1st Edition

Handbook of Medical Tourism Program Development
Developing Globally Integrated Health Systems




ISBN 9781439813140
Published December 8, 2011 by Productivity Press
255 Pages 20 B/W Illustrations

USD $140.00

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Book 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.

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

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Author(s)

Biography

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.

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