Apollo begins insurance pilot with Anthem

 

Apollo Hospitals in India has begun a pilot exercise with US-based insurance company Anthem Blue Cross and Blue Shield, a subsidiary of Well Point. The deal has been arranged by US agency Healthbase.

The arrangement is for a six-month pilot scheme for one small subsidiary, not all of WellPoint or all customers of Anthem Blue Cross and Blue Shield.

The deal only involves one company, Serigraph, with 700 employees and only two Apollo hospitals, in Delhi and Bangalore, will be used.

If the pilot becomes a full programme it will be rolled out to all Apollo Hospitals that are JCI accredited. Preetha Reddy, of Apollo Group commented: “The programme meets the guidelines set for medical tourism by the American Medical Association (AMA) and we will strive to achieve the best healthcare standards to ensure total success of this programme.”

All the patients will be routed through a global third party administrator Mondial Assistance, which as top travel assistance business already has links with Apollo Hospitals.

Boston-based medical tourism agency Healthbase, which already sends customers to Apollo, will handle all the medical travel logistics and arrangements for members. Saroja Mohanasundaram, chief executive of Healthbase said: “Healthbase will assist WellPoint members with coordination of the trip, medical appointment scheduling, digital medical records transfer, and concierge travel service.”

This pilot project of six months only covers 700 health plan group members and their dependents at US printing company Serigraph, based in Wisconsin. The employer-funded healthcare plan will cover the costs of airfare and accommodation, as well as a dedicated case manager to coordinate travel, medical care plus post-operative care upon return to US. India is merely another option for Serigraph’s employees, and not compulsory.

Serigraph's insurer is Anthem Blue Cross and Blue Shield. Anthem serves members in Wisconsin and 11 other US states, and is one of many subsidiaries and affiliates of Indianapolis-based WellPoint. WellPoint is the largest health benefits group in terms of medical membership in the United States, with 35 million medical members nationwide. One in nine Americans receives coverage for their medical care through WellPoint's affiliated health plans. WellPoint is a Blue Cross or Blue Cross Blue Shield licensee in 14 states, Wisconsin being one of them.

Dr Razia Hashmi of WellPoint said: "Medical tourism is a promising option for improving access to affordable, quality health care. We are pleased to work collectively with Healthbase to deliver an international medical tourism pilot product to our clients who are interested in exploring a medical tourism solution.”

Healthcare in the US is in turmoil and one of President Obama’s toughest tasks is reforming it. The reforms will affect US insurers, and could even change completely how they operate. This makes a rollout of the medical tourism programme across the Wellpoint organisation unlikely for a few years.

The pilot is too small to provide accurate information, so the most likely outcome is that during 2009 it will be continued and extended to other states and other employers. But, the possibility remains that, as in other programmes launched last year, insurers and employers will just use it as a big stick to force US hospitals to cut their prices.

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