Health Insurance Blog

Reuters is reporting that Healthbase Online, a medical tourism facilitator, is engaged in a pilot program with Wellpoint to provide global health care coverage to Wellpoints members in Wisconsin.  Healthbase’s involvement in the pilot involves setting up all the medical & travel logistics.

Under the Wellpoint program, members who choose to have non-emergency elective procedures performed overseas, such as joint replacement, will have access to Joint Commission International accredited HealthCare providers in India.

The program would save members thousands of dollars in out-of-pocket costs.

As previosuly reported here in this blog, studies conducted by UCLA medical school have shown that patients who have procedures down overseas have a much greeater chance of experiencing complications or post-op infections.  Nonetheless there continues to be interest in the program in the name of saving money.  We will see if similar programs proliferate among other health insurance carriers, subsequent to this pilot program.

Wellpoint became the latest health insurance company to dabble with a medical tourism program.  Under this new Wellpoint pilot, members can travel to India to have some surgeries done.

Wellpoint would not only save thousands on medical costs, but they would also gain leverage in negotiatons with doctors.

Blue Cross Blue Shield of South Carolina, and Aetna have already launched medical tourism programs and both CIGNA and United Healthcare are currently researching the proposition.

Medical tourism is a practice that has become more common over the past year, and some health insurance companies are now starting to get on-board with the practice and actually paying bonuses to members who agree to get procedures done in this way.

In short, Medical tourism is the practice of traveling overseas to have medical procedures or surgeries done in order to save money.  Over 50 countries have now identified medical tourism as a national industry.

Some health plans are beginning to cover procedures such as heart surgeries, hip/knee replacement and other pricey procedures due to the money that they can save.  For example, open heart surgery in the U.S might cost $100,000, but at an accredited hospital in India, the same procedure might cost only $8,500.

As you can see, the economic advantages of medical tourism are clear, but is it safe?

A recent UCLA study compared 33 patients who had kidney transplant surgery overseas vs. 66 who had the same procedure done here in the United States, at the UCLA hospital.  The study found that 30% of patients who had the procedure done overseas had kidney rejection vs. 12% for those treated at UCLA.  In addition, the rate at which patients needed to be hospitalized due to infection was 3 times higher with the overseas patients.

You can see why medical tourism would be a controversial process for health insurance companies to get involved with.  Nevertheless, Blue Cross Blue Shield of South Carolina (BCBSSC) has created a subsidiary for medical tourism that maintains an international network of doctors and hospitals covering Thailand, Costa Rica, Ireland, Turkey and other destinations.  In addition, Anthem Blue Cross & Blue Shield, will roll out a medical-travel benefit with one of the employer groups they cover in January of 2009.