Global Medical Travel and Reducing Catastrophic Claims

Transcription

1 Global Medical Travel and Reducing Catastrophic Claims September 23, SIIA Medical Travel Session Three Presentations From Overview to Specific Facilitator - BridgeHealth International International Hospital -NZ Patient - Thailand 2

2 Facilitator Presentation Overview Business Concept & Background The Opportunity to Impact Catastrophic Claims Value to Stakeholders Networks Quality Controlling the Client Experience Medical Case Fees Surgery Benefit Contact Information 3 Medical Travel Topics We will cover 3 main topics: Surgery Benefit through Education about specific procedures & Tools on avoiding unnecessary surgery and saving cost Domestic Quality Value Travel Network Discounted Centers of Excellence (COE s) in the U.S. International Network World class deeply discounted quality international COE s All available today to ASO & Some Fully Insured clients 4

3 Why Medical Travel Significant savings Innovative health benefit design Ensures high quality, cost effective medical care - COEs Transparent costs & simplified billing Complements consumer-driven programs 5 The Opportunity The American healthcare system has become so expensive that companies are dropping coverage. Healthcare is virtually unaffordable for those without insurance. American businesses are increasingly unable to compete in a global marketplace due to the high costs of health insurance. Varying countries citizens wanting to access quality value world providers The declining current world economies coupled with health care reform in the U.S. is putting pressure on U.S. healthcare Waiting lists in some countries: Canada & UK 6

4 Major Medical Travel Competitors Aetna Serves one customer in Maine & has one hospital in Singapore. Cigna - Exploring Companion Health Blue Cross/Blue Shield of S.C. subsidiary. Int l only. Several commercial clients and patients sent. BridgeHealth Medical Domestic and International over 2,500 patients, customers: Employers, TPAs, & Insurance companies. HealthBase Focus on India and mostly consumer. Health Place America Domestic only; ~ 50 patients handful of clients recent major reorganization. WellPoint Serves one customer, focus mostly on India. Misc. others mostly focused on B to C, new ones regularly 7 Health Care Reform & Impact to Most Medical Travel Under nearly all proposed scenarios & plans Medical Travel comes out ahead In No Case is it Compromised, though some approaches may need to be modified Medical Travel is in fact part of the solution: Access: Makes more choices available Coordinates High Quality Low Cost Providers Creates World Wide Access To Best Hospitals & Physicians Cost: Lowers cost Educates patient Clearly posts prices in an all inclusive understandable way Quality: Provides quality rankings of hospitals including outcomes results Educates patients on options that may be lower cost and better quality Prepares patients for what to expect in Surgery and how to select a provider Provides high levels of customer service Most Medical Travel is not, nor is it designed to be the cure for all issues or proposed solutions. 8

5 Key Attributes for a Medical Travel Facilitator Look for a top service provider: a company with infrastructure, expertise, growth capital, and industry-specific experience. Specifics to Consider: A domestic and/or an international top quality network of physicians and accredited hospitals and clinics True Centers Of Excellence (COEs) Priority customer service Significant savings on high value medical procedures A clear fixed price using case rate DRG pricing Service & Quality Outcome tracking based measurement systems Experience in sending Americans to healthcare destinations A patient Surgery Education component 9 The Opportunity Total US Healthcare Expenditures 2008 $2.3 Trillion 10

6 The Opportunity Total US Healthcare Expenditures 2008 Other $2 Trillion Pharma $300 Billion 11 Significant & Unmanaged Surgery represents a significant and unmanaged portion of the $2.3 Trillion healthcare market 1/3rd of total medical spend and it exceeds other benefit management areas Other $1.1 Trillion Radiology Behavioral Health $100 Billion $100 Billion Pharma $300 Billion Pharma is a Big Industry Tightly Managed Surgery $700 Billion Bigger Industry Unmanaged 12

7 2 Components of Surgery Supply Side: Provider Selection A quality & value-driven domestic Centers of Excellence (COE) network A greatly discounted & demonstrated quality international COE network Demand Side: Surgery Education/Surgical Benefit (SBM) solution Built on studies that conclude that 30% of surgeries are unnecessary - (Wennberg Dartmouth) possibly better value and quality than traveling Educate employees to make informed decisions about surgery, its risks, and alternatives such as: Evaluating if surgery is even needed Understanding the possible surgery A less invasive surgery Physical therapy Pharmaceutical alternatives Tools to discuss with Surgeon and prepare for surgery & recovery 13 Value to Stakeholders Insurers, Reinsurers/Stop Loss, MGU s, TPA s, ASO s, & Brokers & Consultants Lower costs Higher quality through alternatives Employees make the tough decisions Greater choice True CDHP, as now the employee is educated on choices Presenting a leading edge product May not penetrate the specific or hit aggregate Employers Cost control & Quality improvement Employee satisfaction Not the bad guy, not cutting benefits, but adding choices Employees Informed Consent Control of Decision More options / greater quality Tools and education to understand & evaluate the process Higher satisfaction & lower costs 14

8 Medical Travel for Employers Employer Often has 3 Choices pays Facilitator a no risk case rate by procedure, PEPM, or a shared savings. Employees should be given a choice to travel. Employees should be given an incentive to travel. 15 Centers of Excellence National Network Look for representative top tier domestic (US) network with geographic spread to enable patients to choose a low cost / high quality U.S. provider. Countries Often in International Networks These are representative countries generally having high quality high service and often JCI accredited or equivalent hospitals. Often different countries have different surgical specialties. Brazil China Costa Rica Hong Kong India Malaysia Mexico New Zealand Puerto Rico Panama Singapore South Korea Taiwan Thailand Turkey 16

9 Medical & Dental Procedures Cardiology Gastroenterology Orthopedics Cardiothoracic CyberKnife (cancer) Dental Detox/Rehab ENT Executive Health Physicals General Surgery Gynecology Infertility Internal Medicine Neurosurgery Oncology (selective) Ophthalmology Pain Pediatrics Plastic and Reconstructive Surgery Urology Male/Female Vascular Weight Loss/Obesity Surgery 17 Look for Care Coordination Consultation with Travel Care Coordinators HIPAA compliant Coordination of pre travel communications made for client to hospital and physician After care needs can be coordinated Satisfaction & medical outcomes are tracked and monitored 18

10 Ideally Have All Inclusive Transparent Pricing Plan Which Includes: Surgery/procedure costs Airfare Lodging Transfers 24/7 Concierge Service 19 Example: Savings Potential In a 1000 member company Would have approximately 70 cases/year would benefit from travel If only 1/3 of members used the domestic COE travel benefit Annual savings would be ~10 12% per year! This includes all travel & related costs Many of these would be Catastrophic Claims at the Specific level and collectively could impact the Aggregate International savings per case are about double or more 20

11 Mitral Valve Replacement Sample Estimated Costs of Surgeries Typical US Pricing * U.S. COE Pricing International COE Pricing $ ,000 $47 77,000 $10 31,000 Cardiac Bypass $72 121,000 $37 64,000 $8 30,000 Hip Replacement $48 53,000 $20 25,000 $7 14,000 Knee Replacement $31 74,000 $20 34,000 $7 15,000 Spinal Fusion $39 172,000 $18 49,000 $5 14,000 * Varies by MCO/PPO and region Note: These U.S. COE prices are inclusive of Hospital, Surgeon, Lab, Radiology, Anesthesiology, etc. Prices will vary by location, severity, co-morbidity and are approximate for comparative illustration. COE examples do not include travel costs, but the savings more than offsets them

12 International Network Many Doctors are Western Trained Nurse/patient ratio is better than US Hospitals are accredited by the body that accredits hospitals in the US International locations can reduce catastrophic claims even further than U.S. providers Examples of high quality network are: Wockhardt Hospital in Bangalore, India affiliated with Harvard Punta Pacifica Hospital in Panama & Memorial Hospital in Istanbul affiliated with Johns Hopkins Aftercare Network Locations in U.S. for follow up 23 The Surgery Decision Surgery Path Reduce unnecessary surgery If it s not necessary it doesn t need to happen for lack of alternatives Truly consumer directed the consumer makes their own choices Simplify required surgeries Educate consumer on treatment alternatives to make the best decision Leverage different price/quality/location points = choice, & lower costs Educate the member & give them tools for decisions and recovery Improve quality through COEs & less lost work time Inhibit trend toward more aggressive surgery Compare less aggressive versus more aggressive surgeries Access to multiple networks Local, Other Domestic COE s, and optional International providers 24

13 Surgery Education Member Info Items often in Surgery Education which can reduce unnecessary surgery and educate the patient on expectations: Web based education An overview of the specialty area A look at the subspecialty area An explanation of treatment options A set of helpful consumer tools: How to select a physician and hospital Know what to ask of your provider once you ve chosen one How to involve your family and friends to improve your outcome What to expect from your chosen path Pre and Post operative considerations Understanding legal and financial forms Recovery steps 25 Employer Plan Solutions Reviewed Plan Design Recommendations with financial incentives to seek care at quality hospitals throughout the U.S. and Internationally if selected Covered Member Surgical Benefit Education: Education & Decision Process About Surgery, Alternatives, and Locations, and Recovery. Provide Tools for understanding Dedicated, Care Coordinators Networks: Local, Domestic travel, and International NOTE: Might be offered as a side by side option with employer s existing plan. It can also be offered with a companion hospital reimbursement plan. Travel Care Coordinators to Coordinate Health Record Data & Concierge Travel Coordination Follow up Care & Patient Satisfaction Surveys and Outcomes Tracking 26

14 The opportunity for you to demonstrate innovative thinking that will: Reduce corporate costs today Reduce employee costs today Sustain or increase benefits today Improve quality today Offer a new innovative service 27 Summary of what to Look For in a Facilitator Experience Experienced leadership team with depth; Networks Quality-rated Domestic and International COE Networks + Education Marketing Communications Partnered, strategic plan to drive company utilization & unit cost savings Client Experience Personalized service to clients by experienced coordinators Member Education Reduce utilization and get better outcomes through member decisions 28

15 Proposal Look to form a collaborative partnership between your two organizations to: Outline the Advantages of a World Class Network for Medical Travel Demonstrate Viability and Value of Surgery Education Reduce Benefit Costs for You/Your Clients Show your Thought Leadership with New Services Provide Employees with Exciting and Beneficial Care Options The Trusted Bridge to World Class Healthcare 29 Contact Information The Trusted Bridge to World Class Healthcare Vic Lazzaro, CEO VLazzaro@BridgeHealthInternational.com O: C: Gordon Larson GLarson@BridgeHealthInternational.com

16 SIIA 2009 National Educational Conference A Personal Medical Tourism Experience September 23, 2009 Presented by: Alison J. Saifer, FSA, MAAA AMS Strategies, Inc. Copyright and Disclaimer This presentation is for informational and discussion purposes. All material contained within this presentation is believed to be reliable and is based upon market experience and knowledge of Strategies, Inc. ( AMS ). AMS does not certify to its accuracy or completeness. This document and its contents are proprietary to AMS and may not be copied or reproduced without the express consent of AMS. 1

17 Background: Alison J. Saifer, FSA, MAAA Health Care Consultant (/Financial/Business) for: Reinsurance Companies Direct Carriers MGUs Attorneys Investors Types of Products Employer Stop Loss Limited Medical/ Mini-Med First Dollar, including High Deductible Plans Travel Carve Outs Transplant, Dental, Drug, Vision Student Accident and Medical Blanket Special Risk Pet Insurance 2

18 The Hot Topic of Medical Tourism Everyone is talking about it, but is anyone actually doing it? Many have determined that the potential for cost savings, even after accounting for travel and accommodations is significant After looking at it from an actuarial perspective, decided to participate in an actual experience The Mock Trip I m Not a Doctor, I Just Think All Those Exams Qualify Me to Act Like One! May 27 June 1, 2009 Bangkok, Thailand Medical Services Needed. All parts currently working, so how about an executive physical? Traveled with an Insurer, Reinsurer, Reinsurance Intermediary 3

19 Agenda Tour of Bangkok Hospital Meeting with Hospital Senior Tour of Rehabilitation Clinic and Holistic Medical Center Tour of Samitivej Sukhumvit Hospital Meeting with a Group That Does Aphaeresis Treatments Not Available in the US First Hand Experience with Some Medical Tests and Treatments What about the Tourism Component? Dining Experiences Tour of the City Visit to the Bangkok Night Market 4

20 Trip to Bangkok After 26 hours of travel, arrive in Bangkok, tired, but excited A concierge was waiting for us with a sign AT OUR GATE Helped us with luggage, through customs and to a waiting car Transportation to the hotel Bangkok Hospital Meeting with 5

21 Bangkok Hospital Meeting with (continued) JCI Accredited In 2007, 37% of Patients Were International 9.4% are Americans mostly expats living in Thailand and surrounding areas Most Doctors Have Excellent English Skills, so Language is Not a Big Barrier High Tech with a Light Touch State of the art equipment Caring, dedicated staff with Thai hospitality Bangkok Hospital (continued) No Waiting No Shared Rooms Extremely Clean and Quiet Doctors Spend Time With Patients Affordable, Even After Allowing for Traveling and Accommodations Look After the Family, Not Just the Patient No Visiting Time Restrictions Apartments available in the hospital 6

22 Bangkok Hospital (continued) Seamless Service Referral Center Concierge Services Transportation from airport, to hospital Take people shopping, tourism trips Re-booking flights Stress free Medical Coordination Communication with Referees Patients go home with discharge folders Bangkok Hospital (continued) Longer Inpatient Stays Than US Not rushed out of hospital Re-Hab Patients May Stay at Hotel and Come Back Daily to Hospital 24/7 Service Saturdays and Sundays are very busy Routine operations may happen at 8pm Hospital is the Center of Healthcare 7

23 Bangkok Hospital (continued) Package Pricing Getting you back home is part of their responsibility May advise you to stay longer before you are ready to travel home Cost of Wait time before you are fit to fly included Doctors or nurses may fly back home with you Bangkok Hospital (continued) Typical US Patients are: Well traveled Have passports Understand technology Typical Procedures Include: Cardiac stem cell therapy Computerized diagnosis and radiotherapy for cancer Joint replacement surgery Clinical trials 8

24 Bangkok Hospital Tour of Facility Extremely Clean No Hospital Smell People Smiled and Greeted You as They Passed By Rooms Were Large and Comfortable, and Hotel-Like Patients Drugs Kept in Locked Box in Patient s Room Photo Taken at Registration and Then on Every Page of Medical Records Bangkok Hospital Tour of Facility Procedure Prices Posted on the Wall at the Hospital 9

25 Bangkok Hospital Tour of Facility Outpatient Dialysis Area Bangkok Hospital Tour of Facility Apartments Available in the Hospital for Family Members or Patients with Outpatient Procedures 10

26 Bangkok Hospital Tour of Facility Starbucks Coffee and Au Bon Pain in Hospital Holistic Medical Center Integrated with Medical Care State of the Art Equipment 11

27 Samitivej Sukhumvit Hospital JCI Accredited 40% of Patients are International Japanese, then American Mostly expats living in Thailand or surrounding areas 10% of revenue from medical travelers Thai Patients are Upper and Upper-Middle Class Samitivej Sukhumvit Hospital (continued) Karaoke in Room Internet in Room 24 Hour Hot Line to Nurses Station Using Skype and Web Cams Face to Face Communication After Discharge Connectivity Externally - Pre and Post Care Facilitated Through Web Consult with doctor face to face before patient comes to Thailand 12

28 Samitivej Sukhumvit Hospital (continued) Apartments Available in the Hospital About $80 Day 2 Tour of City Concierge Services Provided Us Transportation, Tour Guide Visit to Grand Palace Wonderful Thai Food Incredible Hospitality 13

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30 Day 3 - Patient Concierge picked us up at hotel at 7:30 am for 8 am appointment on SUNDAY (appointment had been made electronically from home) 7:50 am check-in at International Medical Center Desk handed us voucher for Starbucks or Au Bon Pain so we could eat once we were finished with lab work AMS Strategies, Inc. 15

31 Day 3 Patient (continued) 8:05 am called and all vitals, blood and urine taken Water available at every turn 8:20 am finished with lab piece and head upstairs for chest x-ray Waiting for us, no paperwork, NO WAIT The longest wait we had was the time it took us to change into hospital gown for chest x-rays Were told we could come back in 1 hour for consult with the Doctor AMS Strategies, Inc. Day 3 Patient (continued) 8:40 am Cappuccino and Croissant at Au Bon Pain 16

32 Day 3 Patient (continued) Appointment at 9:40 am with Dermatologist Refused escort to other building all signs in English, so no problem finding it! Arrive at 9:05 am Called into patient room at 9:25 am Doctor was waiting for ME in the room Consult over at 9:45 am, when exam and all my questions were answered in English Cost 750 baht - $22 Services requested all prices explained Were a fraction of costs in USA NO WAIT for Services All services provided by friendly, attentive and knowledgeable professionals, including the Physician AMS Strategies, Inc. Day 3 Patient (continued) Payment was made and our concierge was waiting for us with a sandwich and water bottle But first, back to the International Medical Center for our test results Check in at 11:40 am (with no appointment) Called to speak with Physician at 11:45 am who went over in detail the results of all the labs and showed me my chest x-ray I had come down with a sore throat, so after an additional exam was given a prescription for an antibiotic and headed out at 12:00 pm AMS Strategies, Inc. 17

33 Day 3 Patient (continued) Pharmacy was around the corner. Arrived at 12:00 pm and was on my way with my filled Rx at 12:05 pm Back at the IMC, I was provided a hard copy of all my results and told that a formal report would be done in 1 hour and that I could pick up or it could be ed to me Concierge then provided for a last delicious, authentically Thai meal, a trip to the night market, and transportation back to the airport at 4 am Monday morning Another concierge met us at the airport and facilitated us through the check-in and customs process AMS Strategies, Inc. Day 3 Patient (continued) Cost of the Check-Up Including: Physical exam CBC Blood sugar Liver Function Test Kidney Function Test Lipid screening Urine Analysis Chest X-ray Physician Consult of Results Full Written Report $2,600 Baht or $74 Unparrelled, Courteous and Timely Services PRICELESS! AMS Strategies, Inc. 18

34 Patient Experience All Professionals I Came in Contact with (perhaps 20) had Excellent to Fluent English All Care was Provided Professionally, Politely and Efficiently All Facilities Were Immaculately Clean General Observations Always Felt Safe, Cared For and Never Left Stranded The Food was Delicious No One Got Sick and All Enjoyed the Cuisine The City was Interesting and Culturally Rich The People Were Incredibly Hospitable, Attentive and Professional All Hotels, Restaurants and Sights We Were Exposed to Were Very Safe and Excellent by American Standards Never Experienced a Language Barrier The Medical Care was Efficient, Professional and Provided in a Superior Manner to that of the US AMS Strategies, Inc. 19

35 Most Important Questions And If I Really Needed a Medical Procedure, Would I Go Back? ABSOLUTELY! Only True Down-Side for Me was the Long Trip, But the Care, Quality and Opportunity to Visit a New Country and Experience the Culture Made It Worth While Thank You! Alison J. Saifer, FSA, MAAA President AMS Strategies, Inc. (215) asaifer@actmgmt.com 20

36 WORLD CLASS MEDICAL TREATMENT IN AN ENGLISH SPEAKING, FIRST WORLD COUNTRY DELIVERING EXCEPTIONAL HEALTHCARE VALUE INTRODUCING Dr Edward Watson MBcHB MBA DRACOG FRNZCGP Executive Chairman Medtral New Zealand 1

37 TODAY S AGENDA The Globalization of Healthcare Why offer a Medical Travel option? The Medtral Offer Value Quality Care Hospitals and Doctors Destination - New Zealand Benefits to Insurers and Self-insured companies Patient Experience WHY ARE PATIENTS TRAVELING? THE GLOBALIZATION OF HEALTHCARE Cost Cost Cost Long waiting lists (public healthcare) Expatriates Indication not approved in home country To find the best care available Dissatisfaction with existing providers 2

38 MEDICAL TRAVEL PROGRAM WHAT DO SELF-INSURING COMPANIES LOOK FOR? 1. Cost savings 2. Safety (environment + medical) 3. Quality 4. Compatibility (medically and culturally) 5. Efficiency 6. Continuation of Care 7. Marketable Destination 8. Ease of Travel INTRODUCING MEDTRAL NEW ZEALAND Through Medtral New Zealand, insured customers and employees from self-insured companies have access to world class, non-acute, surgical and medical treatment in an English speaking, first world environment - New Zealand The environment in which the patients are treated is both medically and culturally aligned to North America as well as being clean, green, safe and American friendly. TRAVELING TO NEW ZEALAND WILL NOT BE A FOREIGN EXPERIENCE 3

39 EXCEPTIONAL VALUE OPERATION PACKAGE (Medtral) COST US$ Coronary Artery Bypass Graft Surgery $38,000 Heart Valve replacement surgery $40,000 Total Hip replacement $26,000 Total Knee replacement $26,000 PROCEDURE ONLY (USA) COST US$ Coronary Artery Bypass Graft Surgery $125,000 Heart Valve replacement surgery $135,000 Total Hip replacement $64,000 Total Knee replacement $63,000 EXCEPTIONAL VALUE What is in a cost comparison? Our standard package estimate includes: Integrated concierge service to manage all aspects of the patient s journey Patient and doctor communication Hotel and flight bookings Specialist and hospital bookings Aftercare management Immigration management Feedback and integration with health provider in US Flights from the west coast of the USA Hotel accommodation All expected medical and surgical costs Aftercare (Physiotherapy and Nursing care in hotels) Contingency insurance Treatment and recuperation while in New Zealand Medical evacuation home if deemed necessary 4

40 QUALITY WITHOUT COMPROMISE Focus on patient outcome A complete communication loop on patient care Patients condition worked up while still in the USA All medical aspects of patient care feedback to PCP in USA Inter-physician communication encouraged between NZ and USA doctors Focus on patient experience OUTSTANDING CARE Dedicated Patient Coordinators Personalized medical care Excellent communication across all disciplines Low Nurse to Patient ratios (RN primary nurses) Emphasis on after-care Holistic approach Specially selected accommodations In-hotel Nursing and Physiotherapy A Life Changing Experience Total Customer Satisfaction 5

41 FULL SERVICE FACILITIES Mercy Hospital and Ascot Hospital Both are Quality Health New Zealand Certified. This is an international recognized accreditation (ISQua) Services available: Radiology - with 1.5 MRI, 64 slice CT, ultrasound, general X-ray etc Laboratory services Catheter labs - EPS, angiography, peripheral vascular Allied health - physio, dietician, OT etc On site medical cover Both are teaching hospitals of the University of Auckland (the only private hospitals in New Zealand to have this) Robotic surgery Dual integrated digital operating theatres 6

42 INTERNATIONAL ACCREDITATION ISQua Quality Health New Zealand Joint Commission International Accreditation USA Australian Council on Health Care Standards Quality Improvement Council, Australia Canadian Council on Health Services Accreditation Irish Health Services Accreditation Board (now HIQA) Council for Health Services Accreditation of Southern Africa Taiwan Joint Commission on Hospital Accreditation CHKS-HAQU Health Care Accreditation Unit, UK Japan Council on Quality in Health Care Egyptian Health Care Accreditation Organization THE HOSPITALs - MERCY & ASCOT Personally I would like to thank everyone at Ascot Hospital for the truly wonderful care I received. From the doctors to the beautiful ladies who make painful nights less painful and shorter. I m pretty much at a loss for words to express my gratitude. I hope I wasn t too much of a pain in the arse - after all it was my head they fixed! Many thanks Kiwis. Keith Richards The Rolling Stones 7

43 WORLD CLASS MEDICAL SPECIALISTS 540 CREDENTIALED SPECIALISTS ACROSS ALL THERAPEUTIC AREAS English as their first language Trained in North America, the UK as well as New Zealand or are board certified to work in the USA Leaders in their respective fields within New Zealand Excellent records with regards to adverse events, patient interaction and surgical outcomes Most are involved in international clinical research NEW ZEALAND 8

44 NEW ZEALAND First world country with a long history of high quality healthcare provision Commonwealth Fund ranks New Zealand as having one of the best medical systems in the world One of the worlds safest blood supplies no transfusion transmitted HIV infections since screening began in 1985 Geographical isolation means very low rates of nosocomial and community acquired infections English speaking with a society that shares cultural affinity with other western countries 12 hour overnight direct flight from west coast of North America Temperate climate The most peaceful country in the world (2009 Global Peace Index) MEDTRAL NZ S UNIQUE COMBINATION Certainty of World Class Medical Treatment Transparent Partnership New Zealand is a culturally aligned English speaking destination Internationally Accredited Private Hospitals Cost effective destination Contingency insurance Feedback and communication with US medical providers Personalized care at every step of the journey 9

45 THE BENEFITS TO INSURERS & SELF INSURING COMPANIES World class personalized, quality care Customer Satisfaction An aligned environment Significant cost savings Market expansion Market consolidation Knowledge on how to implement medical travel options: Implementation manuals Systems and processes Defined outcomes Patient Testimonial PROVING THIS WILL WORK FOR YOU. IT IS WORKING FOR OTHERS Don t just take our word for it- see what patients who have travelled to New Zealand say 10

46 Patient Testimonial QUESTIONS? 11

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