In the market for a coronary bypass ? You might want to consider booking a flight to India. As health care costs continue to soar, some insurance companies are paying for their members to travel abroad for cheaper medical treatments.

Anthem Blue Cross & Blue Shield of Wisconsin is the latest group to explore the phenomenon, known as "medical tourism ."

Beginning in January, the insurance company will allow employees at Serigraph Inc., a West Bend graphics company, to travel to India for certain elective surgeries such as spinal fusion , angioplasty , hip and knee replacement and bariatric surgery .

"Why pay $40,000 for a hip in Milwaukee when you can buy one for about $5,000 in India?" said John Torinus, Serigraph chairman. "Add another $5,000 for hotel and travel and you are still saving $30,000."

Anthem Blue Cross will cover the procedure, airfare, hotel stay and a plane ticket for a companion, for Serigraph patients who qualify, said Razia Hashmi, chief medical officer for Anthem’s national accounts based in Worthington, Ohio.

"The uptake of this phenomenon will depend on a number of variables, including what happens with our health care system and economy," Hashmi said. "Going abroad is something that has to be taken seriously and it is limited to a narrow number of people and procedures."

After surveying the company’s 648 employees, Torinus found 17 people would be eligible for overseas elective surgeries.

Guidelines on quality

American Medical Association guidelines specify all medical care outside the United States must be voluntary and all medical institutions must be accredited by a recognized international accrediting body such as the Joint Commission International or the International Society for Quality in Health Care. In addition, local follow-up care should be coordinated and financing should be arranged to ensure continuity of care when patients return to the United States.

Torinus said India was chosen because his company already does a lot of business there and is familiar with that country’s health care system. Other countries typically chosen for medical tourism are Thailand, Singapore, Costa Rica, Turkey and Ireland, according to the Medical Tourism Association, a West Palm Beach, Fla.-based nonprofit that tracks the medical tourism trend.

Serigraph has had its own Wisconsin-based medical tourism program for the past three years called MedSave. Torinus gives employees a list of procedures, such as a hip replacement, and four options of health care providers who are practiced in that procedure and offer a good price.

If the employee chooses to go to one of the providers located outside of West Bend, Torinus pays them $2,000 for their trouble.

He said employees will be given a similar incentive if they chose to travel overseas.

"It isn't just about the cash," Torinus said. "Premiums are based on previous years, so if we keep costs down, everyone benefits."

Torinus is also looking regionally for the best health care deals and already has found the Indianapolis market is 30 percent to 40 percent below the Milwaukee market.

"I think employers have been derelict in letting people go anywhere regardless of quality and regardless of price," he said. "Our co-workers are going to make the decision where they want to go. If proximity is important to them, fine. We’re just steering them with incentives."

Medical tourism is expected to continue in the coming years. A recent study by Deloitte, a New York-based consulting firm, showed an estimated 750,000 Americans traveled abroad for medical care in 2007. That number is expected to grow to 6 million by 2010.

Cost is undoubtedly the driving factor behind the trend.

According to the Medical Tourism Association, a coronary bypass costs $130,000 in the United States, between $6,650 to $9,300 in India, $11,000 in Thailand, $16,500 in Singapore and $24,000 in Costa Rica.

The significant savings that can be realized from traveling abroad has already caught the attention of some insurance companies, although most still don’t include medical tourism in their plans.

Blue Cross & Blue Shield of South Carolina, which is not part of the Indianapolis-based Anthem group, created a subsidiary for medical tourism called Companion Global Healthcare Inc., which includes hospitals in Thailand, Costa Rica, Ireland and Turkey.

Minneapolis-based UnitedHealthcare will complete a feasibility study at the end of the year and determine if the company will offer medical tourism coverage.

"We have not seen a preponderance of customers asking for this," said Daryl Richard, vice president of communications for UnitedHealthcare. "Our customers are saying, 'Is this real?'"

Jon Rauser, president of The Rauser Agency, a Milwaukee-based insurance brokerage firm, said traveling overseas could improve cost and quality in American hospitals if health care providers find themselves fighting to keep local business.

"Traveling overseas for a procedure isn’t any more inconvenient than going to the Mayo Clinic (in Rochester, Minn.) to see a doctor," Rauser said.

However, Rauser thinks Wisconsin is still at least two years away from insurance companies offering overseas coverage and employees are even further from accepting it.

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Source: The Business Journal of Milwaukee