To Save Money, American Patients And Surgeons Meet In Cancun

CANCUN, Mexico — Donna Ferguson awoke within the resort metropolis of Cancun earlier than dawn on a sweltering Saturday in July.

She wasn’t headed to the seaside. Instead, she walked down a brief hallway from her Sheraton lodge and into Galenia Hospital.

A little bit later that morning, a surgeon, Dr. Thomas Parisi, who had flown in from Wisconsin the day earlier than, stood by Ferguson’s hospital mattress and used a black marker to notice which knee wanted restore. “I’m ready,” Ferguson, 56, instructed him simply earlier than being taken to the working room for her whole knee alternative. For this surgical procedure, she wouldn’t solely obtain free care however would obtain a verify when she bought dwelling.

The hospital prices of the American medical system are so excessive that it made monetary sense for each a extremely educated orthopedist from Milwaukee and a affected person from Mississippi to depart the nation and meet at an upscale personal Mexican hospital for the surgical procedure.

Ferguson will get her well being protection via her husband’s employer, Ashley Furniture Industries. The value to Ashley was lower than half of what a knee alternative within the United States would have been. That’s why its workers and dependents who use this selection don’t have any out-of-pocket copayments or deductibles for the process; actually, they obtain a $5,000 cost from the corporate, and all their journey prices are lined.

Parisi, who spent lower than 24 hours in Cancun, was paid $2,700, or 3 times what he would get from Medicare, the most important single payer of hospital prices within the United States. Private well being plans and hospitals usually negotiate cost schedules utilizing the Medicare reimbursement charge as a ground.

Donna Ferguson talks with Milwaukee surgeon Dr. Thomas Parisi earlier than her knee alternative surgical procedure at Galenia Hospital in Cancun.

Ferguson is one among a whole lot of 1000’s of Americans who search lower-cost care exterior the United States annually, with many going to Caribbean and Central American international locations. A key consideration for them is whether or not the power affords high quality care.

In a brand new twist on medical tourism, North American Specialty Hospital, often called NASH and based mostly in Denver, has organized remedy for a few dozen American sufferers at Galenia Hospital since 2017.

Parisi, a graduate of the Mayo Clinic, is one among about 40 orthopedic surgeons within the United States who’ve signed up with NASH to journey to Cancun on their days off to deal with American sufferers. NASH is betting that having an American surgeon will alleviate considerations some individuals have about going exterior the nation, and persuade self-insured American employers to supply this selection to their staff to save cash and nonetheless present high-quality care.

NASH, a for-profit firm that prices a hard and fast quantity for every case, is paid by the employer or an middleman that organized the remedy.

“It was a big selling point, having an American doctor,” Ferguson mentioned.

The American surgeons work carefully with a Mexican counterpart and native nurses. NASH buys further malpractice protection for the American physicians, who might be sued within the United States by sufferers sad with their outcomes.

“In the past, medical tourism has been mostly a blind leap to a country far away, to unknown hospitals and unknown doctors with unknown supplies, to a place without U.S. medical malpractice insurance,” mentioned James Polsfut, the chief government of NASH. “We are making the experience completely different and removing as much uncertainty as we can.”

Medical tourism has been round for many years however has turn into extra widespread prior to now 20 years as extra international locations and hospitals world wide market themselves to foreigners.

There are, in fact, dangers to going exterior the nation, together with the headache of journey and the likelihood that the requirements of care could also be decrease than at dwelling. If one thing goes flawed, sufferers will likely be removed from household and associates who might help — and it is likely to be harder to sue suppliers in different international locations.

Chasing Lower Costs

The excessive costs charged at American hospitals make it comparatively simple to supply surgical bargains in Mexico: In the United States, knee alternative surgical procedure prices an average of about $30,000 — generally double or triple that — however at Galenia, it’s only $12,000, mentioned Dr. Gabriela Flores Teón, medical director of the power.

The normal cost for an evening within the hospital is $300 at Galenia, Flores mentioned, in contrast with $2,000 on average at hospitals within the United States.

A knee alternative surgical procedure prices a mean of about $30,000 at U.S. hospitals, however solely $11,000 at Galenia Hospital in Cancun, Mexico.(Rocco Saint-Mleux for KHN)

A hallway inside Galenia Hospital in Cancun, Mexico.(Rocco Saint-Mleux for KHN)

The different huge financial savings is the price of the medical system — made by a subsidiary of the New Jersey-based Johnson & Johnson — utilized in Ferguson’s knee alternative surgical procedure. The exact same implant she would have acquired at dwelling prices $three,500 at Galenia, in contrast with practically $eight,000 within the United States, Flores mentioned.

Galenia is accredited by the international affiliation of the Joint Commission, which units hospital requirements within the U.S. But to assist medical doctors and sufferers really feel snug with surgical procedure right here, NASH and Galenia labored to transcend these requirements.

That included including an additional autoclave to sterilize devices extra rapidly, utilizing spacesuit-like robes for medical doctors to scale back an infection danger and having sufferers begin bodily remedy simply hours after knee- or hip-replacement surgical procedure.

I. Glenn Cohen, a legislation professor at Harvard and an knowledgeable on medical tourism, known as the mannequin utilized by NASH and some different comparable operations a “clever strategy” to assault among the perceived dangers about medical tourism.

“It doesn’t answer all concerns, but I will say it’s a big step forward,” he mentioned. “It’s a very good marketing strategy.”

Still, he added, sufferers ought to be involved with whether or not the hospital is provided for all contingencies, the talents of different surgical workforce members and the way their care is handed off once they return dwelling.

Officials at Ashley Furniture, the place Ferguson’s husband, Terry, is a longtime worker, mentioned that they had been impressed to date. The firm affords the choice of abroad surgical procedure via NASH for free of charge — and with an incentive.

“We’ve had an overwhelming positive reaction from employees who have gone,” mentioned Marcus Gagnon, supervisor of worldwide advantages and well being at Ashley, a Wisconsin-based firm with 17,000 workers. Ferguson was the corporate’s 10th insured particular person to go to Cancun.

Donna Ferguson is wheeled into surgical procedure at Galenia Hospital in Cancun, Mexico.

Ashley additionally has despatched about 140 workers or dependents for therapies at a hospital in Costa Rica, and collectively the international medical amenities have saved the agency $three.2 million in well being prices since 2016, he mentioned.

“Ever after the incentive payments and travel expenses, we still save about half the cost of paying for care in the United States,” Gagnon mentioned. “It’s been a nice option — not a magic bullet — but a nice option.”

NASH’s technique has its skeptics.

“Building a familiar culture in a foreign destination may be appealing to some American consumers, but I do not see it as a sustainable business,” mentioned Irving Stackpole, a well being marketing consultant in Rhode Island. “It’s not unusual for people thinking about this to have doctors, family and friends who will see this as a high-risk undertaking.”

Stackpole mentioned solely a restricted variety of Americans have been prepared — even with a monetary incentive — to journey overseas as a result of most understand the care received’t be nearly as good.

‘You Are Nuts For Doing This’

Ferguson’s knee began inflicting her bother two years in the past, and final fall a health care provider beneficial changing it. She is on her ft a lot of the day assembling furnishings toolkits at her job at American Furniture Manufacturing in Ecru, Miss. Terry Ferguson talked about the Cancun choice he had heard about at work. The couple pay $300 a month in premiums for household well being protection.

“I had a friend say, ‘You are nuts for doing this,’ but Dr. Parisi trained at Mayo, and you can’t do any better than that,” Ferguson mentioned earlier than the surgical procedure. Also, having an American physician meant that if one thing went flawed, she may file a malpractice go well with within the United States, she added.

Dr. Thomas Parisi checks in on affected person Donna Ferguson after the surgical procedure. “Everything went great,” Parisi instructed her.

IndusHealth, Ashley’s medical journey plan administrator, organized for her to get a bodily examination, knee X-rays and coronary heart exams close to her dwelling to ensure she was a very good candidate for surgical procedure. It even had her see a dentist to ensure she didn’t have an an infection that might complicate her restoration. Parisi reviewed a few of these information earlier than Ferguson headed to Cancun.

The firm additionally coordinated her medical care and made journey preparations, together with acquiring passports, airline tickets, lodge and meals for the couple.

In Mexico, the day earlier than surgical procedure, Ferguson had extra X-rays and had her blood drawn. After lunch, the couple met with Noemi Osorio, a nurse, who reviewed Ferguson’s schedule and confirmed her the bodily remedy amenities. Later, they met Parisi and the remainder of the medical workforce.

“My job is pretty easy,” Parisi instructed her. “How you do over the next five or 10 years depends on how well you work with the physical therapy.”

The surgical procedure started at eight:20 the subsequent morning. Dr. Daniel Rios, an orthopedic surgeon who practices full time in Cancun, labored with Parisi. Rios, who had accomplished a fellowship at Brigham and Women’s Hospital in Boston, checked on Ferguson for a number of days after the operation.

By 9:30 a.m., the operation was over, and at 11 a.m. she left the restoration space. Parisi checked on her there. “Everything went great,” he instructed her earlier than heading to the airport for his 2:30 flight dwelling.

Parisi mentioned that the dearth of English proficiency amongst some surgical workers members created “momentary delays” however that the bilingual surgical assistant helped.

A little bit greater than three hours after the surgical procedure, Ferguson was in her hospital room, and a bodily therapist got here and helped her off the bed. Using a walker, she gingerly took some steps to check out her new knee. By the subsequent morning, she was on crutches strolling the hallway and was discharged earlier than midday. She stayed at her lodge 10 further days whereas having bodily remedy twice a day on the hospital.

“It’s been a great experience,” she mentioned two days after the surgical procedure. “Even if I had to pay, I would come back here because it’s just a different level of care — they treat you like family.”

Physical therapist Carlos Bauque helps Donna Ferguson stroll as she recuperates from her surgical procedure.

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