Although there are some companies that offer medical tourism alternatives, many feel that the offers are not taken for a variety of reasons. Dr. Horowitz believes that one important barrier is the fact that many potential medical tourism candidates find it a daunting task to identify a qualified physician and facility in the global marketplace.

René[<00E9>][<00E9>][<00E9>][<00E9>]e-Marie Stephano, Esquire, COO of the Medical Tourism Association and editor of Medical Tourism Magazine believes that employees need to be better educated about medical tourism. "Once the employee understands that there is high quality care abroad and is willing to go, the type of surgery necessary has to qualify for medical tourism to come about," says Stephano. Some employees are wanting and willing to go but their condition will not allow them to travel. For example, a patient may need a certain heart procedure and is qualified for medical tourism benefits - but his or her doctor restricts travel because of the condition. Stephano feels that medical tourism is still a relatively new offering by most employers and insurance companies, and "it may take a while to start seeing the results and return on investment."

Intrabound Medical Tourism - Centers of Excellence

As an additional benefit, international healthcare options are opening doors that benefit healthcare domestically. Although not as prevalent, intrabound medical tourism patients travel to non-local facilities or "Centers of Excellence" (tiered performance networks, which help associates choose the best care providers and settings to receive treatment while saving on health care costs) within their country. Reasons can include the need for a special, complex procedure that is only done at certain facilities, decreased waiting times, higher quality of care, lower costs and inclusion of the facility under coverage provisions of an insurance program.

Hayes explains that after offering employees the option of traveling to Singapore for hip and/or knee and spine surgery and receiving nationwide media exposure, he received calls from several American hospitals offering to match the savings in Singapore. "This has allowed us to negotiate deals for hip and knee replacements with hospitals in the U.S.," he says.

In fact, large employers with bargaining power are working to or have struck deals with foreign hospitals, and use this as leverage to bargain down the prices at domestic hospitals. Employers are creating networks that give employees the opportunity to access hospitals all over the U.S. that provide a much wider range of cost and quality of care options.

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