2017-04-27

Healthcare as a Service with Medical Toursim Option Health Insurance Companies Reduce Medical Expenditures, Patients Save and Get Free Vacations

It has been much too long since I have posted one of my idea/inventions. I have had ideas, just not taken the time to document and post them. Like all good writers, the punchline/elevator pitch needs to happen right away which was done in the title and repeated here ... medical tourism option for insurance companies to reduce cost and save customers money while providing amazing vacations. I'll get back to the details after providing you some context.

Background

Last night I was at the 10th anniversary of TechStars Boulder and it gave me the push to write this idea I had several months ago. The past few years I have been busy in the Healthcare field in numerous and diverse ways. I was the solution architect, software engineer, and built/managed a team to create a medical patient referral management and tracking system at the TuttiCare.com startup. I was briefly on the board of Colorado HealthOP, a non-profit health insurance company that was created as part of the ACA with Julia Hutchinson as the CEO. Julia is the COO of Apostrophe, a new health plan concept that presented last night. I worked on the math to help explain to the general public why Colorado's Amendment 69 aka Colorado Care was in the best interest of the state community and cheaper for 80% of the population. This work continues as Colorado Foundation for Universal Health Care.

Health Insurance Adviser

One of my inventions I had to put into action myself and started working on the Health Insurance Adviser which is currently part of EcoLocate.Org. The Health Insurance Adviser helps people select the health insurance policy that is the best fit for their specific health and financial circumstance. This software will help resolve the confusion that most purchasers of health insurance experience and facilitate making educated and financially advantageous decisions. Most health insurance brokers are unable to understand the complexity and properly advise their clients resulting in thousands of dollars of waste per customer. Also, many insurance companies pay a percentage commission to the broker resulting in a conflict of interest to sell more expensive policies.

Game Changer and Apostrophe

The Health Insurance Adviser, helps within the current system but does not take the next step to help create a new system like the universal health care solution proposed by Colorado Care. I'm impressed with Apostrophe for taking the step to create a proof of concept of universal healthcare in the only way it is currently feasible ... self insured companies/municipalities/schools/etc. These organizations have a large enough long-term populations that they can address short-term preventative healthcare for the financial long-term benefit of their population. These organizations are also protected to some extent from leeches, those who sign up for a health insurance policy because they have major medical issues that have been building for years, in referring to people who don't believe they should pay for healthcare until they are sick and then want someone else to pick up the bill . If these organizations have social values focused on the betterment of their employees and society as a whole then they get that additional bonus. Apostrophe, in my opinion, takes the first step of changing the rules by removing the overhead of billing for the provider by having their customer, the employer, paying all the bills at the time of service. The result is a ~20% reduction in negotiated price of the service, according to the presentation last night, as a result of reduced billing overhead, write-offs for non-payment, and stress for small providers who now have a single payer for their invoices and don't need large financial reserves.  The patient also has a single payer, reimbursing their employer for their portion of the medical services received, reducing their stress and complexity of paperwork. Good for the patient, provider, and employer. My personal preference is still to get the employer out of the insurance business all together but for now this is a brilliant subversive step in the right direction.

Medical Tourism Creates Global Competition

Healthcare-as-a-Service (HaaS), Long-Term Price Decreases in the US

Now for the invention and another way of reducing healthcare costs in the United States, where we spend much more than other countries with no better and frequently worse outcomes (ex: United States Comes in Last Again on Health, Compared to Other Countries, Life Expectancy Years Less). Until we find ways of reducing healthcare costs in the US, why not take advantage of high quality less costly healthcare provided all around the globe in the form of medical tourism. Insurance companies can save money/increasing profits while simultaneously offering their customers lowering  premiums, deductibles, co-pays, out-of-pocket expenses, and offering larger networks.

The following are just a few example scenarios focusing on non-emergency care:

  1. You live in a small rural community in the US that does not have the specialist you need or the cost of bringing that specialist to your community is very high. The insurance company offers the option to pay the travel expenses, arrange the travel, and accommodations to go to a US city you have always wanted to visit to have your procedure at a higher quality with no cost difference to the patient. The result is a happy patient and the insurance company saves money.
  2. Need orthopedics (joint, spine, hip replacement, knee, etc), reproductive (fertility, IVF, etc), dentistry (restorative, general, etc); prices can be significantly cheaper in (France, England, Italy, Germany, Canada, etc) and at times 1/4 the price in (Costa Rica, India, Malaysia, Mexico, Thailand, Turkey, etc).
  3. The patient can decide to visit one of these locations and receive great care while enjoying a vacation to a location they have always wanted to visit and might never visit otherwise. The insurance company might be legally allowed to lower the deductible for those selecting the travel option and reimburse the patient for additional time away from work. Patient could not be happier and the insurance company would save thousands if not tens of thousands of dollars.
As borders between states and countries fade for medical care, increased competition will resulting in improved cost parity. Competition is important for products but the service industry is frequently localized resulting in large disparity in cost.

Healthcare in the United States has a long way to go and requires major reworking of the entire infrastructure. We need to get profit out of the medical system and consider it a necessity that needs to be available to all. This includes addressing the legal issues and costs caused by malpractice law suits. Large bureaucratic over head and in many cases overly lavish medical facilities competing for patients the same way universities have gone overboard focusing on creating spas instead of providing education. Those entering the medical profession (doctors, nurses, dentists, etc) need to have free education so they can make a comfortable living instead of spending the first few decades of their careers working merely to get out of debt and to pay malpractice insurance - resulting in the increased medical expenses patients in the US must absorb. In the mean time, we can create ways of addressing the issues today with solutions that can help us transition to a functional system.

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