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Risk Management for Medical Travel

David Boucher, for HealthLeaders Media, June 2, 2009

Editor's Note: This is the first of three contributed features submitted by members of the International Medical Travel Association's Board of Directors. The IMTA is a not-for-profit global organization of stakeholders in the international medical travel industry.

In 2008 our country witnessed the largest drop in home prices since the 1930s and The Great Depression—a decrease of about 8.2%—while a conservative estimate for medical inflation in America was 7% during 2008. This 15% swing and the seemingly unstoppable inflationary trend are causing many individuals and employers to pause long enough to at least consider the benefits of international medical travel.

Of course, they also contemplate the risks along with the benefits. An increasing number of employers are progressively getting more comfortable with surgery overseas—especially at JCI-accredited facilities. But employers thinking about amending their benefit plans to encourage employees to travel to JCI-accredited hospitals abroad are considering the possibility of unintended consequences—either as a result of the procedure or in making the international journey to receive medical care. Employers want to make sure they have a solid risk management plan to protect 1) their employees and 2) themselves.

Some employers and individuals may have concerns with the international legal process if they find it cumbersome to sue a provider in an overseas locale. Certainly, the naysayers of this trend are quick to point out its deficiencies, as a spokesperson for the American Hospital Association recently commented, ". . . medical tourism isn't without risks. Should something go wrong with your surgery you have no legal recourse as you do at home." We know, of course, that this is not entirely true, and that seeking damages for malpractice may vary from country to country. Additionally, employers want to be sure they and their directors and officers are protected if the employee decides to file a lawsuit.

After substantial research, many have learned that there does not seem to be a legal precedent to guide injured parties regarding who is responsible for unintended outcomes as a result of the employee’s decision to select an international care benefit option through an employer plan. Even though many facilitators include only JCI-accredited hospitals in their networks, the risk for unintended outcomes—as it does here in the United States—still exists. Overseas hospitals have worked hard to accommodate Western expectations and limits. However, overseas court systems may not be as rewarding as American juries, and access to them may not be as easy.

From a risk management perspective, the entire continuum of services for international medical travel needs to be examined and attention paid to each opportunity to minimize exposure: 1) Provider selection and credentialing, 2) Care management processes, 3) Travel services, 4) Aftercare, 5) HIPAA privacy and security. Layer on top of this the need to monitor political events, currency, weather, and events like swine flu pandemics, and employers may quickly conclude that it makes sense to engage a trusted medical travel facilitator. With care and focus, each of these risk exposures can be addressed.

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