Fast forward a few years after IMT has become headline news… and a new trend has gained traction which alleviates much of the worry regarding standards of care, language and cultural barriers, post-operative follow-up responsibility and legal recourse should anything go seriously wrong. Domestic Medical Tourism (DMT) allows patients to remain within the United States and find the same cost savings that they, otherwise, would have had to travel across entire oceans to realize. Now patients can travel to see a physician within the continental U.S. and save thousands of dollars even with the addition of travel, lodging and sometimes even the cost of a travel companion. Many employers are now beginning to see the value in DMT. For certain conditions, they are giving their employees the option to seek their healthcare outside of their existing traditional health insurance plan and travel for their surgical care in order to save on healthcare costs and in return receive highly specialized and efficient care. Some very large companies in the U.S. including Walmart, Boeing and Lowe’s are giving employees the option of traveling to get medical care from facilities considered to be the best in the nation, deemed as “Centers of Excellence.” Unfortunately, the problem of loss of follow-up care still exists with DMT. Nonetheless, the growth of DMT has been fueled by several factors:
- The role of the insurer or self-insured employer in directing care
- The development of “Centers of Excellence”, which provide lower costs and better outcomes for patients
- The desire to reduce health care costs
- The shift to a “value-based” reimbursement system
As the cost of medical care has risen, new ideas and forces are brought to bear in the delivery of health care. DMT facilities and self-insured employers or third-party payers have worked together to agree upon a standard bundled payment for certain procedures (such as hip and knee replacements or simple spine surgeries) that is much less expensive than the patients’ local care options. Even accounting for the involved travel, lodging, forgiveness of copay, and patient stipend, this bundled payment arrangement with DMT still represents a significant cost savings opportunity for self-funded individuals, self-insured employers and third party insurance plans. Again the only problem is…loss of follow-up care.