that includes thousands of doctors, pharmacies, and hospitals around the globe. For more information about Seven Corners, please call 800-335-0611 or visit www.SevenCorners.com.

PlanetHospital Establishes Middle East Office to Promote Medical Tourism

PlanetHospital, the California-based leader in medical tourism since 2002, used the occasion of the Healthcare Travel Exhibition in Dubai to announce the official opening of its Jeddah office to serve the inbound and outbound facilitation of medical tourists from the Gulf region.

"The Gulf is where the next growth of medical tourism will come from" said Mohammed Alarifi, the managing director for the new operation. "It is not only a destination from where patients seek medical care abroad but is also becoming a medical tourism destination inbound thanks to major hospital developments in the region.”

PlanetHospital has had several clients from the Middle East utilize its services in the past to receive innovative medical care in the top medical destinations around the globe.

PlanetHospital Middle East will be aggressively promoting its ability to generate patient volume to the Gulf region hospitals, work with local new insurance providers to create a medical tourism based benefit, and eventually attract Middle Eastern-based workers from the United States to come to the region for medical treatment.

Health Minister: Medical Tourism in Singapore Stable
www.chinaview.cn

SINGAPORE, Nov. 11 (Xinhua) -- Singapore's Health Minister Khaw Boon Wan said Tuesday that medical tourism in the city-state have not been affected by the recent financial crisis, and he blamed its slower growth on the lack of capacity.

Quoted by local radio 938LIVE, he said that Singapore's medical industry has been enjoying a steady growth of about 20 percent a year.

His remarks came after a spokesperson from Parkway Health, one of the largest health care service providers in Singapore, said they have seen a dip in the number of medical tourists. The Parkway Health spokesperson said that over the past three months or so, the number of foreign patients to the private hospital has dipped slightly, by about 5 to 7 percent.

Khaw added,"I don't think it's because of demand or lack of competitiveness, but that capacity is constrained. Both public and private hospitals are short of capacity.”.
He added, however, that the number of foreign patients seeking treatment in Singapore last year was not on par with that of 2006.

Many in Singapore see medical tourism as an engine to boost the country’s economy and hope to attract more than 1 million international patients a year by 2012 -- nearly three times the current number.

Khaw believes the current financial meltdown may influence the price of drugs and wages.

"I think the impact will be both plus and minus, to the extent that commodity prices and oil prices are coming down, which would have an impact on drug prices, for example. So in the past two years, we saw drug prices increase significantly, which many trace back to oil price increases. This is softening, of course,” Khaw added.
Khaw made his statements at the groundbreaking ceremony for Parkway Health's flagship hospital.

NRIs Cancel Trips for Medicare in India

India Post News Service Monday, 10.20.2008, 02:34am (GMT-7)
MUMBAI: The flourishing healthcare industry in Mumbai has been experiencing a recent slowdown in the wake of the economic recession in the United States. In the past few years, hospitals and clinics in Mumbai had become the preferred choice among people from different countries, especially non-resident Indians (NRIs) in the United States.

Many NRI clients from the United States who had once come to city hospitals for in vitro fertilization (IVF) treatment have put their plans on hold, citing the current financial downturn and a need to save jobs rather than start families.

According to a report in the Mumbai Mirror, Sonam Shahani, a 35-year-old U.S.-based NRI, had come to the city for IVF treatment because she was unable to conceive naturally. She had already received treatment for 14 days, but had to end treatment prematurely because her husband could not come to India to donate his sperm.

Shahani's husband, who works for Morgan Stanley - an erstwhile market leader in securities, asset management, and credit services that had to be turned into a full-fledged bank to pull it from the brink of collapse - told his wife that he was currently struggling to keep his job and could not travel to India.

Shah told her doctors at the Malpani Infertility Clinic in Colaba that she and her husband would come back in more stable times. This was not an isolated scenario. In fact a large number of IVF patients have terminated treatment before completion.

“Right now, they are more worried about saving their jobs," said Dr Anjali Malpani, IVF consultant, Malpani Infertility Centre.

NRI Malini Chacko’s husband works with JPMorgan Chase, where his job contract will soon expire. Chacko says if it is not renewed, her husband, an information technology professional based in New Jersey, may not be able to travel to Mumbai.

Dr. Duru Shah, medical director of Gynacworld, an infertility clinic at Kemps Corner, said, "One of our patients from the United States who was planning to come in November for IVF treatment has now postponed the plan citing financial problems."

Another woman from the United States, who had taken an appointment at the Malpani Infertility Clinic, cancelled her plans by email, citing shaky economic conditions back home.

"Though the drop in the number of patients from abroad is not significant, the signs are ominous. We do foresee a problem in the near future," said Hrishikesh Pai, IVF consultant, Lilavati Hospital.

Col Manesh Masand, CEO of Jaslok Hospital and president of the Association of Hospitals in Mumbai, affirmed that the health care industry is certainly being affected by the recession in the United States and other countries.

"Though it is too early to give figures, we are already feeling the pinch. There is already a drop in the number of patients from abroad who used to come to us for cancer treatment, hip replacement, knee replacement, and other orthopedic problems," he concluded.

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DESTINATION

Robin Elsham is busy preparing for a trip to East Asia. We look forward to his upcoming first-hand reports from Korea and Taiwan. In the meantime, you may access previous stories at the following links.

• Guatemala
• New Zealand
• Monterrey
• Panama
• Philippines
• Malaysia
• Changes in air travel certain to cause major changes in medical tourism industry
• Inflation's Threat to Medical Tourism
• Adopting a Global Perspective

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MEDICAL SPOTLIGHT: Knee Replacement

According to the American Association of Orthopaedic Surgeons (http://www.aaos.org), an estimated 300,000 knee replacements are performed annually in the United States.
While people of all ages have knee surgery, the average patient is between 65 to 70 years old. During 1979 to 2002, the rate of knee replacement procedures among those aged >65 years increased approximately eightfold with women having the procedure more often than men.

Usually people who undergo knee replacement have a long history of osteoarthritis
or rheumatoid arthritis.

In the instance of osteoarthritis, the cartilage of the knee becomes frayed and pitted from the wear and tear of repeated stress and trauma. When this happens, the normally smooth movement of the knee is replaced by painful friction. 

In the case of rheumatoid arthritis, the tissue lining the joint becomes inflamed
and causes pain. Over time, the inflammation causes swelling in the joint and damages the cartilage and bones of the joint.

A physician will often recommend a knee replacement for:

• Knee pain that has failed to respond to medication, injections, and physical therapy for 6 months or more
• Knee pain that limits or prevents the patient from engaging in activities of importance to them
• Decreased knee function 
• Inability to sleep through the night because of knee pain

Of course each and every case is different, and an orthopedic evaluation is critical to determine what type of treatment would best serve the interest of the patient. An evaluation involves a review of a patient's medical history, a physical examination, and the taking of several x-rays of the patient's knee. Often a blood test, a magnetic resonance imaging (MRI), or a bone scan will also be included.

Knee replacement surgery is considered medically necessary and is typically covered by both private insurance and Medicare. However, a patient's out-of-pocket expenses may be impacted by their co-pay or deductible. These costs are often quite high and contribute to the popularity of this procedure abroad.

Cost Comparison of Knee Replacement :

Country	Price in US dollars
U.S.	$30,000+
India	$6,500
Thailand	$12,500
Mexico	$11,500
Costa Rica	$10,500

(Source: Healthbase, 2008. All costs approximate and exclusive of travel and lodging)

According to Saroja Mohanasundaram, CEO of Boston-based Healthbase, "Knee replacement is as popular among our clients as hip resurfacing and heart bypasses. It's definitely one of the top 10 sought by Healthbase clients."

The majority of Healthbase's knee replacement clients travel to India, Thailand, Mexico, and Costa Rica for their procedures. "India is popular for the value it offers for the money,” Mohanasundaram adds. “Also, orthopedic surgeons in India are world-renowned for their skills.” Mexico and Costa Rica have the advantage of being closer to the United States while offering great discounts at the same time. Thailand is appealing for both its hospitality and care at low rates."

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UPCOMING EVENTS

Developers Symposium on Cell Phone Use in Healthcare Planned for
November 2008

November 25-26, 2008
The Ambassador Hotel, New Delhi, India

The Center for Cell Phone Applications in Healthcare (C-PAHC), a division of the Medical Records Institute, will hold a two-day symposium on phone applications in healthcare on November 25-26, 2008, at the Ambassador Hotel in New Delhi, India.   

"Cell phone applications are the next big wave in healthcare," says C-PAHC executive director C. Peter Waegemann. "Hundreds of systems are already available and more are under development. This field is about to explode onto the international health care scene. This symposium will describe the range of applications and their hurdles and impact."

Programming will highlight the applications currently available for healthcare and discuss their potential to improve efficiency and quality of healthcare in the international marketplace.  Discussion topics will include specific mobile phone applications for patients, doctors, and other health care professionals, and how to integrate already successful cell phone applications into existing health information technology (HIT) systems.

Hosted by C-PAHC (Center for Cell Phone Applications in Healthcare) 

For more information visit www.C-PAHC.com

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Date Set for Healthcare Travel Exhibition & Congress in Dubai:
January 26-29, 2009

With the health care travel industry poised to play an important part in Dubai's growth strategy, IIR Middle East the organizers of the first medical tourism conference in the United Arab Emirates (UAE), which concluded in Dubai, recently have reported high levels of interest from a potentially huge international market.

"Research unveiled at the event indicated a global market of around two million medical travelers a year and an industry constrained by hospital capacity and lack of consumer familiarity with medical travel," said Sietske Meerloo, marketing manager at IIR Middle East and organizer of Healthcare Travel Exhibition & Congress.

IIR Middle East is also the organizer of the Arab Health exhibition and congress, the region's premier event for Middle East healthcare that takes place in Dubai 26-29, January, 2009.

“Large numbers of hospitals and clinics around the world are attempting to tailor their health services to cater to medical tourists," Meerloo added. "Several major insurance companies offer a travel component in their policies and governments are looking closely at policies to take account of the trend."

The health care event was officially opened by Dr. Haidar Al Yousuf, transition director at the Dubai Health Authority, who highlighted the importance the Authority is placing on the future of medical tourism. 

"As we look to develop our domestic health strategy we also want to develop a joint strategy, with our colleagues in the Department of Tourism & Commerce Marketing (DTCM), for the future of health tourism in Dubai," said Dr. Al Yousuf. "The health care sector in Dubai will become an increasingly attractive place for international health care investors, providers, services, facilities, and other health care professionals."

PlanetHospital, a California-based leader in medical tourism, used the event as a platform to announce the official opening of its Jeddah Saudi Arabia office to serve inbound and outbound medical tourists from the Arabian Gulf region.

"The Gulf has the potential to drive growth in medical tourism," said Mohammed Alarifi, managing director for the new operation.  "It is not only a destination from where patients seek medical care abroad but is also becoming a medical tourism destination itself thanks to major hospital developments throughout the region."

The American Hospital Dubai also had high visibility at the event. There was "a lot of exchange of experience among colleagues from around the world," said Naser Saleh, director of marketing and sales. “On the conference side the sessions were very informative."

Gary Miller, CEO of Health Travel TV, said the event had been important for them. "We have a unique product and we’re the only broadcast media here dedicated to this area," he said. “I’m coming back to Arab Health in January."

Organized in association with the International Medical Travel Association, the Healthcare Travel Exhibition and Congress was supported by the UAE Ministry of Health and the Health Authority of Abu Dhabi. Platinum sponsors were Singapore Medicine. Gold sponsors were the American Hospital Dubai and Dubai Health Authority.

For details about Arab Health events, please visit: www.arabhealthonline.com

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Asia’s Biggest Landmark Healthcare Congress – Global Health Conference (GHC) 2009—Announces Its Agenda

Disease management will directly impact the future models of care. But what shape and form these models will take is of question. Will we see more of specialized hospitals? If so, where will they be located? How will innovative ‘disruptive’ technologies help the future health care cities and hospitals cater to and deal directly with new disease management?

The future of health care delivery lies mostly in disease-based intervention programs. The health care cities and hospitals of the future will greatly benefit from a clearer understanding of how to effectively integrate disease management into future facilities and core competencies to be built.

Another contributing factor that will shape future care models is the growing number of highly valued patients globally – many of whom are crossing international borders in search of quality care and access.  How should hospitals convert their centers of excellence to cater to this growing sector? How can they adequately build capacity and expertise to ensure they are able to meet new and growing demands?

Leaders in global healthcare will be tackling these issues head-on at Asia’s biggest landmark health care congress, Global Health Conference (GHC) 2009, which will feature two co-located events, “Healthcare Cities & Hospitals of the Future” and “Crossing International Borders” (February 23-26, 2009, Singapore). 

For more information on the event, please visit www.magenta-global.com.sg/healthcare or kindly contact:
Attn: Ms Catherina Koh
Conference Director
Magenta Global Pte Ltd
DID: (65) 6391 2539
Email: catherina.koh@magenta-global.com.sg with subject code “GHC-MTT”

For media inquiries, please contact:

Nathalie Visele
Director
Shamal Marketing Communications
Dubai, United Arab Emirates
Tel.: +9715 04576525
E-mail: nathalie@theshamalgroup.com

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Thailand Convention & Exhibition Bureau to Sponsor the 2009 World Medical Health Tourism Conference in Phuket

Thailand Convention & Exhibition Bureau (TCEB) is set to sponsor the World Medical Health Tourism Conference: A New Way Forward, which will be held in Phuket, Thailand, September 2009.

TCEB’s participation and sponsorship in this internationally diverse networking event will aim to promote Thailand on an international scale as a medical tourism destination and a preferred venue for international meeting, incentive, convention, and exhibition ( MICE) events.

The whole of Phuket Island is getting behind the conference, which will cater to more than 1,200 delegates. Local supporters range from local community groups, tourism operators, and many of the major hoteliers and resort owners, namely Woraburi Phuket Resort, Millennium Resort Patong, The Moevenpick Resort, Karon Beach Resort of Kata Group, Aquamarine Resort, Cape Panwa Hotel, and Andaman Seaview Hotel group.

Phuket, dubbed as the medical tourism hub in Asia, is the ideal location to hold the conference because of its infrastructure, capacity to host a massive number of international guests, and the availability of cutting-edge technology, and internationally trained medical experts manning their world-class medical facilities.

Sometime within the next month the floor plan or layout for exhibitors at the venue, Hilton Phuket Arcadia Resort & Spa, will be published online, and application forms will be available for the exhibitors to download from the website. Many pre-conference and post-conference activities have been planned for the conference, which early estimates expect to bring a windfall to Phuket of about U.S. $10 million over the two-week period. Interested parties are advised to visit the conference website: www.sosmedicaltourism.com for more information.

Alternatively, for more information call + (66)76-289-800, to request a printable registration brochure by email sosmedical@sosmedicaltourism.com or sosmedical@ymail.com