Plenty of countries around the world depend on visitors to boost their economy. Some are holidaymakers, looking for a couple of weeks off from the hard grind; others are travelling for business and spending time and money in hotels, venues and restaurants.

“Mexico, Egypt, the Dominican Republic, Turkey and Greece are high-volume, traditional trip travel locations,” explained Jayson Glover, Global Provider Network Manager for Healix. “On top of that, they receive some business travel as well, and in addition, they’ve all got government embassies. These countries would be in our top 10 most-dealt-with countries by any metric.”

Glover explained that all of those countries have a high volume of travellers, who are not necessarily tourists, and they have differences internally as well. He gives the example of Greece, where a city like Athens is very different to the islands or more seasonal tourist destinations.

“There are two worlds with each of these countries,” he said. “There’s the densely urban areas around the capital cities, and then there’s what happens in the tourist areas as well.”

Either way, it is an obvious fact that more people in a particular country and, on a more granular level, in a region or city also require more infrastructure – including medical care. Travellers need access to medical care for the usual issues, from sunstroke to a sprained ankle, but also more serious emergencies that can happen anywhere, from a broken leg to a cardiac arrest.

Strong local knowledge is important

Healix ensures they have strong local knowledge across the countries in which they are working. That means being aware of everything that might be useful to visitors to the region – from which hospitals have specialisms in which areas of medicine to which tourist areas have only pop-up clinics during the high season.

“Sometimes it can go quiet for half a year and then you’re very, very busy with trip travel,” said Glover. “[Visitors] might be going to clinics that are practically closed for half the year. You will have some which literally stop working as a functional clinic for all the winter months, and they set up the following spring ready for the tourists to come, and then in the autumn, they close down again.”

With specialist resources in scant supply, prices going up isn’t unknown as facilities compete for staff, space and equipment.

John Spears, Vice President of Business Development and Marketing for Global Excel, said that he once knew a clinic that had seven different price lists that were dependent not on the time of year, but the country the visitor was from.

“Although there are seasonal pricing adjustments,” he said, “there are also other ways these providers have of maximising their revenue.”

And demand also increases prices – so costs are likely to be higher during peak travel season when resorts are coping with an influx of tourists, as well as their residents, plus any business visitors.

“Turkey, as a destination in comparison to the European Union countries, can be cheaper,” said Glover. “In fact, it’s an evacuation destination in some cases, such as moving people out of the Middle East, or moving people out of northern areas of Africa, and actually it can be relatively easy to get high-quality care in Turkey, and at a price that would be cheaper than the European Union private market. However, even though base pricing is good value, some comparison work at a local level is vitalin order to select the facilities with best payment integrity practices.”

Taking steps to ensure a fair price

Inflation is, of course, a global issue, and there is not much that assistance companies or insurers can do about that. But they are taking steps to ensure prices are fair for everyone.

There are two worlds ... the densely urban areas around the capital cities, and then there’s what happens in the tourist areas

“You can’t necessarily stop inflation because there are pressures causing inflation that we don’t control: general worldwide inflation, increasing costs of consumer items of materials, labour wages, everybody’s having to pay their doctors and nurses more, they’re having to pay the cleaners more, the cost of utilities, the electricity bill, the gas that they’re having to use in those hospitals,” says Glover. “They’re inflationary items that we simply can't control. So what we're doing is not really working against the inflation. We're trying to work around the inflation. We’re using tactics that we would have used historically anyway, we’re just having to work harder.”

One of those is directional care – or steering a patient towards a particular hospital with whom the company has a pre-existing relationship, rather than dealing with a brand-new hospital when a patient just turns up and asks for care.

“We manage claims around the world and our job is to know what’s available – where should we direct patients if we get the chance?” says Spears. “That is a key thing: get your patient to the right level of care, at the right time, in the right place, at the right cost. That’s how you save your client the most money and provide the best customer service to the patient.”

That means assistance companies are having to think about their strategies and communication with travellers before they even get on a plane.

“How do we reach those patients quickly, and how do we get them to call us first?” asks Glover rhetorically. “Because often patients won’t call this company first, they'll just go down the hospital route – they'll call from the [hotel] reception desk, and then they're there. It's much more difficult to steer them at that point. So we’re working with our insurers to see how can we put out marketing to get patients to contact us first, and using that we can steer them into the hospitals within the city or the town where we think we’re going to get the most reasonable rates or that’s going to have the least amount of overcharging.”

Keeping travellers informed

Technology is one way that assistance companies are looking to help travellers understand what they should do if they need medical care while they are away. Spears gave the example of sending an SMS ahead of travel to give the individual the right phone numbers to contact in a medical emergency, or encourage them to download an app ahead of a trip.

“We can send visiting physicians into any resort in Mexico, the Dominican Republic, and around the world,” he said, “but let’s say you’re on vacation in the Dominican Republic, and you’re feeling a little off, wouldn’t it be better simply to use an app and to say, ‘Hey, listen, I’m not feeling well. What should I do?’”

After that, a doctor could make a phone call and triage the patient, and then either send in a colleague to visit them at the resort, or direct them to the correct facility with whom the assistance company has an existing agreement.

Keeping hospitals in the loop

Of course, it isn’t all about what travellers need to be doing. One thing Glover and Healix are pursuing is increasing the loyalty from the hospitals with whom they are working.

“Once we’ve managed to direct patients to specific hospitals, they can see the loyalty [from the assistance company],” he said. “It means that they’re less likely to do things such as overcharging because they know that we’re steering business into them anyway. So it creates a better working environment, a better relationship environment, where the tactic doesn’t have to be to inflate the bill, because we’re sending business their way.

“It becomes in their best interest to have that repeat business and to treat us in the way that we need to be treated: to invoice correctly, and not submit bills that are inflated, and to actually have more reasonable rates.”

Building relationships with facilities can also mean a smoother experience for patients, who can benefit from cashless billing, for example; they are simply able to go into a hospital, present their insurance documents with details of their assistance company, and they will receive treatment without having to give a guarantee of payment in that particular moment. That means they are spared the hassle and stress of having to think about money at a time of emergency.

Spears said that cashless billing is Global Excel’s preferred way of working if a contract can be established; in Europe their Fast Track product means they agree contracts with providers to set out their rules and ensure facilities get their money for treatment quickly.

“There are some providers around the world where we represent the single largest portion of the payments coming in, because we have the clients and the clients are going to that particular area,” he said, “so we’re able to negotiate good deals.”

“Cashless works if you make it work,” agreed Glover. “If you try and implement cashless without putting in the surrounding pieces to make it work, it won’t work.”

Get to know hospital staff

He suggests that companies need to get to know hospital management, their staffing, and their ability to provide proper training for all of their administrative team, ensuring the same expertise is on offer around the clock, rather than leaving it all to one individual who specialises in the area.

“Cashless is only as good as the reception desk,” said Glover. “You don’t want it where one staff member is really good at knowing how to do cashless, and they’re treating the patients, but the guy on the night shift doesn’t know what cashless is, because it then all falls down.”

And cashless billing is likely to work better if a facility knows that an assistance company is reliable and will be sending plenty of patients their way.

You don’t want it where one staff member is really good at knowing how to do cashless ... but the guy on the night shift doesn’t know what cashless is

“You have to put volume to cashless,” he said. “There’s no quality without quantity when it comes to cashless. What you really want to do if you truly want it to work is to funnel [patients] into probably even just one hospital because you need the volume to follow; otherwise you’re just splitting your volume.”

Healix are also benefiting from working with a cost containment partner who operates across the industry with other assistance companies and thus have higher purchasing traction, enabling them to secure discounts on a case-by-case basis.

Ultimately the best way to keep costs low for everyone – even at the height of tourist season – is to ensure everyone is communicating with each other: insurers, assistance companies, medical facilities, and travellers.

“Assistance companies need to build partnerships and loyalty with specific providers,” concluded Glover, “and also encourage patients through their insurance to contact the assistance company at the earliest outset.”