Growing Number of Employers, Insurers Pay for Workers To Seek Medical Treatment

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A “small but growing” number of employer-sponsored health plans have begun to allow members to seek medical care abroad, a practice called medical tourism, as part of an effort to reduce costs, the Wall Street Journal reports. Until recently, medical tourism for the most part involved U.S. residents who sought medical procedures not covered by their health insurance, such as cosmetic surgeries or dental procedures, or those who lacked coverage. However, some employer-sponsored health plans have begun to cover heart surgeries, hip and knee replacements and other major medical procedures performed at hospitals abroad.

According to the Journal, most plans as currently structured offer “little incentive for workers to endure long flights overseas for treatment,” as they “usually cover 100% of the cost of medical treatment once workers reach an out-of-pocket limit for coinsurance and copayments.” As a result, plans that allow members to seek medical care abroad often “throw in a bonus for employees if they agree to undergo elective surgeries abroad,” agree to “split the cost savings between the employer and worker” or provide reimbursements for travel and accommodation costs, the Journal reports.

Implications
Medical tourism “isn’t expected to be a solution to the country’s soaring health care costs,” but the practice could “produce savings for insurers, employers and workers,” as medical procedures performed abroad often cost thousands of dollars less than they cost in the U.S., according to the Journal. Supporters of medical tourism maintain that many hospitals abroad have U.S.- and European-trained physicians on staff and have accreditation from the Joint Commission International, an affiliate of the Joint Commission, which accredits most U.S. hospitals.

However, critics of medical tourism “remain concerned about such issues as the safety of blood supplies for transfusions and tissue for bone grafts,” and travel abroad also “poses special risks to patients, including blood clots from airplane flights and lack of legal recourse for negligence and malpractice,” according to the Journal. In addition, according to critics, “follow-up care can be difficult to find once a patient returns home,” as many U.S. physicians and dentists “are reluctant to treat such patients for fear of being exposed to malpractice lawsuits because of possible poor treatment abroad,” the Journal reports (McQueen, Wall Street Journal, 9/30).

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