WellPoint to launch medical tourism pilot program

INDIANAPOLIS – Health insurer WellPoint Inc. will dabble in medical tourism next year when it launches a pilot program that sends patients to India for some surgeries.

The insurer says the program can save thousands of dollars, and the concept could eventually give WellPoint extra clout at the bargaining table with U.S. doctor networks.

About 750,000 Americans headed abroad last year for major health care, and an estimated 1.5 million are expected to this year, according to a study released last summer by the Deloitte Center for Health Solutions. The largest U.S. health insurers are starting to take notice.

Aetna Inc. launched a medical tourism pilot program earlier this year. Cigna Corp. and UnitedHealth Group Inc. representatives say they're studying the idea.

Medical tourism generally involves traveling to another country for non-emergency care that can include hip replacements, shoulder surgery and even heart bypasses. The Deloitte Center predicts that the number of people trying it could jump tenfold over the next decade to nearly 16 million Americans a year. The center says savings is one of the drivers.

A knee or hip replacement that may have a retail price of between $65,000 and $80,000 in the U.S. costs between $8,000 and $10,0000 in India, said Razia Hashmi, chief medical officer for Anthem National Accounts.

She also said care quality in their program will equal U.S. hospitals. The program will comply with both American Medical Association medical tourism guidelines and Blue Cross/Blue Shield Association service standards.

WellPoint's pilot program will allow people to travel to hospitals in either Bangalore or New Delhi for procedures like joint replacement or upper and lower back fusion.

WellPoint subsidiary Anthem Blue Cross and Blue Shield in Wisconsin will set up the medical care and take care of scheduling and travel service. The insurer will cover the travel and lodging costs for both the patient and a companion.

The company also will set up follow-up care back home for the patient.

WellPoint decided to launch the pilot program because employers had been asking when it would test the concept, Hashmi said. The insurer is starting small.

It will offer the program only for people who receive insurance through Wisconsin-based Serigraph Inc., a self-insured printing company that employs about 700 people in the U.S. Serigraph does business in India, which was part of the reason WellPoint picked that country.

The insurer could expand medical tourism to markets outside Serigraph and Wisconsin as soon as next year, once it evaluates the pilot.

"We want to make sure we've got everything working smoothly," Hashmi said.

Medical tourism could help WellPoint, if it catches on and grows, by pinching market share for doctors in the insurer's U.S. markets.

"When there is a threat of losing market share ... it may bring folks to the table to have a dialogue about a more effective rate for us," Hashmi said. "And so, in that manner, it may change the game in terms of local contracting conversations."