I had the opportunity to tour a hospital in Grand Cayman last month which is a disruptive model that really gets at the cost, quality and waste of our healthcare system. There is a business called "medical tourism" that has been emerging over the past 15 years (primarily in India and Thailand) that is now making inroads into the U.S. The hospital is called Health City (www.healthcitycaymanislands.com) and they recently opened up the first facility that will expand to a 2,000 bed specialized hospital focusing on the highest cost procedures including cardiac, orthopedic and oncology.
The model was developed by a cardiac surgeon (Dr. Devi Shetty) in India who wanted to expand access to care for major, cost-prohibitive procedures. He built the first hospital in 2003 and now has 56 hospitals in India treating tens of thousands of patients. (www.narayanahealth.org). The model operates on five basic principals:
1) Modular designed hospital that is much less costly to build and minimizes hospital acquired infections. (I'll spare the detail, but they provided data which I've validated...but they were able to build the hospital in Grand Cayman for $400K/bed that costs over $1 million/bed here in the U.S.....think about how expensive it is to build on an island and you can appreciate how significant that number is...and it's not a cheap facility by any stretch).
2) Leveraging technology...a qualified surgeon performs the procedure, but is tied to a team (back in India) via telemedicine and videoconferencing.
3) Complete standardization of medical devices, equipment and procedures....for instance, the only use one manufacturer for pacemakers and a limited number of options. The Materials Management supply room was one tenth the size for a similar size hospital here in the U.S.
4) Tort reform...Narayana negotiated with the Caymanian government to cap medical malpractice.
5) Bundled pricing....you are provided the entire price for the procedure. For instance, if you need a quadruple bypass, the price includes everything from consultation, surgery, anesthesia, post-op recovery, physical therapy follow-up physician visits and discharge.
The result? That bypass costs 1/4 the price that it does here in the U.S. and the outcome data is identical. (not to mention you get to recuperate in Grand Cayman with your family!!!).
Will a 2,000 bed hospital in the Caribbean change the way healthcare is delivered here? No, but they already have an agreement with Ascension Health (a 90+ Catholic hospital system here in the U.S.) to provide these procedures to its employees. Think about that...a hospital system has just offered outsourced and off-shored care to their employees) at a lower cost.
I have spent over 35 years of my career in healthcare and have been in hundreds of hospitals, but never have I seen such an impressive or "disruptive" model.
The day I went back to work, there was a copy of Modern Healthcare, one of the main industry periodicals on my desk featuring a story on Health City. They never mentioned the story being published to me while I was there. Competition drives value (cost/quality/outcomes); but the sad thing is we will now be outsourcing more work and jobs outside of the U.S.. Now you know why I think the ACA is a joke.
The model was developed by a cardiac surgeon (Dr. Devi Shetty) in India who wanted to expand access to care for major, cost-prohibitive procedures. He built the first hospital in 2003 and now has 56 hospitals in India treating tens of thousands of patients. (www.narayanahealth.org). The model operates on five basic principals:
1) Modular designed hospital that is much less costly to build and minimizes hospital acquired infections. (I'll spare the detail, but they provided data which I've validated...but they were able to build the hospital in Grand Cayman for $400K/bed that costs over $1 million/bed here in the U.S.....think about how expensive it is to build on an island and you can appreciate how significant that number is...and it's not a cheap facility by any stretch).
2) Leveraging technology...a qualified surgeon performs the procedure, but is tied to a team (back in India) via telemedicine and videoconferencing.
3) Complete standardization of medical devices, equipment and procedures....for instance, the only use one manufacturer for pacemakers and a limited number of options. The Materials Management supply room was one tenth the size for a similar size hospital here in the U.S.
4) Tort reform...Narayana negotiated with the Caymanian government to cap medical malpractice.
5) Bundled pricing....you are provided the entire price for the procedure. For instance, if you need a quadruple bypass, the price includes everything from consultation, surgery, anesthesia, post-op recovery, physical therapy follow-up physician visits and discharge.
The result? That bypass costs 1/4 the price that it does here in the U.S. and the outcome data is identical. (not to mention you get to recuperate in Grand Cayman with your family!!!).
Will a 2,000 bed hospital in the Caribbean change the way healthcare is delivered here? No, but they already have an agreement with Ascension Health (a 90+ Catholic hospital system here in the U.S.) to provide these procedures to its employees. Think about that...a hospital system has just offered outsourced and off-shored care to their employees) at a lower cost.
I have spent over 35 years of my career in healthcare and have been in hundreds of hospitals, but never have I seen such an impressive or "disruptive" model.
The day I went back to work, there was a copy of Modern Healthcare, one of the main industry periodicals on my desk featuring a story on Health City. They never mentioned the story being published to me while I was there. Competition drives value (cost/quality/outcomes); but the sad thing is we will now be outsourcing more work and jobs outside of the U.S.. Now you know why I think the ACA is a joke.
