Handbook of Medical Tourism Program Development: Developing Globally Integrated Health Systems, 1st Edition (Paperback) book cover

Handbook of Medical Tourism Program Development

Developing Globally Integrated Health Systems, 1st Edition

By Maria K. Todd

Productivity Press

255 pages | 20 B/W Illus.

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pub: 2011-12-08
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Description

This handbook prepares readers to build the medical tourism service line, integrate physicians and other service providers, develop a safe and effective quality and patient-centered infrastructure, document processes and workflows, evaluate reimbursement contracts, and measure outcomes.

Reviews

The Medical Tourism Industry has a great but, as of yet, unrealized potential to transform the way global healthcare is delivered. After much press and many start ups, no one has yet developed the ideal system to connect patients and providers on a global basis. Perhaps, had her book been available earlier on, the Medical Travel Industry would look completely different today. Dr. Todd writes with much wit and grace and explains the elements required to succeed in this difficult but essential business. Following her suggestions and implementing her ideas are as important to Medical Tourism as following a detailed recipe is to cake making. In either situation, the end result can be very tasty or a disaster. My experience tells me there are many bad cooks in the Medical Tourism arena. Dr. Todd is the Chef’s Chef of this industry. To be a successful Medical Tourism cook, I recommend a short course in her kitchen!

—Armando Baez, FLMI, General Manager – China, Global Benefits Group / "Insurance Without Borders"; Board Member - Self Insurance Institute of America

Maria crafted this hands-on guide from the lessons that she learned and her wide-ranging proficient experiences in both clinical and non-clinical aspects, from the view of a patient, a consumer, a health administrator, and a marketing person. This Handbook, therefore, demonstrates a concrete practical roadmap in developing true 'medical tourism health delivery systems' in the real-world that puts an emphasis on patient safety, quality, service, and accountability.

—Chatree Duangnet, M.D., F.A.A.P., Chief Executive Officer, Bangkok Hospital Medical Center, Bangkok Dusit Medical Services, Plc., Thailand

The Handbook provides the reader with detailed information and practical tools on program development, all conveyed with the author’s unique wit. Ms. Todd shows that, if understood and implemented correctly, all stakeholders in international medical travel can have their cake and eat it too.

—Margaret A. Bengzon, Group Head-Strategic Services, The Medical City (TMC), Pasig City, Philippines

Table of Contents

What is Medical Tourism?

Programs within the global healthcare domain

Medical Travel options

Medical Tourism for elective and cosmetic cases

Globalized health sourcing for medically necessary services

Case Appropriateness

Coordinating the Continuum of Care

Who are the stakeholders?

Patients

Foreign and Domestic Hospitals and Physicians

Healthcare Accreditation Bodies

Many options available from which to choose

Insurance Plans and Employers

Self-employed individuals

Government Ministries of Public Health, Economy, Tourism, and Foreign Export

Numerous health policy implications

Sustainability implications in the local setting

Infrastructure concerns

Underwriters, Actuaries, Brokers and Insurance Agencies

Legal counsel

Immigration officials

Medical Tourism Facilitators and Travel /Transportation Providers

The Internationally Integrated Health Delivery System

Elements of the System

Quality and Accreditation

Provider Credentialing and Privileging

Which standard is required?

Marketing the Network

Print

Web-based

Service Line Development

Revenue Cycle Implications with Third-Party Reimbursement

Preauthorization and Precertification

Billing, Coding, Claims submission, Follow up

Denials and Appeals Management

Investigational and Experimental Procedures

New Technology to Some; Standard of Care for Others – But Who Pays?

Revenue Management Staff Training and Development

Development of the Medical Tourism Network

Medical and Hospital Provider Network Development

Representative Agreements, Contract Laws, Tax and Currency Issues

Reimbursement Agreements with Employers, Insurers and Governments

Quality, Safety and Medico-Legal Liability Issues

Tort Liability and Negligence

Working with Facilitators

Fee-for-service

Commission-based arrangements

Developing a Facilitation Agency In-house

The four domains of Medical Tourism Facilitation

Travel Agency Operations

Web-based and Traditional Marketing

International Business

Medical Case Management

Confidentiality and Patient Medical Privacy and Security

Basics you must know and comply with

Case Management

Prior to Departure

On Arrival

At Discharge

Return to the Gateway City and Coordinated Aftercare

Working with Health Plans and Insurance Schemes

Major Players

United States

Australia

National Health Service (UK)

Canada

European Union

Others

Working Directly with Multinational Employers

What is at stake?

Employers’ Major Concerns

Whom to Approach and how

Client Satisfaction Issues After the Trip

Satisfied Customers tell One; Dissatisfied Customers tell Ten

Follow up and defining the value outcome

Techniques to encourage repeat business

Appendix: Bibliography

Additional Resources

About the Author

Maria K. Todd, MHA, PhD, is the CEO of Mercury Healthcare. Dr Todd's background includes postgraduate degrees in Health Administration, and more than 30 years of healthcare industry experience. Her professional experience includes work as a HMO provider relations coordinator, an Independent Practice Association (IPA), Physician Hospital Organization (PHO), and Management Services Organization (MSO) developer and executive director, contract analyst and negotiator, medical group administrator, surgical assistant and EMT, hospital business office manager, health law paralegal and certified mediator. She is the author of the industry's bestselling book, IPA, PHO MSO Development Strategies: Building Successful Provider Alliances (1997, McGraw Hill and the HFMA, Chicago).

Dr. Todd has led the project management of more than 150 integrated health delivery systems, many still in successful operation today, and is a highly-regarded international healthcare industry consultant and contract negotiator who authored hundreds of journal articles, several white papers and nine professional trade books. Since 1989, she has presented more than 2700 US and International educational presentations and keynote addresses on topics ranging from managed care contract analysis, integrated delivery system development, medical tourism, contracted reimbursement, and global healthcare program development.

In her role with Mercury Healthcare, she leads the world's first and only globally integrated health delivery system® making its vast integrated provider network available by contract to a variety of payers of health benefits, including insurers, third party administrators or employers. Mercury also grants access to individual consumers seeking local care and domestic and international health travel for elective healthcare and related services, and manages logistical coordination and medical case management services for clients.

Subject Categories

BISAC Subject Codes/Headings:
BUS027000
BUSINESS & ECONOMICS / Finance
BUS042000
BUSINESS & ECONOMICS / Management Science
BUS053000
BUSINESS & ECONOMICS / Quality Control
MED035000
MEDICAL / Health Care Delivery