Cost of medical procedures: not the only consideration

Cost is very important to payors, but when you are talking about patients and medical procedures, that is not the only consideration. Travelling a great distance, what the evidence shows in terms of outcomes, and the “overall” patient experience, all play into the decision. This gives a qualitatively unique analysis, which will help patients make the right decision for their healthcare. It will give them the opportunity to adopt a locus of responsibility for determining good value for money. Where they or their employers must freight the cost of travel, now the patients and payors will know what value is being offered on the other end, and at what price relative to newly proposed standards.

A coalition of aggregated data is clearly one step to solving the “which hospital is best” guessing game. Analysing that data in a meaningful way that combines hospital and patient-reported outcomes is the hard part. We deal with the case-mix problem every day in the pharmaceutical world. We solve this problem the same way when we compare hospitals based on objective measures of cost and quality.
The end-user is the patient and it is really patient satisfaction that needs to be compared accurately across procedures, hospitals, languages and international borders. If a hospital is willing to stack up against others with long-standing reputations for excellence, that hospital must collect reliable outcome measures and report them in a manner that can be trusted. Even if procedures are different, patient satisfaction can be measured and compared across settings. We do this already in the pharmaceutical world and it is an easy step for us to measure treatment satisfaction in this world.

Why are American companies willing to send their personnel abroad for healthcare? One reason would be if the quality of care is really better than we would otherwise see at home. Another would be if the care given is better value for money. A third but essential reason would be if our personnel report high satisfaction with medical tourism. Ultimately, resources are going to flow into procedures and regions where patients report the highest satisfaction. Those hospitals which are not on that short-list may struggle.

Healthcare, and more specifically, hospital costs in the US are rising at double-digit rates. Payors have hit a wall in terms of their ability to increase premiums. Insurers have become very motivated to look at ways of reducing costs, yet maintaining excellence. Additionally, self-insured employer groups are searching for ways to control costs. These pressures point to an increased opportunity for travel outside of the US for certain procedures. Ultimately, we live in a global world market, markets are efficient so long as patients can make a fair assessment based on robust information. The tipping point rests in making sure this information is accurate. That is in turn one step in the direction of ensuring that, when push comes to shove, every employer can adequately insure their personnel to a high standard and without breaking the budget. The secret rests in the accuracy of information.