Direct Contracting with CoE’s is growing, but Patient Experience is Key to Sustainability

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As healthcare spending in the U.S. continues to rise, employers are increasingly turning to direct contracting with Centers of Excellence (COE’s) in order to lower healthcare costs and provide competitive insurance benefits to employees. Companies such as Boeing, Jet Blue, Walmart, and Pepsi have partnered with top healthcare providers such as Cleveland Clinic, Mayo Clinic, and Mercy Hospital Springfield, because of their ability to deliver better outcomes at a lower cost than many competing facilities. 


Employers can also better anticipate employee healthcare costs as COE’s will often provide upfront fixed pricing. This growing trend is also known as domestic medical travel or medical tourism. In this scenario, employers will often waive co-pays and deductibles, cover the cost of travel and accommodation for the employee and a companion and, in some instances, pay them a percentage of the savings. 


How does direct contracting work?

As an example, it was recently reported in the media that a Walmart employee was suffering from debilitating neck pain and hand tremors. After a local surgeon recommended spine surgery due to spinal column narrowing and disc degeneration, Walmart paid for the worker and his wife to travel to a facility in Pennsylvania for a second opinion. The hospital evaluated the patient’s condition and diagnosed Parkinson’s disease. After receiving treatment for the disease, the patient traveled back home to recover and soon returned to work. The fact that Walmart had a direct contract with a CoE, prevented an unnecessary $30,000 spinal surgery.


The patient experience is key for employee utilization


While the opportunity to access better outcomes and lower costs is the main driver of direct contracting (e.g. hospitals must meet a set of quality parameters to be included in the employer’s network), the ability of the hospital to deliver an outstanding patient experience through each step of the medical travel process is the key to increase employee utilization and ensure a sustainable domestic medical travel program. This includes:


  • Coordination of the qualification process and pre-travel tests


  • Education for the patient and companion on what to expect during the medical travel process


  • Providing travel, lodging, and logistical support


  • Ensuring appropriate transition of care back home


Enhancing the patient experience is especially important in medical travel due to the hospitality and travel components that must be managed across the Medical Travel Care Continuum (each stage of the medical travel process including pre-arrival and post-discharge). A hospital or clinic may deliver great healthcare outcomes but still fall short of delivering a high-quality patient experience. Potential potholes on the road to achieving a high-quality patient experience in medical travel include:


  • Patients getting lost on a hospital’s website or not finding relevant information


  • Slow response times to patient inquiries


  • Poor communication and education due to lack of standardized processes


  • Patients being directed to hotels and transportation providers that do not offer the appropriate services for medical travelers’ needs


  • Lack of established care paths and protocols for medical travelers


  • Poor follow-up after a patient travels home


  • Staff have not been trained to understand and manage a medical traveler’s expectations


  • Bad patient experience can negatively impact your brand


Depending on the employer’s particular employee profile, there may also be potential cultural or language barriers that must be managed. Ensuring standardization of processes and protocols is critical; if there are gaps in communication and education or if employees are not comfortable with certain interactions at different touchpoints, this will lead to dissatisfaction and a poor patient experience. 


This not only impacts the patient and future employee engagement with the program, it can also impact the employer’s and hospital’s brand. As we all know, in the age of social media, a poor customer experience can go viral in an instant, potentially crippling an organization’s brand. 

GHA is supporting top Centers of Excellence with medical travel standards


To address these gaps, the Global Healthcare Accreditation (GHA) Program was established in 2016, with the goal of enhancing the patient experience for medical travelers across the entire Medical Travel Care Continuum. GHA has developed standards, with input from key industry stakeholders including hospitals, insurance companies and employers, that are aligned with the needs of medical travelers and that facilitate a safe and high-quality patient experience. 


Top U.S. Centers of Excellence such as Cleveland Clinic, Ohio and Mercy Hospital Springfield have turned to GHA for support and validation of the quality of services provided to medical travelers, both domestic and international. 


According to Ms. Karen Timmons, GHA’s Chief Executive Officer, "The results of the GHA accreditation process places healthcare providers in a better position to attract and effectively serve health tourism or medical travel patients. It has been gratifying to hear feedback from our accredited clients which highlights improved patient experience scores and an increase in patient volume since becoming GHA accredited.” 


As further evidence of the relevance and quality of the GHA standards, in June of 2019, the International Society for Quality in Health Care (ISQua), through its recently formed accrediting arm, The International Society for Quality in Health Care External Evaluation Association (IEEA), accredited the Global Healthcare Accreditation (GHA) Program Standards. ISQua is widely recognized as the "accreditor of accreditors" and the reference point for international healthcare accrediting bodies seeking external validation of their standards. IEEA accreditation provides assurance that the GHA standards meet the highest international benchmarks for accreditation entities.


For more information about the Global Healthcare Accreditation program and how it can benefit your organization, visit www.globalhealthcareaccreditation.com or contact info@ghaccreditation.com or call +1 561-228-4014.