James Ritchie, Business Courier of Cincinnati

The list of jobs that can be outsourced continues to grow.

Now it includes doctor.

When reports came out a few years ago of Americans traveling to other countries for cheaper medical care , they were regarded as an oddity.

Now the idea of looking overseas for care is being considered, or implemented, by companies across the country and by major insurance companies – including the largest carriers in Greater Cincinnati.

Anthem parent WellPoint Inc., based in Indianapolis, started a pilot this year giving certain patients the option of going to India for care.

The program started with Serigraph Inc., a Wisconsin-based provider of printed decorating solutions, and applies to certain common elective procedures, such as major joint replacement and upper and lower back fusion.

Those procedures have to be performed at designated facilities belonging to “an extended network of respected hospitals and health care providers in India ,” according to WellPoint.

All travel arrangements are covered under the plan, for both the member and a travel companion.

“Depending on the findings from our pilot in Wisconsin, such as quality outcomes, member satisfaction and cost-savings, we will then decide the future of the program,” said Deb Wiethop, spokeswoman for Anthem Blue Cross and Blue Shield.

McKinsey & Co., a New York-based national management consulting firm, estimated the medical tourism market at 60,000 to 85,000 inpatient travelers a year.

The numbers are smaller than others have reported, owing partly to McKinsey’s strict definition of what constitutes a medical tourist. Travelers had to be “people whose primary and explicit purpose in traveling is medical treatment in a foreign country” and not, for example, ordinary tourists who become sick.

And the market is more complex than the hype would suggest. About 40 percent of medical travelers are not seeking cheaper care but, rather, advanced technology. Most originate from Latin America, Europe, the Middle East and Canada and enter the United States for treatment.

Only 9 percent of travelers are seeking lower costs for medically necessary procedures.

The medical tourism market is valued at $20 billion annually and should grow rapidly in coming years, author Josef Woodman has claimed.

He wrote the book “Patients Beyond Borders: Everybody’s Guide to Affordable, World-Class Medical Tourism.”

Popular destinations for U.S. patients include India, Thailand, Mexico, Costa Rica and Singapore. Patients are commonly uninsured or underinsured, Woodman has said, and patients can expect rates 25 percent to 75 percent less than those in the U.S.

That can amount to tens of thousands of dollars for major procedures such as a hip replacement or a heart valve replacement.

Patients often get treatment in state-of-the-art, even luxurious facilities, and often by U.S.-trained doctors.

Some have added credibility through accreditation by the Joint Commission International.

Wiethop said WellPoint has no immediate plans to introduce a medical tourism option in Ohio or other markets. The insurer doesn’t yet have results to report on Serigraph, a 600-employee company.

But clearly the potential savings haven’t escaped other major insurers.

UnitedHealthcare, another major player in Greater Cincinnati, “feels that it has an obligation to look into this growing phenomenon,” said United spokeswoman Debora Spano.

But the carrier has no medical tourism product yet. Among factors to be considered before offering one, Spano said, are quality of care, pre- and post-medical management requirements, legal implications and patient privacy.

“We must take a very prudent, thoughtful approach,” she said.

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