The CDC recently issued two reports on the progress US hospitals have made in reducing the number of Hospital-Associated Infections (HAIs). HAIs remain an expensive form of wasted healthcare spending – with associated costs reaching $9.8 billion USD a year. To make matters worse, the US does not currently have a system in place to effectively measure and track the progress of the initiatives implemented to reduce or prevent hospital associated infections.
America’s healthcare landscape has begun to look very different compared to that of 10 years ago. The shift towards a single-payer system has begun. Healthcare coverage has been expanded, mandated and subsidized. Hospital networks and mergers have consumed smaller private practices or clinics. Big Data is slowly taking the steps towards implementation. Yet, consumers are still unaware of the true costs to accessing and obtaining healthcare here in the US.
The option to self-fund employee health insurance is becoming very favorable for many of the US’ large employers. Seen as a way to avoid many of the healthcare reforms taxing provisions, self-funding can yield huge savings on employer-sponsored health plans. In fact, almost 60% of todays large employers choose to self-fund over traditional employer-sponsored options.
Choosing to self-fund also opens a variety of channels where even further savings can be achieved. One of these is the concept of implementing a corporate wellness program. A corporate wellness program does exactly as it sounds – it promotes wellness amongst a company’s employees to ensure maximum performance is achieved. Wellness programs often target specific goals towards creating a healthy corporate culture such as improving productivity, cutting absenteeism, and overall reducing medical costs.
For most complex medical procedures, some form of diagnostic imaging is often conducted prior to administering treatment. Currently, diagnostic imaging is amongst the fasting rising area of medical expense, increasing almost twice the rate of prescription drugs at 20% growth. Almost $100 billion is spent on imaging in the US annually. Factor in its growth rate, and that figure could almost double in five years.
It was announced in January by the World Health Organization, in conjunction with theWorld Palliative Care Association, that a resolution to expand Palliative Care access throughout the world will be confirmed at theWorld Health Assembly in May.
The proposal would do more than just expand access to such treatments; it could also be critical in lowering spending & costs across global healthcare systems. By determining patient preferences in their treatments and coordinating care effectively, many healthcare systems could reduce the number of unnecessary readmissions, treatments, and diagnoses.
How? Because Palliative Care offers more than just pain relief. It is patient-centered and can often address physical, psychosocial and emotional suffering for many patients and their families fighting serious illnesses. The problem is, palliative care is only readily-available in wealthier countries and is normally administered to the elderly.
Barriers Restricting Access to Palliative Care
Currently, there are an estimated 40 million people worldwide requiring palliative care treatments. 50% of those individuals are elderly patients seeking end-of-life care, while 6% are children. The more alarming fact, however, is that 6.5 million of these patients will die without ever receiving the palliative care treatments they require.
The resolution proposed by the WPCA is seen as a way to drastically reduce these numbers, specifically by expanding access to lower- and middle-class individuals worldwide. A WPCA Spokesman stated, “Our efforts to expand palliative care need to focus on bringing relief of suffering and the benefits of palliative care to those with the least resources.”
Today, only 20 countries offer sufficient palliative care access through their healthcare systems – Australia, Austria, Belgium, Canada, France, Germany, Hong Kong, Iceland, Ireland, Italy, Japan, Norway, Poland, Romania, Singapore, Sweden, Switzerland, Uganda, United Kingdom, United States of America.
Furthermore, a 2011 study by the WPCA found that 74% of countries have no palliative care services or their services reach only a small percentage of the population, while only 3 Million people actually received the care they required.
This is a result of multiple barriers restricting the delivery of palliative care services and treatments. Some of these include:
- Lack of clearly defined regulations and policies promoting access to palliative care for various age groups and patient types.
- Lack of palliative care education amongst healthcare professionals and the public.
- Lack of access to resources for palliative care providers and national healthcare systems.
- The misconception of associating palliative care with elderly patients and hospice care.
Implementing a Resolution
The WPCA hopes to break these barriers by urging those countries with poor palliative care services to expand access to pain medicines and treatments for life-threatening illnesses. The pain associated with such illnesses can be treated with relatively inexpensive medicines.
Additionally, an increase in technical assistance and training of healthcare workers, under the supervision of the WHO & WPCA could dramatically decrease the amount of unnecessary treatments issued to patients that are not only seeking pain relief.
The proposed resolution is built around effective integration of palliative care amongst national health systems, and could also encourage more patient-centered care while avoiding aggressive or costly treatments.
It has been drafted under the leadership of Panama and co-sponsored by Albania, Australia, Brazil, Chile, Colombia, Ecuador, Ghana, Japan, Lebanon, Libya, Kazakhstan, Malaysia, the Maldives, Mexico, Nigeria, Panama, South Africa, Spain, Switzerland, Turkey, Ukraine, Uruguay, and the US.
As for now, we must wait until May to see where the next step lies ahead for Palliative Care services across the globe.
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Medical tourism is a hot topic these days. Providers and payers worldwide both see multiple benefits in offering or arranging medical treatments across borders - however it’s the patient’s demand for better quality at lower costs that continue to drive medical tourism’s growing popularity. As a result, many domestic medical providers have begun to lose patients and ultimately revenue and market share.
Corporate-Sponsored Medical Tourism VS International Medical Tourism
Recently, a team of UK-based researchers looked further into the feasibility behind “International Medical Tourism” and just how cost-effective it really is. There research revealed three underlying myths associated with the idea of medical tourism:
- The number of patients who seek treatment through medical tourism is rapidly rising;
- National governments play a large role in stimulating medical tourism through high-tech investments; and
- Opportunities for growth into the medical tourism sector are restricted to international services only.
Furthermore, most of the data surrounding medical tourism has been captured and encouraged by already-interested parties.
On the flip-side, for healthcare parties that may lose revenue and market share to international medical tourism, an alternate offering exists – Corporate-Sponsored Medical Tourism.
What is Corporate-Sponsored Medical Tourism?
Corporate-Sponsored Medical Tourism works very similar to a hospital-system that is utilized only by a contracted employer and its employees. A group of participating providers will partner together in conjunction with the employer to form an Employer Center of Excellence Network and agree to a fixed fee or bundled payment for the entire episode of care.
For the patient, or employee, they no longer have to worry about out-of-pocket costs, transportation to and from facilities, and an accompanying caregiver. Patients and employees living in rural areas can gain access to quality medical facilities that may traditionally be viewed as out-of-network or out-of-area.
For the employer, immediate savings may come in the form of cheaper treatments, but they’ll see greater savings in the long-run through the reduction of hospital-incurred infections or complications; unnecessary revisions and diagnosis; and employees getting back to work quicker than anticipated.
While the benefits for employers and their employees can be easily measured, corporate-sponsored medical tourism is touted to have an even bigger effect on achieving the overall goal of healthcare reform – transparency & price.
The idea behind this corporate-sponsored form of medical tourism and essentially payment reform is to better mold the current healthcare landscape to the needs of small, medium and large employers. Corporate-sponsored medical tourism could generate new forms of competition allowing regional providers to compete with the larger health systems that have begun to emerge.
The system seeks to further its impact by aligning itself with medical centers that offer specialty treatments. Through such a system, employers or groups of multiple employers can manage the relationships amongst their own hand-picked, contracted network of providers, monitor cost and behavior drivers, and ultimately create a transparent healthcare system.
Corporate-sponsored medical tourism is becoming a very popular alternative to traditional PPOs and is saving large national companies, such as Lowes and Walmart, money that would originally have been spent on out-of-network costs or even sending its employees across borders to seek care.
To learn more about how corporate-sponsored medical tourism can help your business, or if you’d like to hear about PayerFusion’s alternatives to traditional PPOs, subscribe to our monthly Health Insights newsletter here.