Group to Study Inbound Medical Tourism

So the US Department of Commerce has given out a grant of $500,000 for a group of academic medical centers to do research to benefit inbound medical tourism.  The Dept. of Commerce is saying that inbound medical tourism hasn’t been adequately tracked in the past.  I think we all knew that.  But the problem, as I see it, is that inbound medical tourists don’t typically go to the teaching hospitals, so if this group intends to only research their own clientele, the numbers won’t be accurate.  Also, we are going to jump into the issue of (cue dramatic intro music) fee splitting with this. 

Fee Splitting?  How so?

Well, most hospitals that have been participating in providing care to inbound medical tourists drew in these patients in one of two way.  Either the patient sought out the hospital for a rare condition that the hospital had a specialist in (which will lead them to academic hospitals as well as private because most leaders in a condition will be teaching as well as practicing) OR, these patients come to the US through a medical tourism facilitator.  If you’ve been reading this blog for a while, you’ll know that medical tourism facilitators frequently take payment directly from the patient that covers the medical fees at a marked-up rate.  Not all facilitators work under this model, but a lot do.  I know of one  facilitator in Canada marking up as high as 300% for medical care.  Ouch!  And he gets away with it because people see the US billing prices rather than the real price, so they don’t know that the mark-up is so big. 

Now, back to my point – if a hospital accepts a patient from a facilitator who collected the money from the patient at a mark-up, and then gives the portion due to the hospital, we have fee splitting.  The patient is left unaware that they paid way too much, and sometimes the hospital also had no idea the patient paid too much.  But now, hospitals and doctors are learning to be careful and may not want to disclose their numbers from previous encounters with international patients out of fear.  I don’t blame them!   They simply don’t know if the facilitator put them into a fee-splitting situation or not.   Working with a facilitator has a lot of gray areas as far as fee-splitting goes.  So if this research group wants to start looking at the books, I don’t know how many hospitals they will find jumping at the chance to volunteer.

I’m very curious how this group intends to spend their grant money.


By Bruce Japsen

Rush University Medical Center, working with a national group of academic medical centers, was awarded a $500,000 grant designed to “help boost medical travel to the U.S.”

The three-year grant from the U.S. Department of Commerce will be used in part to better quantify the number of foreigners coming to the U.S. for medical care, which researchers and the government believes say has not been adequately tracked.

Medical care purchased by individuals from outside the U.S. that can be grown would fit President Barack Obama’s “National Export Initiative,” which hopes to double by 2015 the number of exports and spur U.S. job growth, Rush said.

Rush is working with the University HealthSystem Consortium, a group based in the western Chicago suburb of Oak Brook, that includes teaching hospitals from across the country.

In 2007, Rush researchers Andrew Garman and Tricia Johnson estimated that between 43,000 and 103,000 foreigners came to the U.S. for medical care. And though there are tens of thousands of U.S. residents who go outside this country for medical care, the researchers have estimated a trade surplus to the U.S. of nearly $1 billion.

With the grant, the researchers will “develop the methodology to value medical care exports and assess the impact of these strategies on exports over the next three years.”

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