Exporting patients: Money versus possible safety issues

Lured by cheaper care overseas, payers increasingly are offering patients the option to go outside the United States for certain procedures.

By Jonathan G. Bethely, AMNews staff. Sept. 18, 2006.

Blue Ridge Paper Products Inc. of Canton, N.C., claims to be the first paper mill to make bleached pulp out of southern pine trees, the first to print paper out of that pulp, and the first to use the bleached filtrate recycling process for minimizing pollution. Now, in its 101st year of operation, Blue Ridge is establishing another, radical first that raises questions about the future of patient care -- it sent an employee overseas for an insurer-covered surgery.

This month, a Blue Ridge worker headed to New Delhi to have his gallstones removed and his rotator cuff repaired. Blue Ridge has added overseas hospitals and physicians to its PPO.

For Blue Ridge, it costs less to send an employee 7,800 miles to New Delhi than nine miles to the nearest hospital -- with the quality being equal in the company's eyes. The company estimates the employee's surgeries would cost $100,000 in North Carolina but $20,000 in India.

"We want better than what we can get here," said Darrell Douglas, vice president for human resources. Blue Ridge is even kicking in for travel expenses and paying employees a bonus of up to $10,000 for going to India.

It used to be that "medical tourists" were looking for less-expensive alternatives for cash-only procedures, such as plastic surgery, or seeking medicine or procedures not approved here.

But the combination of rising medical costs and a greater emphasis on consumer-directed care has self-insured companies and insurers expanding the map of where employees and members can get treatment. Overseas hospitals have taken notice, pitching their services to American companies and lining up in increasing numbers to be accredited by the Joint Commission on Accreditation of Health Care Organizations. Some 100 hospitals all over the world are accredited, including the one Blue Ridge is using in New Delhi.