Medical Tourism: A MBA Healthcare Tutorial

Medical Tourism:

A MBA Healthcare Tutorial

Medical tourism I thought involved black market dark alley surgeries and stolen organs. But apparently my Hollywood based assumptions were for the most part fictional. In fact Medical tourism in the medical world is becoming more and more appealing to highly respected physicians in the United States and motivated patients. I asked myself WHY?

1.      Why are patients choosing to leave the United States where we have the best and most well trained doctors to go to other countries to have procedures completed?

2.      Who are the doctors completing these procedures and what are their credentials?

3.      What procedures are available in other countries?

4.      What are the risks involved in leaving the United States to have a procedure done in another country?

1. a. One of the reasons people have begun to travel for medical procedures is due to the high cost of medical care and inaccessibility to comprehensive care. Patients are not as they were in the past, traveling for non-elective surgeries such as plastic surgery, but patients are now traveling for non-elective procedures such as hip surgery, heart surgery and even brain surgery.

    b. Also in conjunction with the lower costs, the patients are often getting the same care with the great physicians but in a different country.

(The costs are lower due to lower wages and less structured or demanding health coverage and governmental restrictions, these add to absorbent costs. There are also lower costs due to lower malpractice insurance costs for physicians who work in developing countries.)

2. The doctors that are completing procedures may have been trained in the United States or any other country that offers medical training. When traveling abroad to receive medical treatment it is explicitly important to DO YOUR RESEARCH! There are plenty of qualified doctors who work outside of the United States but as a patient going into a new situation it is important to familiarize one’s self the countries standards of care as well as the doctor’s certifications and training. Familiarizing yourself with the types of surgeries and the number of surgeries they have done is also a good indicator of the qualifications of the physician.

3. There are a lot of procedures offered in other countries the more common surgeries are those that are not covered by medical insurance in the United States. Such as stem cell procedures, weight loss, spinal surgery, cancer surgery/treatments or any alternative type treatments that the United States has not yet accepted as appropriate treatments meaning they are still often considered ‘experimental’.

4.  There are risks when getting medical treatment anywhere. However medical tourism to some can add a bit of extra anxiety since a person is going to a new place and seeing a physician that they have usually never met before. While medical tourism can be a wonderful option for many to receive cutting edge treatments and/or lower cost medical care it is of the utmost importance to do research and feel comfortable with the country, hospital, and physician before receiving any procedure.

 As we become more developed medically across the globe we have opportunities to discover what options and discoveries are being made. As a MBA healthcare student at Baylor University understanding how healthcare is spreading around the world is fascinating and leaves a lot to be learned and investigated. 

Everyone gets Healthcare but How do We get it?

Healthcare Reform: What Do I Do to Get Insurance?

A Healthcare MBA Tutorial

Simply, keep it simple. This is the idea behind helping Americans sign up for insurance. The Affordable Care Act has not been praised for being straight forward however it was made clear that the process of signing up for healthcare should be as easy as possible for everyone to use. This tutorial will explain all the steps that go on behind the computer screen. (Since I am obtaining my MBA in Healthcare at Baylor University in Texas I will use Texas’ Insurance Exchange in this tutorial.)

A.      The user will input some different information, including social security number, date of birth and other demographics.

B.      The demographic information then moves to the Texas Exchange almost directly sent away

C.      The demographic information is then sent to the Department of Health and Human Services, a Federal Organization the demographic information is then sent to be confirmed

D.     The demographic information is then sent to the IRS (Internal Revenue Service)

E.      The IRS then sends a request to provide income history to the Department of Health and Human Services (DHHS)

F.       That request of income history filtered through the DHHS is then sent to the Texas Exchange

G.     The Texas Exchange takes the inquiry of income history and sends a request to other states and third parties. For example to check unemployment, child support, credit bureaus etc.

H.     After the Texas income history, other state and third party organization data has been collected it is sent back to the Texas Exchange where it is aggregated and reconciled.

I.        The compiled data is then sent back to the consumer, the American signing up for the insurance. They need to confirm the information.

J.        The consumer then must offer any information available about employer health insurance programs available to them.

K.      This information about employers from the consume is sent to the Texas Exchange

L.       The Texas Exchange then takes the employer information and sends it to the consumer’s employer for confirmation.

M.   The employer than confirms the employee and verifies if the employer is using insurance options. The employer also verifies any tax credit and/or Medicaid eligibility. This information is then sent to the Texas Exchange.

N.     The Texas exchange takes the employer information and sends insurance plan options and premiums with the consumer.

O.     The consumer then can choose from the available plans afforded to them their selection is then finally sent to the Texas Exchange, where it is recorded.

The purpose of this tutorial is to help Consumers, Health professionals and MBA Healthcare students understand the process of applying for and receiving insurance through the Affordable Health Care Act. With all the changes in healthcare it has given me a lot of interesting and applicable information to study and share while gaining an MBA in Healthcare from Baylor University.