Medical Travel Today

Increased efforts by health insurance companies to promote medical travel to consumers are palpable (see INDUSTRY NEWS). We also have news of a new partnership intended to streamline the travel and care coordination process for American patients traveling to Mexico.

But along with the upbeat news comes some cautionary items related to the industry. Under INDUSTRY NEWS we have recent news items dealing with the dangers of cosmetic surgery abroad as well as organ trafficking. In addition, our SPOTLIGHT interview features a conversation with Nathan Cortez of Southern Methodist University, who has published a paper related to the challenges facing Americans attempting to recover compensation for medical malpractice committed abroad. Cortez is also an advocate of mandatory licensing for U.S.-based medical travel agencies.

You’ll also want to take note of a new book in our WHAT YOU’RE READING section. Written by three of the country’s leading experts in value-based design, Cyndy Nayer, Jack Mahoney, and Jan Berger, M.D., Leveraging Health weighs in heavily on the healthcare reform debate. Of particular interest is the author's endorsement of medical travel, both domestic and abroad, as an innovation that uses quality measures of safety, improved health, continuity of care, and electronic information transfer to assure global health access around the world.

And finally, Medical Travel Today is now on Twitter. You can follow and connect with us at http://twitter.com/medtravtoday.

CORRECTION: In our last issue of Medical Travel Today (Volume 3, Issue 17), we featured a press release that indicated Harvard University currently operates hospitals abroad when, in fact, Harvard University is not operating any hospitals outside of the United States nor is it operating hospitals within the United States. There are Harvard-affiliated teaching hospitals in Boston.

Editor's Note: Nathan Cortez teaches and writes in the areas of health law, FDA law, administrative law, and the legislative process. He is publishing an article in the Yale Journal of Health Policy, Law and Ethics in which he examines whether American patients can recover compensation for medical malpractice committed abroad. In the paper, he suggests several ways to better reallocate the risks of cross-border healthcare. In previous work, he has recommended mandatory licensing for U.S.-based medical travel agencies.

Medical Travel Today recently spoke to Cortez about his research on medical travel and the ramifications of proposed mandatory licensing.

Medical Travel Today (MTT): When did you first become aware of medical travel?
Nathan Cortez (NC): Like most people, I learned of it through media stories, including a segment on 60 Minutes around 2005. At the time, I was a healthcare regulatory lawyer in Washington, D.C., and I started brainstorming about all the legal and policy issues raised by medical travel. When I began researching the industry, I found that there wasn’t much legal or policy research. And what did exist was very specialized research about fertility and transplant tourism. I realized that there was so much to say about the phenomenon that hadn’t been said.

My first article was part of a first wave of legal scholarship focused on the industry. A few scholars like me have tried to outline all the issues related to medical travel: what is it, why do people travel for care, what are the legal and ethical issues, what are the policy issues, and so forth. This first wave tried to identify the legal issues and begin to dissect them.

Now, we’re seeing a second wave of scholarship in which scholars like me are delving deeper into the legal issues and starting to talk about the industry and the legal ramifications in a more sophisticated way. At first, there were too many issues to do them all justice.

Given this research, I think the biggest theme pervading the industry is uncertainty. Especially legal uncertainty. Who’s liable if something goes wrong? Do patients have legal recourse? If so, do they have recourse here in the United States, or must they sue overseas? What recourse would they have in foreign jurisdictions?

MTT: What are your biggest concerns regarding the practice of medical travel?
NC: My biggest concern is for patients, primarily because they might be vulnerable when making these medical decisions, and I strongly suspect that patients don’t fully appreciate the legal risks they’re being asked to take. I don’t think most patients fully understand what it means to waive legal claims in the United States and subject themselves to foreign jurisdiction, particularly because there is so little information about malpractice claims in these jurisdictions. Patients might not realize how difficult it would be to litigate overseas and how little compensation they stand to collect, even if they are successful.

Other countries simply don’t provide the same legal remedies that we’re accustomed to here—or at least that has been a big assumption. Until now, no one has really compared medical malpractice compensation systems in these countries, partially because it’s very cumbersome and time-consuming. However, I’m researching these issues now. I recently posted a draft paper that can be downloaded online and will be finalized this winter. My research tries to look at some of the leading destinations for medical travel— India, Thailand, Singapore, and Mexico—and understand how each of these legal systems works. How does each handle medical malpractice claims? What’s the range of compensation available, and what’s typical? And how long does it take to resolve medical malpractice cases? What hurdles do plaintiffs face?

My research concludes that it will be challenging to bring successful claims in these jurisdictions. Each country’s legal system operates differently, and each raises a different set of challenges. These four foreign legal systems aren’t easy to navigate, and even if you’re successful, the recovery will probably be a fraction of what you might expect here in the United States.

That’s not to say there aren’t a lot of great hospitals, doctors, and companies in the medical tourism industry. But even at the best hospitals, there’s always the possibility that something will go wrong. The same possibility exists if you have surgery here in the United States. But the difference is that if you go abroad, you may not have much legal recourse.

MTT: How does a potential medical traveler best contend with the lack of recourse?
NC: Patients should ask for it. If patients are looking at different medical tourism facilitators, many will ask patients to waive all legal claims in the United States and to agree to hold the company harmless. Some may ask patients to arbitrate, which may not be a bad alternative. But it doesn’t hurt to ask. The worst a company can say is “no,” and patients can choose someone more accommodating. Otherwise, I would recommend purchasing medical malpractice insurance for medical tourism, which a few companies now offer.

And the truth is that these companies are trying to figure out the legal issues as well. Companies and hospitals are trying to figure out what’s fair and how exactly they should do business. They don’t want to leave patients out in the cold, but they also need clients to realize that if they’re going abroad to save money, they shouldn’t expect U.S.-style jury awards.

MTT: What have medical tourism suits looked like in terms of settlement and length of time to reach settlement?

NC: The ones I’ve heard of have been settled out of court. It’s really hard to tell how many suits there have been because there haven’t been reported legal opinions, and we simply don’t have good data right now. We haven’t heard many media stories of patients having trouble overseas, but that’s probably not a good indicator of the actual number of complaints because the industry has no incentive to publicize these incidents.

I do worry that as the industry grows and more patients travel overseas, patients may be sent to lower quality foreign providers. Currently, it seems like most U.S. patients visit the high-quality hospitals, which shows patients are capable of identifying them. But there’s no guarantee this will continue.

MTT: You've suggested compulsory licensing for U.S. medical travel facilitators via an overseeing body or agency. What would this accomplish?

NC: Because there’s so much uncertainty and so few standards in the industry, I think licensure would be a good way to introduce standards and transparency. It would allow regulators to gather data. It would allow companies and providers in the industry to benchmark each other and identify some best practices. And it would allow patients to do their homework more easily, from a reputable source of information.

I use one agency in the United Kingdom as a potential model. The Human Fertilization and Embryology Authority (HFEA) is a specialized, independent regulatory agency that licenses and monitors U.K. fertility clinics and acts as a clearinghouse for research. It tracks the technologies available and keeps tabs on outcomes. HFEA really serves as a source of impartial and authoritative information not only to the public, but the industry as well. A similar agency overseeing the medical tourism industry could also gather data and serve as a clearinghouse for information. It would reduce the uncertainties for everyone.

I know that it might be a bit premature to regulate such a young industry. And I don’t see the government stepping in any time soon, unless we see more patients being harmed. But I found HFEA to be a nice model for a long-term regulatory approach.

Another model to look at is Joint Commission International’s (JCI) hospital accreditation system. JCI accreditation is becoming a de facto requirement for the medical tourism industry. Though it’s not perfect, it’s certainly better than nothing. JCI accreditation signals to patients that the foreign hospital meets certain minimum standards, although you can argue about what these standards really mean in terms of quality of care.

One segment of the industry that might also consider voluntary licensing is insurance companies that send patients abroad. This is an interesting group because insurers certainly have a financial interest in shedding light on the quality of outcomes overseas and making the industry more transparent.

And medical travel facilitators, at least the reputable ones, should welcome this type of licensing. These facilitators are on the frontlines of any legal disputes because they’re the ones most likely to be sued if something does go wrong. Licensing would help reduce uncertainty to them as well by establishing standards.

MTT: Just out of curiosity, would you ever consider medical travel for yourself or a family member?
NC: You know, it really depends on the circumstances. I’ve heard of patients with no health insurance who desperately need a surgery, and going overseas is their only real option. I suppose that if I was in a similar situation I’d consider it.

I don’t want to be big naysayer about the industry. There are very impressive hospitals and practitioners overseas—on par with the best we offer here. But as a law professor, I worry about patients, especially those in desperate situations who may be underestimating their worst case legal scenario. If patients are going to travel overseas for surgery, they should understand the risks, and they should understand any waivers they are asked to sign. In their shoes, I’d certainly go to a credentialed physician at an accredited hospital, and I’d look into malpractice insurance.

About Nathan Cortez
Professor Cortez teaches and writes in the areas of health law, FDA law, administrative law, and the legislative process. His scholarship focuses on international and comparative health law, particularly the regulation of emerging international markets in healthcare and biotechnology, such as cross-border healthcare, medical tourism, and clinical trials. He also writes about immigration federalism.

Before joining the SMU law faculty, Professor Cortez practiced with the Washington, D.C., law firm Arnold & Porter, where he represented medical technology clients in administrative, legislative, litigation, and transactional matters, with a special emphasis on healthcare fraud and abuse, FDA enforcement, health privacy, and the Medicare and Medicaid programs. While at Arnold & Porter, Professor Cortez litigated pro bono cases with the Mexican American Legal Defense and Educational Fund (MALDEF), and was a Board Member of the D.C. Hispanic Bar Foundation. In 2006, he was a Visiting Assistant Professor at Rutgers-Camden Law School.

In an attempt to rein in exploding medical costs, a growing number of health insurance companies are offering their customers, both individuals and employers, an opportunity to get their healthcare overseas. Some medical and dental procedures overseas can cost up to 80 percent less, excluding travel costs, than in the United States.

Source: http://www.xinhuanet.com/ Aug. 24 -- The number of organ transplants from deceased donors in China has only been 130 since the first case in 2003, one of the country's leading transplant experts said at a seminar Sunday.
About 11,000 transplant operations are performed each year in China -- both living- and all deceased-donor transplantations, including executed prisoners -- making the country the second largest in the world to the United States in total number.

But that number is far from enough to meet demand, Chen Zhonghua, the Chinese Medical Association's deputy director for transplanting, said at the seminar held in Xining, capital of Qinghai Province. The meeting was organized by the Ministry of Health and a subsidiary of the Novartis company.

Chen told the Global Times that that organ trafficking is the major obstacle facing China's organ-transplant practice. According to official figures, more than 1.5 million people in China need organ transplants each year.

"The huge shortage of organ donors and organs has created a significant black market for organs, which in turn has ruined public faith and willingness to donate organs," Chen said. "There are already signs of backlash, with the nationwide number (of donations) falling last year to 36, from 41 the previous year, and only about 10 cases so far this year."

Chen noted that executed prisoners, with written consent either from themselves or their family members, still provide the major source of transplants in China. He claimed, however, that organs from executed convicts are dwindling gradually amid a dramatic drop in the number of executions. This started, he said, after China's Supreme People's Court started reviewing some death penalty cases in 2007.

China passed the Regulation on Human Organ Transplantation in 2007 to ban all forms of such trafficking, prevent "transplant tourism" by foreigners, and request that living donations be restricted to spouses, lineal blood relatives, or collateral blood relatives within three generations, or people sharing family bonds.

But despite the crackdown, "organ brokers" have procured organs from the poor and jobless by making them "relatives" of organ recipients by forging documents with the help of lawyers and medical workers, Chen said.

"In 2006, living transplants accounted for 15 percent of the total number of national organ transplantations; in 2007, the number reached 50 percent; last year, the number varied between 40 percent and 60 percent," Chen said, adding that the sharp rise in the past two years is closely related to the “fake relative” phenomenon.

Mainland hospitals conducted 450 liver transplants from living donors in 2007, and 438 in 2008, accounting for most of the 1,162 total cases from 1993 through May of this year, according to data collected by CLTRnet, an online data collection system run at the University of Hong Kong.

A www.sina.com blogger, identifying himself as Li Zhe and an organ-transplant dealer, regularly lists contact information to get matching data for kidney transplants.
"If there are available matching organs for patients, trading can start immediately. I'll take care of all the procedures, while the receivers will bear the cost," Li said.

"A single case costs as much as 200,000 yuan for a patient who needs a kidney transplant," Li told the Global Times by telephone, adding that the medical checkups for potential donors run at around 10,000 yuan. But he refused to say how much he could make out of such a deal.

It takes at least a month for the donor to go through necessary medical procedures at hospitals, and another two weeks for the operation and recovery of the receiver, Li said.
Dealers also have to fake the identities of patients to show that donors and receivers are related. Apart from bribing relative departments to obtain all essential documentation, money has to be paid to physicians who will carry out the operation, Li said.

"30,000 yuan is an average sum for doctors in Beijing," he said.

Authorities have stepped up their crackdown on illegal organ-transplant dealings this year, following reports that 17 Japanese tourists spent about 595,000 yuan each for liver or kidney transplants at hospitals in the southern city of Guangzhou, Li said.

"The number of hospitals that are accessible for us dropped sharply this year. But the number of patients who need organs and want to buy from us remains, expanding the time needed to process each case," Li said. "The business is even more risky and difficult. You can only count on luck. A fruitless year for me is not rare at all. Four to five cases per year could be really good.

"There are four to five thousand people who are willing to trade their organs in the country, according to our estimate. Meanwhile, three to four thousand organ dealers like me are mainly scattered in Henan, Beijing, and Northeast regions."

Zhengzhou, the capital of Henan Province, has seen the most trade of organs, Li said, adding that many donors are from there. He put the country's total number of organs traded at several hundred a year.

"I haven't dealt with any foreigner receivers. That must be very tricky. It would be extremely troublesome for us to fake identities for their stay and access to Chinese hospitals and the medical facilities," Li said.

But that doesn't mean there's a lack of interest. Li noted that he would do business with foreigners as long as they pay more and have Asian faces, preferably South Koreans and Japanese, which he said would make business easier.

From a legal and safety standpoint, Chen noted that the illegal organ trade must be phased out. As a lucrative business, violent disputes often arise, and organ recipients often turn to loan sharks to pay for their operations.

According to a report by www.transplantation.org.cn, police found a corpse missing organs June 15 in Guizhou Province. Preliminary investigations indicated that a local organ broker killed a healthy man and sold his organs to three doctors at the Guangdong-based Third Affiliated Hospital of Sun Yat-sen University. The hospital is one of the 164 medical institutions officially qualified to carry out organ transplants.

The Ministry of Health didn't confirm the information, saying only that they have seen the report.

But the ministry has launched an overhaul of illegal organ transplantations at mainland hospitals. Under the leadership of the National Organ Transplantation Committee and the ministry, an expert team has begun final evaluation of the 164 practitioners.

"We'll let the people know and decide which hospital to go to for quality and ethical transplants," the ministry said in an August 12 statement.

"A waiting list will be made public to secure transparent and fair practice in terms of organ-donation allocations and procurements," vice minister of Health Huang Jiefu said.
The Red Cross Society of China, in collaboration with the ministry, plans to establish an independent organ-donation system that would include a waiting list of patients, as well as stipulations on the sources of donations, according to its executive vice president, Jiang Yiman.

As the initiator and director of the first organ-donation platform for the deceased, which is based in Shenzhen, Chen said he was worried about the low donation rate on the Chinese mainland of just 0.03 donors for every million people, far lower than that of Spain, which is 36 donors per 1 million people – the highest proportion in the world.

"It will take China five to 10 years to raise the number to 0.3 in 1 million people," Chen estimated.

Mexicali HealthCare Partners with Health Travel Technologies to Manage Medical Travel Operations

Health Travel Technologies, architect of the medical tourism industry’s most comprehensive technology and services platform for medical travel management, has signed an agreement with Mexicali Health Care to provide the technology infrastructure for managing its international patient operations.

Mexicali Health Care was formed in response to the long-term trend of U.S. patients – particularly from California and Arizona – crossing the border for dental and surgical care at significant savings over U.S. prices. A recent study by the UCLA Center for Health Policy Research estimated that nearly one million people from California alone seek medical, dental, or prescription services in Mexico each year. Mexicali Health Care’s partnership with health Travel Technologies is designed to keep pace with that demand.

“Mexicali is very serious about becoming a major international healthcare provider,” says Carlo Bonfante, a prominent investor in the Mexicali Health Care enterprise. “As a new entity, Mexicali Health Care was starting at ground zero and needed to work with a company that could guide us in building procedures for establishing a professional system for processing and managing patients. Working with Health Travel Technologies has helped us to get up and running with minimal up-front investment. Now we have the capability to grow our business and focus on healthcare delivery instead of the details of handling medical tourism.”

Health Travel Guides CEO Herb Stephens adds, “Our core business is providing behind-the-scenes operational support for international healthcare providers. Our technology platform has been architected specifically to take the headache out of providing medical tourism services for large international hospitals, and our experience on the consumer end enables us to help newer entries into the medical travel field develop a brand and quickly begin generating requests for surgery quotes and patient flow.”

Health Travel Guides is the first and only technology and services company dedicated to managing the complex needs and growth of the medical tourism industry. The company’s systems currently process more than one million international travelers representing more than $500 million in financial transactions per year. According to Stephens, Health Travel Technologies is the ideal solution for any business currently offering, or planning to offer, medical travel services – including medical tourism facilitation agencies, online travel agencies, hospitals, insurers, and businesses.

“Health Travel Technologies supports the marketing, operations, and brand objectives of medical tourism providers; our business model means our success is always aligned with our clients,” says Stephens.

Medical tourism continues to garner considerable attention as a growing number of U.S. employers, consumers, and other stakeholders explore cost-effective healthcare options for their organizations. Experts currently estimate the size of the medical tourism market to reach $100 billion by 2012. According to Stephens, this increased volume creates a significant issue for international healthcare providers servicing an international patient base. “Medical tourism is here,” says Stephens. “We’re well beyond the point of asking, is this a safe, quality option? The superb level of healthcare in Mexico and other countries is indisputable. The question now is how can the growing volume of international patients be most effectively managed? Health Travel Technologies provides a centralized, automated system for managing medical tourism - not just booking procedures and travel, but also strategic marketing, web page hosting, quote management from multiple sources, as well as accounting, billing, collections, loan servicing, and insurance offerings.”

The National, ABU DHABI — The lure of “very cheap” plastic surgery abroad was too great for one woman wanting a breast augmentation and lift. The immediate results, too, left her pleased with the procedure.

But six months later the scars were still spreading and the implants had moved up towards her collarbone, necessitating secondary surgery and highlighting the risks involved with what has been termed “cosmetic tourism”. Upon her return to the United Arab Emirates, the unnamed patient turned to Nicanor Isse, M.D., who is among the UAE surgeons warning of the risks of botched treatments from unqualified practitioners that people face when travelling abroad for cheap cosmetic surgery without doing proper research.

Cosmetic tourism has grown increasingly popular as plastic surgery becomes more desirable and socially acceptable, particularly in the Gulf region. However, experts say patients who go elsewhere for cheap surgery, which they can combine with a short holiday, may not receive the proper aftercare and run the risk of life-threatening complications. Sylvia Angerer, M.D., a specialist plastic surgeon who works at the Bodyworx clinic in Abu Dhabi, has reservations about cosmetic tourism. She says she has seen a number of “very bad results” in patients who had traveled to other countries for cheaper treatment.

“The main problem is aftercare,” she says. “There is always a risk of complications and without the proper care, these can be dangerous. “I have seen some very bad results. I have seen totally visible scars from incisions in places no trained plastic surgeon would put them. There have also been some very bad wound-healing problems and infections.” Bodyworx has also received patients who have had too much fat removed during tummy tucks and wounds that have become seriously infected and left permanent scarring.

“Travelling abroad for surgery is all about the money. It’s very tempting if a company offers you a breast augmentation for a low price, but usually low price means low quality,” says Dr. Angerer. People were becoming more inured to the reality that cosmetic surgery was still a surgical procedure, she adds, and one that posed similar risks to those of non-cosmetic medical procedures. “It is a medical surgery and it can have complications; you should not risk your own body just to save a little money by going to a doctor you know nothing about. Some of the time the doctors are not well trained. It is essential people do their research and not base decisions only on price.”

Before opting for any type of surgery, a patient must check up on the doctor and find out what qualifications he or she holds, says Dr. Angerer, who is registered with the German National Board of Plastic, Aesthetic and Reconstructive Surgery. Doctors listed as specialists might not be qualified plastic surgeons. Instead they could, for example, be ear, nose, and throat specialists or gynecologists.

Most countries in the West have medical boards with which cosmetic and plastic surgeons can register. Many, such as the American Board of Cosmetic Surgery, require members to undertake a written exam before joining. Dr. Isse, an American board-certified plastic and reconstructive surgeon who also works at Bodyworx, warned of other complications associated with travelling abroad for cheap treatment. Most health insurance packages do not cover individuals for surgery performed outside the UAE, so if somebody needed extra care it could result in extra costs as well as extra worry, he says.

“While part of the allure of medical tourism is the ‘holiday’, it can also be one of the risks,” he adds. “Drinking, spending too much time in the sun, or just not resting enough can lead to complications with the recovery, including undue swelling, haematoma, scarring, infection, skin slough, and other complications.” Dr. Isse, who also has a clinic in Newport Beach, Calif., adds that there are also some “very serious complications” associated with the journey back home after the surgery. High altitude, sitting still for long periods, recovering from surgery, and some medical conditions can cause blood clots and blocked blood vessels, both potentially fatal conditions. He also warns of the possible problems of aftercare, and says if difficulties arise once the patient returns home it can be “very serious and potentially pricey.”

Dawood Sulaiman, M.D., of the International Aesthetic Medical Centre in Jumeirah, Dubai, says he too has seen a number of patients who had received treatment abroad but not the proper aftercare. “Aftercare is very important,” he says. “It is important that a patient returns to the surgeon after one week, two weeks, six months, and so on so they can check everything is fine. “Even having another surgeon remove stitches is not ideal. It is much better to have one surgeon doing everything, and this is not always possible if the surgeon is in another country. A patient might not be able to afford to travel for another trip.”

Dr. Sulaiman, who has a doctorate in plastic and reconstructive surgery, says his registration as a U.K. board-certified surgeon reassures his patients that they are in safe hands. Regulations governing plastic and cosmetic surgery in the UAE have been toughened in the past few years, and recently the Ministry of Health warned clinics, hospitals, and pharmacies that they face disciplinary action if they are found to be using “unregistered” chemicals in cosmetic surgery.

Last summer the Dubai Health Authority also cracked down on the industry, targeting clinics run by doctors who were not qualified to do so, and those that bumped up prices set by the authority. Ramadan Ibrahim Mohamed, M.D., the head of the department’s clinical governance office, says it has already shut down a number of clinics and would remain vigilant. He says the case of a woman who ended up in a coma after receiving liposuction and a facelift highlighted the need for stricter regulations.

HighRoads' First Medical Travel Survey Shows Hospital Pricing Can Vary up to $40,000 for the Same Services

BOSTON--(Business Wire)-- HighRoads, the company providing employers - for the first time - complete control over their health care costs and compliance, today announced findings from the industry's first medical travel request for information (RFI) for Fortune 500 employers to compare health care procedural ethics, quality and costs around the world. Initial results show that flat pricing, surgeon compensation and use of electronic medical records vary dramatically from hospital to hospital.

HighRoads’ first Medical Travel survey represents 66 vanguard facilities including over 50 U.S. hospitals and ambulatory surgery facilities and 11 outside the U.S. These health care organizations, including BridgeHealth, Healthplace America, HIMA Health, Intermountain Healthcare and Scott & White, responded to HighRoads first medical travel request for information based on their desire to introduce procedural cost and quality transparency and reduce health care costs.

Leveraging HighRoads industry-standard benefits management technology, the RFI was designed to provide Fortune 500 employers comparable ethical, quality and flat fee data to make the best choice for superior medical procedures for employees at the lowest possible cost. The HighRoads Medical Travel RFI included questions such as:

"I have been leveraging medical travel for the past 14 years to improve the quality of medical care, reduce the practice of unnecessary procedures in order to improve the health of US employees, while reducing health care costs," said Tom Emerick, President of Emerick Consulting, and former VP of Benefits for Walmart Stores, Inc. "HighRoads' application of its technology to provide a transparent database of worldwide ethics, quality and flat prices for medical procedures will accelerate the adoption of medical travel and can dramatically
reduce health care costs for patients, insurers and employers."

"Employers need an efficient mechanism to compare the ethics, quality and cost of medical procedures at top healthcare centers," said Michael Byers, CEO and president, HighRoads. "It is too complex and time consuming to attempt alone. This is why HighRoads has developed a technology platform that will automate this data collection and comparison so employers have increased choices when it comes to the safest and healthiest options for their employees."

Results of the first HighRoads Medical Travel RFI are immediately available to HighRoads clients and upon request.

HighRoads Company Contact:
Petra Marino, 781-503-4031
pmarino@highroads.com

Authors: Cyndy Nayer M.A., Jack Mahoney, M.D., and Jan Berger, M.D.

Soft cover: 145 pages
Publisher: Amazon; 1 edition (September 2009)
Language: English
ISBN-1-4392-4567-3
ISBN-13: 9781439245675
Review by Laura Carabello, Publisher and Executive Editor

Leveraging Health is an eloquent body of work that weighs in heavily on the healthcare reform debate. The authors, three of the country’s leading experts in value-based design, don’t simply theorize about ways to address our bloated health care system -- they provide simple but compelling real-world examples of innovative benefit design at work in public and private organizations. The best news for medical travel stakeholders is that this industry is included in the discussion.
Readers will learn how leading executives use “levers” (insurance designs, incentives, and disincentives) to motivate behavior changes that reduce risk for chronic disease, manage health, and improve bottom-line costs. The results for the average consumer are irrefutable: reduced patient out-of-pocket expenses and lower-priced services when there is less use of emergency departments and more folks traveling to health centers of excellence -- whether abroad or here at home.
Leveraging Health is a valuable tool for senior level executives and a definitive reference work that provides the tools, guidance, and case studies for implementing programs that make a difference – like offering medical travel to employees. Each key point in the book is thoughtfully articulated and backed up with relevant data that tells a story more people should hear: value-based design yields the kind of results that can bring about fundamental change not only in health behaviors but also in the country’s entire healthcare delivery system.

Specifically, the book explores what has worked for organizations such as the City of Springfield, Oregon, Quest Diagnostics, Gulfstream, and Hannaford Brothers – a supermarket chain that offers employees a quality, low cost medical travel option to travel to other stateside destinations as well as overseas for knee and hip replacements, covering transportation and waiving deductibles and co-payments. Medical travel is cited as just one innovative approach companies can take to provide access to quality, cost-efficient care at Centers of Excellence in the United States and around the globe.

More specific to medical travel, Peter Hayes, director of Associate Health and Wellness at Hannaford, is quoted (Chapter 10): “We are at a unique crossroads. We can continue to pay the system for units of care, and we will receive what we always have: higher costs per unit and struggling economies. Or we can create communities of health where we pay for units of health, and we will get healthier people, healthier businesses, and healthier bottom lines.”

The authors show readers how to follow on the heels of innovators like Hayes – and many others – to weave creative new ideas into the fabric of their operations and how to launch breakthrough ideas into health management. In this way, the book serves as a how-to for incorporating value-based design “levers” in order to fine tune performance and measure outcomes that matter to business executives.

Leveraging Health urges readers to think differently and to “learn, do, and share.” The authors endorse medical travel as an innovation that uses quality measures of safety, improved health, continuity of care, and electronic information transfer to assure global health access around the world, citing the rapid rise in medical travel within the United States. That medical travel to Centers of Excellence means high-quality, cost efficient care is no secret, but it’s heartening to see it endorsed in a book that is sure to fall into the hands of key players on Capitol Hill.
For anyone looking for strategic and practical solutions in the healthcare quandary, Leveraging Health is a must-read.

Meet the Authors & Book Signings for Leveraging Health

September 30, 2009
8 a.m.
National Press Club, Washington, D.C.
Limited Seating
Contact jstroh@cpronline.com or www.vbhealth.org

September 30, 2009
5:30 p.m.
Consumer Health Care Congress, Alexandria, Va.
For more info, click here.

SERVICE SUMMIT GUATEMALA 2009 to Provide Matchmaking Meetings for Medical and Wellness Services

The Service Summit Guatemala 2009 scheduled to take place in Guatemala City, Central America, September 10-14, 2009, will feature unique Matchmaking Meeting Program of medical and wellness services.

Attendees, such as Laura Carabello, Publisher of Medical Travel Today, representatives of World Med Assist and MedVoy, among others, will have the opportunity to meet with Guatemalan companies that specialize in providing medical and wellness services such as dentistry, cancer radiotherapy, hospitality, surgeries, ophthalmology, plastic surgery, fertility treatments, and others.

Selected companies are recognized for their high level of quality services, modern infrastructure and equipment, and competitive prices. Plus, all services are provided with the warm, personalized approach considered by many to be an integral part of the Guatemalan culture.

Interested participants will receive a customized meeting agenda tailored to your needs, requirements, and the services you promote. Attendees will also be invited to participate in a unique Familiarization Tour of several hospitals and clinics as well as through the beautiful city of Antigua; a wonderful 16th Century town declared World Heritage site by UNESCO.

Join us and meet your next strategic alliance!

For more information contact us:
By email: servicesummit@agexport.org.gt
By phone: Guatemala Trade Office 212.689.1014.
On the web: http://www.servicesummit.com/

Newswise — This summit will attract more than 1,200 experts from more than 25 countries and across the United States. It will feature more than 100 speakers, including governors, federal officials, and top researchers and scientists and will discuss new federal stem cell policies, scientific discoveries, and human interest stories. This is your chance to meet and talk to all the experts at one location and time with on-the-record sessions, press briefings, and interviews.

The World Stem Cell Summit, held this year at the Baltimore Convention Center on September 21-23, 2009, is the only conference that combines this mix of researchers, policy makers, business leaders, and ethics and legal advocates to share, explore, and discuss the latest breakthroughs and advancements in the emerging field of stem cells.
Demonstrations and discussions will range from tracking how reprogrammed stem cells (iPSCs) might supersede the use of embryonic stem cells to stem cells use in regenerative medicine and how new devices such as a stem cell integrated fluidic circuits might soon automate and simplify the entire process.

Follow the latest on the conference arrangements on the Website and Twitter site. Story possibilities will be posted by participating universities and agencies on the conference news blog.

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 Web site. 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 $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

Dates for Costa Rican Medical Care's Medical Tourism Conference Announced

There are only 10 days left to sign up to attend Costa Rican Medical Care's Medical Tourism conference in San Jose, Costa Rica October 6-7. Registration will close on September 9.

"People can read about Medical Tourism or attend seminars with Medical Tourism providers, but the only way to really learn about Medical Tourism is to experience it first hand. The purpose of our seminar is for insurance company executives, employee benefit mangers, health insurance agents, third-party administrators, and others is to experience first hand the hospitals, physicians, dentists and other medical service providers that Costa Rican Medical Care works with. Once people see the quality of the health care Costa Rica has to offer, they will be comfortable working with us and recommending our services to their people," said Tim Morales.

"We feel it is important for us to provide these educational seminars at a price people care afford, so we proud to be working with The Barceló San Jose Palacio, a five-star hotel to accomplish this and we have priced this event at only $799.00 all included."

Who Should Attend?

Employee Benefit Advisors
HR Mangers
Insurance Executives
Health Agents
TPAs
Health Savings Account Providers
Self Insured Firms
Individuals interested on saving on healthcare treatments

For more information on attending this event please visit http://costaricanmedicalcare.com/seminar_oct_6_7
or call Costa Rican Medical Care at 262-348-1300.

Omanexpo Organizing Major Health Exhibition for October 19-21, 2009

In view of the rapid growth of Oman’s health and medical sector, Omanexpo LLC is currently organizing an international exhibition called MedHealth & Wellness to be held on October 19-21, 2009, at the Oman International Exhibition Centre in Seeb. MedHealth & Wellness 2009 will showcase everything required in achieving and maintaining good health and well-being.

Supported by the Ministry of Health (MOH), the three-day international exhibition will feature medical tourism, health products and services, laboratory and medical equipment, pharmaceutical products, hospital and clinic infrastructure, sports and fitness, and alternative therapies.

“We envision MedHealth & Wellness 2009 as the definitive event in Oman for everything related to healthcare, medicine, and fitness. It will be highly relevant to all medical professionals in the sultanate as well as to everyone looking for ways to effectively improve their health,” says C.J. Paul, general manager of Omanexpo LLC, the leading exhibition management company in the sultanate. Paul pointed out that, with the official support of the Ministry of Health, MedHealth & Wellness 2009 is expected to attract the participation of leading companies in Oman’s vibrant health and medical industry.

In line with this, a briefing on the exhibition will be held on April 20 at the Crowne Plaza Muscat to inform all medical equipment suppliers in Oman about MedHealth & Wellness 2009. “The strong presence of local companies in the exhibition will prominently showcase the quality of healthcare in the sultanate and also clearly reflect the continued development of Oman’s vibrant health and medical industry,” Paul stresses.

Apart from local companies, MedHealth & Wellness 2009 is also expected to attract many international exhibitors who want to take full advantage of the growing opportunities in the sultanate’s medical sector. In addition to the Ministry of Health, MedHealth & Wellness 2009 is also supported by Middle East Health magazine as the print media partner; Malaysia Healthcare.Com, Global Ayurveda and Placid Way as the online media partners; and Becker Travel as the official travel partner.

For stall reservations or for more information on MedHealth & Wellness 2009, please contact Melwin D’Cunha, Project Manager, at tel. no. +968-24660124, mobile no. +968-92881982, or e-mail melwin@omanexpo.com. More details about the event are also available online at www.omanexpo.com/medhealth.

Date Set for Healthcare Travel Exhibition & Congress in Dubai: October 27-29, 2009

With the healthcare travel industry poised to play an important part in Dubai's growth strategy, the Institute for International Research (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," says 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 27-29, October, 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 Haidar Al Yousuf, M.D., 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," says 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," says 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," says Naser Saleh, director of marketing and sales. “On the conference side, the sessions were very informative."

Gary Miller, CEO of Health Travel TV, says the event had been important for them. "We have a unique product, and we’re the only broadcast media here dedicated to this area. 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

Healthcare Abroad and Health Tourism 1st International TEMOS Conference
November 15-17, 2009 in Cologne / Germany

TEMOS is pleased to announce the 1st International TEMOS Conference on “HEALTHCARE ABROAD AND HEALTH TOURISM” in Cologne, Germany from November 15-17, 2009.

The main objective is to bring together the parties and markets of:

Health insurance companies and payers from Germany and Europe
Hospitals and medical facilities from all over the world
International facilitators, health tourism operators and telemedicine providers

to discuss about quality management, and the potential of health tourism & healthcare services abroad – from the stakeholders’ perspective.

To push these conference topics we have the pleasure to introduce several international experts as members of the TEMOS Conference Advisory Board, for example:

Health insurance: Dr. Franz Benstetter, Head of Operational Services Munich Health, Munich Reinsurance Company.

Medical facility: Dr. Kalyan S Sachdev, M.D., Chairman and founder of Privat Healthcare Group, member of the governing Board of Indian Spinal Injuries Center.

Telemedicine: Prof. Dr. Michael Nerlich, M.D., Head of the Department of Trauma at the University of Regensburg Academic Medical Center Surgery, President of the International Society for Tele' and eHealth (ISfTeH).

Science & Economics: Prof. Dr. Wolfgang Goetzke, Director of gewi-Institute for health economics, Co-founder of the Fresenius University in Cologne, Coordinator of the regional initiative “Health Cologne” and “Health Region Cologne Bonn”.

Click here to find additional members of the Advisory Board.

Please also visit the Conference Website for registration and further information!

Register now via the Online Registration Form and benefit from the early bird rates!

Please contact info@temos-conference.com or the conference hotline +49–2203–601 3000
for any questions regarding the International TEMOS Conference.

Exhibitors can increase their profile by choosing between several attractive sponsoring options for this event. Please get in touch with us to learn more about your opportunities.

Please note: You can ideally combine the attendance of the TEMOS conference with a visit to MEDICA®, the world’s largest exhibition for ' technology, which is held in the neighbouring city of Duesseldorf from November 18-21, 2009.

Destination Health Exhibit Set for London

Destination Health is a brand new exhibition designed exclusively for people planning to travel abroad for all types of treatments. It is set to take place on 17 - 18 April 2010 in London.

If you are involved in any aspect of health tourism, then you should be exhibiting at Destination Health.

For everything from heart disease to hip replacements to breast implants, to medical spas, Destination Health is dedicated to every area of health tourism. Bringing together thousands of patients and medical providers under one roof. Offering you an exclusive platform to meet people who are ready to invest in their personal health, body image and wellbeing.

Whatever the size or nature of your business, if you want to promote and increase awareness of your health and medical travel services in a focused and dedicated environment, you should be at Destination Health.

To find out more, visit the Destination Health website or call us on + 44 (0) 20 8230 0066 or email sales@destinationhealth.co.uk

SITUATIONS WANTED:

International Patient Development in your Country – Medical Tourism

With present economic down turn I would like to offer my skills and global experience to develop much needed healthcare business.
I am sure my experience in medical tourism will provide original strategy as I come from the other side of the world.

Now is the perfect time to participate in global healthcare which is the world's second largest industry.

I would like to know if I can bring my successful career to work for your organisation to develop international business.

For further information visit www.surgeryexpress.com or contact me at as@surgeryexpress.com

JOBS:

Director of Quality Improvement

As the Director of Quality Improvement, you will be responsible for the planning, developing and directing QI functions. Provide leadership, management and supervision of the QI Department operations and staff. Ensure quality of healthcare services rendered meets or exceed professionally recognized standards. Develop and implement measures and controls to achieve company's goals.

Requirements:
BSN/BS/BA Degree in Healthcare related field. Master's Degree in Healthcare a PLUS
QI experience – min. 5 years; Managed Healthcare – min. 5 years.
Knowledge of NCQA standards.
Medicaid experience – min. 2 years.
Management Experience – min. 5 years.
Knowledge of applicable state, federal and third party regulations with special emphasis on Medi-Cal Managed Care.
Excellent communication skills.
Proficiency with computer information systems and software.
Strong analytical and problem solving skills.

Salary is commensurate with experience.
Located in Jackson, MS, USA.

For consideration, please forward your CV w/salary requirements to vvanover@headwaycorp.com or apply at www.headwaycorp.com/jobs

EEO/AA/M/F/V/D

To submit your job posting or a description of your desired position to ahaar@cpronline.com. Please keep text to 100 words or less.