Lots of talk, not much action—until now. In January, Serigraph Inc., a West Bend, Wis., manufacturer, will become the first U.S. company of any size to embrace medical travel or medical tourism, offering employees the option of having certain nonemergency operations, such as joint replacement, in India. The company will pay all expenses, including travel and lodging for a companion. The incentive for employees is that they don't have to pay a deductible—typically $1,000 to $5,000—or the hospital copay, which would be 10 percent to 20 percent of the charges.
Last May, I went to India and Singapore to explore the trend of growing numbers of under- and uninsured Americans heading to both places and other foreign climes to take advantage of package prices for hip replacement, heart valve repair, spinal surgery, and other elective procedures that can be 80 percent less than the sums charged by U.S. hospitals. To cite one expensive example, heart bypass surgery can easily run up a $70,000 to $133,000 bill at a U.S. center, compared with an average of $7,000 at Indian hospitals catering to westerners. An uninsured patient I interviewed extensively in India paid a total of about $25,000 to have both hips and one knee replaced, including airfare and incidentals. He easily could have paid more than $125,000 at a U.S. hospital. And there are plenty of similar cases of huge price differences.
Perhaps 50,000 Americans currently go abroad for that kind of surgery. Hundreds of thousands of others go as actual medical tourists, combining cosmetic plastic surgery, extensive dental work, and other treatments with time spent sightseeing and lying on the beach in fun destinations like Mexico and Costa Rica.
Until now, however, the movement has largely been fueled by patients paying out of pocket. Health insurers and corporations have stayed on the sidelines, talking endlessly about whether to get involved and, if so, how. There's reason to be cautious. How can the quality of care abroad be guaranteed? What if an employee has a surgical complication after coming home?
But the potential savings for employers are too large to be ignored forever, and Serigraph, which has about 1,200 employees worldwide and slightly fewer than 1,000 in the United States, is taking the plunge. The pilot program will be administered by Anthem Blue Cross and Blue Shield of Wisconsin, an affiliate of WellPoint, the largest U.S. health insurer in numbers of members (and the originator of the Serigraph initiative). Employees needing the following procedures will be covered:
- Hip replacement or resurfacing
- Knee replacement
- Heart bypass surgery
- Heart valve repair or replacement
- Spinal fusion
- Prostate surgery
Employees will be treated at two Apollo Group hospitals, in Bangalore and New Delhi, both accredited by the Joint Commission International. An Anthem case manager will steer patients through the process, including managing medical complications should they occur.
Finally, a corporate pioneer. The Serigraph move will get a lot of attention. I'll be watching, and WellPoint, of course, will as well. "One reason we're doing this is to understand the extent that employees will choose this option," Lisa Latts, WellPoint vice president for programs in clinical excellence, told me. "They will do their own risk-benefit analysis."