Domestic medical tourism is the latest concept in the medical tourism industry. When a patient travels from one city to another or one state to another within his own country for medical care then domestic medical tourism is said to have taken place. Patients usually conduct domestic medical travel to avail of major discounts on elective surgical procedures or to seek procedures that are not available in his neighborhood.
Domestic medical tourism goes by several other names, such as, medical tourism within US, local medical tourism, inbound medical tourism, out of state medical travel, in-country medical travel, etc.
Watch the video below to learn more about this cost-effective way of receiving medical care within the US.
Benefits of domestic medical travel within USA
Low cost for elective high-cost major surgeries
High quality of care as hospitals are accredited by the Joint Commission (JCAHO)
Shorter traveling distance compared to international medical tourism
AMMAN – With Jordan ranking first in the Arab world and among the top 10 in the world as a medical tourism destination, the private health sector is struggling to preserve such a lofty status by attracting patients from new markets.
The Jordan Private Hospitals Association (PHA) has recently launched a marketing plan that is expected to attract more patients to receive treatment in Jordan from the US, Britain and Canada, according to its president, Fawzi Hammouri.
To achieve this goal, the PHA invested in a familiarisation visit that attracted representatives from health sector and insurance companies from the three targeted countries to have a first-hand look at the facilities available in the Kingdom.
“The global financial crisis has hit most of the world’s countries, but we are trying to make use of it and attract patients to receive treatment in Jordan through the good quality and fair prices we offer,” Hammouri told the press this weekend.
“Have your surgery in Jordan for 25 per cent or less than you would have to pay in your countries, in addition to the excursions to the Dead Sea and Petra that you will receive as part of the package,” Hammouri said, listing the privileges that a patient from these countries will enjoy by coming to Jordan for surgery .
He added at a press conference held in the presence of a delegation from the three targeted countries that the association is also ready to provide better offers for patients depending on the delegation’s recommendations.
“Our customers have three concerns when considering treatment. This includes cost savings, the quality of services and accessibility, all of which are available in the sector in Jordan,” Saroja Mohanasundaram from the US-based medical tourism company , Healthbase , told reporters.
As for accessibility, she said that flying 12 hours from the US to Jordan is not long compared to the 20-hour flights that some American patients take to receive treatment in other countries.
“We are impressed with the high quality of the healthcare system here in Jordan, the physicians, who are well-educated, and the fact that they have English language as a second language and this will make it a better destination for medical tourism ,” Gabriella Vicuna, representative of the Medical Tourism Association in the US, said.
However, despite all the offers to be provided for patients from these countries, the visiting delegation called on the PHA to provide compensation in case of malpractice.
“There are many countries competing with Jordan in this sector,” a representative of a UK-based company said, adding that a patient should be aware of what he will receive in the event of a failed surgery to decide which offer and which country to choose.
The delegation members mentioned that citizens of their countries seek treatment in other countries in the fields of orthopaedics , cardiology , neurology and cancer .
Considered one of the main contributors to the national economy, medical tourism brings in revenues that reach $1 billion annually, and the sector has been witnessing a steady annual increase in foreign patients of around 10 per cent.
A study conducted by the PHA shows that 210,100 patients from 48 countries received treatment in the Kingdom last year, compared to 190,000 in 2007.
Today, medical tourism is a widely accepted and proven formula for top quality care at low cost. Given the manifold increase in the number of patients traveling overseas for medical and surgical care from the US, the American College of Surgeons (ACS) has recognized that surgical care has become more readily available in a wider global market, and that this phenomenon is here to stay. So, the College recently developed an official “Statement on Medical and Surgical Tourism”, which according to ACS are “consistent with the College’s longstanding advocacy position of promoting an environment of optimal care for the surgical patient”.
The College has developed several key principles (listed below) for those who choose to seek surgical care abroad. The College:
encourages patients to seek care of the highest quality and supports their rights to select their surgeons and health care institutions without restriction.
encourages its Fellows to assist all patients in reaching informed decisions concerning medical care, whether at home or abroad.
advises patients to consider the medical, social, cultural, and legal implications of seeking medical treatment abroad prior to deciding on a venue of care.
encourages patients electing to receive treatment abroad to seek care at health care institutions that have met the standards for accreditation established by recognized accrediting organizations.
encourages patients electing treatment abroad to seek care from surgeons and anesthesiologists certified in their specialties through a process equivalent to that established by the member boards of the American Board of Medical Specialties.
encourages patients receiving treatment abroad to obtain a complete set of medical records prior to returning home so that the details of their care are immediately available to their physicians and surgeons in the U.S. Follow-up care at home should be organized prior to travel whenever possible.
encourages patients contemplating medical tourism to understand the special risks of combining long international flights and certain vacation activities with anesthesia and surgical procedures.
opposes the imposition of provisions for mandatory referral of patients by insurers to health care institutions outside the U.S., unless such provisions are clearly and explicitly stated in the insurance contract and accepted by the subscriber.
supports the view that payors referring patients for mandatory treatment abroad should be responsible for the coordination and reimbursement of follow-up care in the U.S., including the management of postoperative complications, readmissions, rehabilitation, and long-term care.
Medical Tourism is no longer restricted to outbound medical tourism i.e. Americans seeking care outside of the country. Domestic medical tourism is gathering pace as more and more Americans are now crossing state borders to take advantage of cheaper prices available for quality health care out-of-state. It’s amazing to know that the price differential on healthcare within the same country can be tremendous if only you take the trouble to shop for it.
Recently Healthbase partnered with many health care providers in several states within the United States. The prices on major procedures that these providers offer to Healthbase clients are as low as 10% of the prevailing cost of those procedures in other typical hospitals within the country. Read more about this partnership.
So how can some US providers offer such low rates?
Patients can avail of such low rates if they choose the one-pay option. AARP Bulletin Today recently covered the story of Rodney Larson, an uninsured Minnesota resident and a Healthbase customer who had his triple bypass surgery at a heart care hospital in Kansas.
According to the bulletin,
As a father to nine daughters, electrician Rodney Larson always looks for ways to cut costs. So in 2008 when he was told he needed triple bypass surgery – totaling $80,000 or more – he shopped around.
Rodney Larson traveled within the United States for heart surgery.
Larson, 56, of Boyd, Minn., searched the Internet and found a hospital that would do the surgery for $13,200. The facility, Galichia Heart Hospital in Wichita, Kan., participates in a domestic medical tourism program run by Healthbase Online.
Located in Boston, Healthbase is one of a handful of companies reaching out to U.S. hospitals to provide specialty surgeries at much lower costs than traditional providers. The company also offers international medical tourism – in which patients travel abroad for procedures – but is finding a market for U.S. specialty hospitals.
Most patients who use medical tourism companies are uninsured and must pay upfront for procedures. Larson liked the one-pay option.
“They saved me a lot of money, but the point is, it was excellent care,” he says.
Available procedures
Most major procedures are available at discounted rates within the US through Healthbase. Procedures fall in the categories of cardiac, orthopedic, bariatric, spinal, etc.
A post recently appeared in the Wall Street Journal Blog which talked about Healthbase, Healthbase’s customers and the latest trend in medical tourism or global healthcare – traveling from one state to another within the United States in search for cheaper prices for major surgeries. Healthbase is one company that has been helping American patients connect to affordable hospitals in the US for major surgeries. The author writes,
Uninsured Americans also are shopping around for surgery in the U.S. in record numbers, and using new services such as Healthbase Online Inc. , a Boston-based medical brokerage that arranges treatments for patients at health-care facilities worldwide. Rodney Larson, a self-employed electrician from Minnesota, used Healthbase Online to arrange a triple heart bypass at Galichia Heart Hospital in Wichita, Kansas. He paid $13,000 flat fee for the surgery, about $90,000 dollars less than the rate for uninsured patients in Minnesota.
The current economic conditions…
Worsening economic conditions have made employers and workers more inventive in dealing with ever-rising health-care costs. Some are taking advantage of new health services that offer fixed rates for surgery to patients willing to travel to get care.
The financial benefits of domestic and international medical tourism cannot be overlooked and some insurers have taken active steps to reduce the health care costs for their clients in this slowing economy by offering them medical tourism options. The author mentions about the forward thinking by some health insurers and writes,
Others insurers aren’t sold on asking customers to travel for health care. Aetna Inc. says it already negotiates significant discounts with medical providers. Typically, it pays physicians within three days of submitting a claim, so up-front cash payments aren’t a strong incentive for achieving additional discounts, according to a company spokesperson.
Medical Tourism Facilitator and International Insurer Partner to Provide New Protection for Medical Tourists
Press Release
January 28, 2009
Seven Corners, one of the industry’s most experienced specialty travel insurance underwriters, announces a new partnership with award-winning medical tourism facilitator, Healthbase Online, Inc. By combining Seven Corners’ experience in underwriting and administering specialty travel insurance plans, and Healthbase’s expertise in matching medical tourism patients with a world-class network of internationally accredited hospitals, the companies have developed the industry’s first custom benefits package covering medical complications to be provided to all Healthbase clients.
The strategic alliance between Seven Corners and Healthbase is founded on a shared vision to unify patients seeking medical treatments abroad with relevant medical insurance benefits specifically designed for medical tourists. By engaging the companies’ unique and expert competencies in their respective markets, the alliance will allow both companies to better serve the unique needs of medical tourists — ultimately transforming the medical tourism business by reducing patients’ medical costs before, during and after treatments abroad.
“We are the only medical travel facilitator to provide a custom insurance program to our clients as a further commitment to providing high quality medical travel services at an affordable cost,” said Saroja Mohanasundaram, CEO of Healthbase. “The insurance program enhances our clients’ satisfaction in the economic delivery of quality healthcare; whether they are seeking minor procedures like hernia surgery, or major procedures like knee replacement or spinal surgeries.”
The insurance plan provides Healthbase patients coverage for the treatment of common surgical complications such as adverse reactions to anesthesia, stroke, myocardial infarction, deep vein thrombosis, infections and other medical complications incurred during and after their treatment abroad. The insurance plan provides first dollar coverage for medical complications, which further reduces follow-up care and unexpected medical expenses for an uninsured or underinsured patient.
“The cost of the insurance plan is a fraction of the overall cost of the treatment, which in and of itself, is significantly less than the expense of treatment in the United States,” said Jim Krampen, executive officer of Seven Corners. “The medical complication benefits we designed for Healthbase clients will provide peace of mind and cover the cost to treat medical complications abroad and when they return home.”
About Healthbase:
Healthbase is a one-stop source for global medical and dental choices, connecting patients to internationally accredited providers in 14 countries including India, Thailand, Singapore, South Korea, Turkey, Panama, Costa Rica and Mexico. Healthbase caters to individual consumers, self-funded businesses, insurers, benefits plan consultants, third party administrators and those using Consumer Directed Healthcare Plans (CDHPs) or voluntary benefit plans. More information at http://www.healthbase.com.
About Seven Corners
Seven Corners is one of the industry’s most experienced international travel, expatriate health insurance and trip cancellation providers. For more than 15 years, Seven Corners has served the medical insurance needs of U.S. citizens traveling abroad and foreign nationals visiting the United States.
Seven Corners is a licensed Third Party Administrator as required in certain jurisdictions of the United States. Seven Corners is a Lloyd’s of London Coverholder and also enjoys underwriting authority from key AM Best “A” rated carriers, such as Nationwide Insurance Company, The Insurance Company of the State of Pennsylvania (AIG) and Fairmont Specialty Group.
Seven Corners is a member of the U.S. Travel Insurance Association (UStiA), the Medical Tourism Association (MTA) and the International Medical Travel Association (IMTA). More information at http://www.SevenCorners.com.
Healthbase collaborates with WellPoint to bring affordable healthcare benefits to Americans through an international medical tourism pilot program. Members will now have more choices regarding where to receive care and a greater involvement in the care they receive
BOSTON, Jan. 5 /PRNewswire/ — Healthbase Online Inc., a Boston-based award-winning medical tourism facilitator, has collaborated on a pilot basis with WellPoint, Inc., an Indianapolis-based health benefits company to provide global health care coverage to members of WellPoint’s affiliated health plan in Wisconsin. Healthbase will handle all the medical travel logistics and arrangements for WellPoint members.
According to Saroja Mohanasundaram, CEO of Healthbase (http://www.healthbase.com), “Healthbase is committed to providing high quality medical travel services at affordable cost. Healthbase will assist WellPoint members with coordination of the trip, medical appointment scheduling, digital medical records transfer, and concierge travel service.”
Under this program, effective from January 2009, members who travel for certain non-emergency elective procedures like joint replacement and spinal fusion, will have access to Joint Commission International accredited healthcare providers in India. This will result to lower out-of-pocket costs for members translating into thousands of dollars in total savings. A hip replacement surgery, for example, costing over $60,000 in the US, costs less than $8,000 at an accredited hospital in India.
“We are pleased to work collectively with Healthbase to deliver an international medical tourism pilot product to our clients who are interested in exploring a medical tourism solution,” said Dr. Razia Hashmi, vice president and medical director for WellPoint’s national accounts division. “Medical tourism is a promising option for improving access to affordable, quality health care. Working with Healthbase, our case managers will coordinate all steps of the medical tourism process for members interested in receiving care overseas.”
About Healthbase:
Healthbase is a one-stop source for global medical and dental choices, connecting patients to internationally accredited providers in 14 countries including India, Thailand, Singapore, South Korea, Turkey, Panama, Costa Rica and Mexico. Healthbase caters to individual consumers, self-funded businesses, insurers, benefit consultants, third party administrators and those using Consumer Directed Healthcare Plans (CDHPs) or voluntary benefit plans. More information at http://www.healthbase.com.
About WellPoint, Inc.:
WellPoint, Inc. is the largest health benefits company in terms of medical membership in the United States. WellPoint is an independent licensee of the Blue Cross and Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at http://www.wellpoint.com.
Healthbase has helped an uninsured American patient get double hip resurfacing surgeries in India. The high cost of Birmingham hip resurfacing surgery in the United States plus the lack of expertise in this procedure in the country continues to drive scores of Americans to India.
Nov. 21, 2008, Boston, MA. Healthbase Online Inc., an award-winning medical tourism facilitator based in Boston, Massachusetts, helps an Arizona-based former ballet dancer treat her hip osteoarthritis in India. 53-year old Katharine Frey who had arthritis in both her hips traveled to Apollo Hospitals, Chennai to have her hips resurfaced and availed of the 85% discount on the cost of the surgery.
“I have appreciated everything we have experienced and received at the Apollo Hospitals . Everyone has been very kind, supportive and helpful,” says Katharine after her hip resurfacing surgery last winter. She was so happy with the quality of care she received at her overseas hospital that she went back a few months later to have her second hip resurfaced.
Being uninsured, the $60,000 required to have a single hip resurfaced in the US seemed out of reach for Katharine. This led her into researching her other option – surgery overseas – and contacting Healthbase who coordinated both her surgeries in India for $8,000 each. The price included doctor’s fees, physical therapy and a week in the hospital.
According to Saroja Mohanasundaram, CEO of Healthbase , “Our clients prefer going abroad for Birmingham hip resurfacing because it is a fairly new procedure in the US but has been in use, say, in India, for many years. Being a major procedure it demands years of practice on the surgeon’s part to gain proficiency. The fact that Katharine went back to have her other hip resurfaced in India speaks volumes about the high level of satisfaction with our service and that of our partner hospitals and surgeons.”
Katharine Frey taking off on a paragliding flight just weeks after her Birmingham hip resurfacing surgery in India coordinated by Healthbase
Katharine returned to work merely two and a half weeks post operation and to teaching ballet twenty days post operation. Katharine actively participates in swimming, yoga, hiking, paragliding, and cross-country road trips. “She has no pain in her hips and is moving and functioning like a normal human. I am so grateful and am enjoying watching Katharine return to life,” remarks Scott Martin, Katharine’s husband.
Katharine was operated upon by Dr. Vijay Bose and his team. Dr. Bose, a specialist in Birmingham Hip Resurfacing, Joint Replacement and Sports Medicine, has over a thousand BHR surgeries under his belt.
“Beyond the cost savings, the attention given was remarkable. Dr. Bose and his qualified staff will always be remembered for this,” adds Katharine.
Impressed by the high quality of care in India, even Scott, who accompanied Katharine to India addressed some of his periodontal issues through dental scaling and crowns at Apollo Hospitals while Katharine recuperated after her second Birmingham hip resurfacing surgery.
“It has been a positive life changing process for both of us. Thank you, Healthbase, for being so receptive, supportive and professional,” acknowledge Katharine and Scott.
Healthbase connects patients from across the globe to health care facilities in India, Singapore, Thailand, Malaysia, South Korea, Philippines, Turkey, Belgium, Hungary, Costa Rica, Panama, Brazil, Mexico and United States. Healthbase has over 45 providers on its network.
About Healthbase Online Inc.:
Healthbase, an award-winning Boston-based medical tourism and dental tourism facilitator, is a one-stop source for global medical and dental choices, connecting patients to leading healthcare providers around the world. Healthbase coordinates over 200 procedures in various categories like orthopedic, spinal , cardiac, bariatric, urology , oncology , dental , cosmetic and general surgery . Some of the common procedures offered are Birmingham hip resurfacing , total hip replacement , knee replacement , ACL repair , rotator cuff surgery , spinal fusion , spinal disk replacement, heart bypass surgery , lap band , gastric bypass , cancer treatment , liposuction, dental implants, crowns, bridges, etc. for a fraction of the cost in the US with equal or superior outcomes. Healthbase’s partner healthcare facilities are located in Thailand, India, Singapore, Malaysia, Philippines, South Korea, Turkey, Belgium, Hungary, Costa Rica, Panama, Brazil, Mexico and USA, and are expanding to Canada, UK, Jordan, Taiwan, Argentina, New Zealand, Australia, El Salvador and Guatemala. To ensure that patients receive the best care possible, Healthbase works mainly with hospitals that have international accreditations like JCI, JCAHO and ISO. Healthbase caters to the needs of individual consumers, self-funded businesses, insurance carriers, benefit consultants, insurance agents, and third party administrators seeking affordable medical travel and dental travel options. To learn more, call 1-888-691-4584, email info.hb @ healthbase.com or visit http://www.healthbase.com.
Anatomy of the human spine
Have you ever wondered what makes your back and neck bend, stretch and even rotate so swiftly and smoothly? These movements are possible due to the spinal column or vertebral column in your body which extends from the skull to the pelvis and is made up of 33 individual bones termed vertebrae. The vertebral column is not actually a column but is sort of a spiral spring in the form of the letter S.
The following figure illustrates the human spinal column:
Human Vertebral Column or Spinal Column
Between each vertebra are strong connective tissues which hold one vertebra to the next, and acts as a cushion between the vertebrae. The disc allows for movements of the vertebrae and lets you bend and rotate your neck and back. The type and degree of motion varies between the different levels of the spine: cervical (neck), thoracic (chest) or lumbar (low back).
The cervical spine is a highly mobile region that permits movement in all directions. The thoracic spine is much more rigid due to the presence of ribs and is designed to protect the heart and lungs. The lumbar spine allows mostly forward and backward bending movements (flexion and extension).
WHAT BREAKS YOUR BACK?
Spinal osteoarthritis
Back pain
Spinal arthritis or osteoarthritis of the spine is a common cause of back pain. It is the mechanical breakdown of the cartilage between the vertebral joints in the back portion of the spine leading to mechanically induced pain. The joints become inflamed and pain may be felt when performing even the simplest of activities like standing, sitting or walking. Over time, bone spurs – small irregular growths on the bone, also called osteophytes – typicaly form on the vertebral joints and around the spinal vertebrae which may become so large as to cause irritation or entrapment of nerves passing through spinal structures and result in spinal stenosis (diminished room for the nerves to pass).
Classification of spinal osteoarthritis
- Lower back (lumbar spine) osteoarthritis or lumbosacral arthritis, which produces stiffness and pain in the lower spine and sacroiliac joint (between the spine and the pelvis)
- Neck (cervical spine) osteoarthritis or cervical spondylosis, which causes stiffness and pain in the upper spine, neck, shoulders, arms and head.
Causes of spinal osteoarthritis
The most common causes are repetitive trauma to the spine from repetitive strains caused by accidents, surgery, sports injuries and poor posture. Other risk factors include aging, gender (more common in post-menopausal women), excess body weight, genetics, and associated diseases (like infections, diabetes, rheumatoid arthritis, etc.)
WHAT REMAKES A BROKEN BACK?
Surgical treatment of spinal arthritis
For spinal arthritis, the only effective surgical treatment is spine fusion surgery, to stop motion at the painful joint. In fusion, one or more of the vertebrae of the spine are united (fused together) using bone grafts so that motion no longer occurs between them.
Interbody Spine Fusion System
Uses of spinal fusion surgery
Spinal fusion surgery is used to treat:
- a fractured (broken) vertebra e.g. spondylolisthesis
- deformity e.g. scoliosis or kyphosis (spinal curves or slippages)
- pain from painful motion
- instability
- some cervical disc herniations (fusion together with discectomy)
- weak or unstable spine caused by infections or tumors
Urinary diversion is a way of surgically rerouting or diverting urine flow from its normal pathway in order to treat the condition of diseased or defective ureters, bladder or urethra, either temporarily or permanently. Using the surgical method of urinary reconstruction and diversion a new way is created for the patient to pass urine.
There are three main types of urinary diversion surgeries
• Ileal Conduit Urinary Diversion
• Indiana Pouch Reservoir
• Neobladder to Urethra Diversion
For all of these procedures, a portion of the small and/or large bowel is disconnected from the fecal stream and used for reconstruction.
Ileal Conduit Urinary Diversion: The ileal conduit urinary diversion surgery is used in patients who have had their bladder removed and is usually used in conjunction with radical cystectomy in order to control invasive bladder cancer. In this procedure, the ureters are surgically unattached from the bladder and a ureteroenteric anastomosis is made in order to drain the urine into a detached section of ileum (a part of the small intestine). The end of the ileum is then brought out through an opening (a stoma) in the abdominal wall. The urine is collected through a bag that attaches on the outside of the body over the stoma. The bag must be periodically emptied of urine.
Indiana Pouch Reservoir: The Indiana pouch surgery is used for patients who have had their urinary bladders removed as a result of bladder cancer, pelvic exenteration, bladder exstrophy or who are not continent due to a congenital, neurogenic bladder. In this procedure, a reservoir, or pouch, is created out of approximately two feet of the ascending colon and a portiom of the ileum (a part of the small intestine). The ureters are surgically removed from the bladder and repositioned to drain into the pouch. A piece of small intestine is brought out through a small opening in the abdominal wall called a stoma. Since a segment including the large and small intestines are utilized, also included is the ileal-ceceal valve. This is a one-way valve located between the small and large intestines which normally prevents the passage of bacteria and digested matter from re-entering the small intestine. After a period of several weeks, the body adjusts to the absence of this valve by absorbing more liquids and nutrients. Unlike other urinary diversion and reconstruction techniques, the Indiana pouch has the advantage of not using an external pouch adhered to the abdomen to store urine.
Neobladder to Urethra Diversion: With the Neobladder to Urethra Diversion procedure, the intent is to create a new bladder that mimics the storage function of a normal urinary bladder. The surgery makes a reservoir or pouch by utilizing a small part of the small intestine and connects the pouch to the urethra. The ureters are repositioned to drain into this pouch. As in normal urinary system, urine is able to pass from the kidney, to the ureters, to the pouch, and through the urethra out of the body.
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