Today we announce the launch of our new cross-border payment solution for patients traveling overseas for medical care. The offering is targeted at healthcare institutions serving the growing market of patients seeking medical care abroad – estimated at up to $40 billion annually and growing at a rate of 15-25% per year. We made this announcement at Money20/20 which took place this week in Las Vegas.
Approximately 11 million patients seek health care outside of their home country every year according to Patients Beyond Borders, an organization specializing in medical tourism. The primary reasons range from the availability of specialized treatments, long wait times for care in their home country, desire to recover away from friends and colleagues, and the high cost of care at home.
We decided to move in this direction because, “People started coming to us- there’s a good correlation between educational institutions and medical. Many top universities have hospital systems, and the CEOs of academic organizations started introducing us to medical executives having the same pain points. Patients had no easy and convenient way to pay medical bills remotely; these were large dollar amounts with consumers coming from other parts of the globe needing to make payments quickly and securely. The hospitals aren’t structured to handle 24/7 international payment-related questions, consumers are paying really high forex rates, and hospitals are hit with cross-border fees and reconciliation problems. We saw the opportunity on the market side and folks asked for our solution to be brought. Flywire is not a vertical solution- it can be taken to any vertical. There’s really nothing education specific about it,” said Mike Massaro, CEO of Flywire.
We are initially focusing on health care facilities in the United States serving the estimated 1.2 million international patients who opt for treatment here each year. Health care institutions can now offer our advantages to international patients seeking medical care, providing a stress-free, localized payment experience while streamlining payment collection and reconciliation efforts in the back office.
“The payment challenges faced by hospitals and their international patients are similar to those faced by educational institutions and their international students,” said Massaro. “A significant percentage of international patients pay for care abroad themselves, without the involvement of insurance companies. It’s a stressful time and patients want the peace of mind knowing that the payment side of their treatment is taken care of, so they can focus on getting better. On the hospital side, the reconciliation issues for international payments can be complex and time-consuming. The more efficiently the hospital can confirm payment, the better it is for everyone involved.”
Our cloud-based solution enables hospitals to offer international patients a variety of familiar online and offline payment options in multiple currencies. Patients can pay in their local currency, using a simple web experience that is customized by their country of residence. Our discounted currency conversion rates can also offer significant savings when compared to rates offered by banks in the patients’ home countries. Funds are transferred quickly and safely, and patients can track payment status online, via email or SMS. Patients also receive 24/7 multilingual support via phone, chat and email.
Although patients can come from anywhere and go anywhere, in many cases, patients choose the U.S. for acute, serious care, making the decision based on factors such as cost of care, the variety of procedures offered and location.
The challenge in serving these international self-pay patients is having a process that can facilitate the billing and sending of invoices to them – cross border – and how that might need to change in order to accommodate the growing demand.
A big change is billing. Payment in full, based on an estimate of services, is required up front, before a patient arrives. Though some health care providers are more advanced in producing these estimates than others, many have databases that determine the specific costs involved with a procedure, and can add additional costs to cover possible unknowns.
The challenge then becomes both billing – based on an estimate – and receiving and reconciling funds from patients before they arrive. Recently, an Australian family was seeking care for a child at a prestigious U.S. hospital and needed to send their payment to the hospital as quickly as possible. The hospital provided the family with an estimated cost and we walked the family through the process to ensure that the payment arrived at the hospital before they did.
It’s one element of a really stressful, scary time that can be taken and put aside and then you can really focus on getting better yourself or getting your family member better.
As international medical travel becomes more common and more funds are processed between patients and health care providers across borders, keeping payments both convenient and cost-efficient is key.
The division at Cleveland Clinic, rated the second best hospital in the U.S., appoints a “global services coordinator” to its incoming patients to provide them end-to-end assistance with planning their first international appointment, including visa information, billing and payment assistance, lodging and even special rental car discounts.
In 2012, the Cleveland, Ohio-based hospital treated 3,200 international medical travelers — a third of whom came from the Middle East. Since then, the hospital has extensively grown its international patient services division to cater to its increasing traffic. In 2016, the hospital treated 4,000 medical travelers, who came from 170 countries. To entice a larger number of medical travelers, top medical centers, especially in South Florida, New York and Houston, have been spending millions of dollars cultivating their facilities to attract international patients. More recently, they are seeing a growing influx of patients from China.
Health care facilities across the U.S. are implementing new programs that appeal to a diverse base of patients seeking treatments today. The special language assistance program is one such offering that is a common denominator at all of the popular health care facilities in the U.S. The Cleveland Clinic currently offers its services in 12 languages. Its top competitors — Mayo Clinic in Rochester, Minn., which is ranked number one, and Mass General in Boston, Mass., ranked number three — do the same.
These hospitals are also furthering their efforts to reach patients who cannot travel all the way to the U.S. by offering second opinions through telephone and video conferencing services. Nine out of the top 10 U.S. hospitals now remotely offer second opinions for a $500–$700 consultation fee.
US hospitals go abroad
With demand for high-quality and advanced medical treatment growing, U.S. hospitals are now increasingly expanding their footprint overseas by establishing representative offices in their target markets.
Mayo Clinic is particularly focused on tapping into affluent Canadian and Latin American travelers wanting to seek treatment in the U.S. The hospital has opened three representative offices in Canada and one each in Colombia, Ecuador, Guatemala and Mexico that act as local points of contact for patients in the region.
The hospital publicizes its specialties in treating cancer, neurology, cardiovascular diseases and transplants and offering top-notch executive health programs.
Johns Hopkins, which is ranked number four in the U.S., is using collaborations with other hospitals as a strategy to expand its international presence. So far, the Baltimore, Md.-based hospital has collaborated with 19 hospitals in North America, Europe, Middle East, Asia-Pacific and Latin America to offer its services outside the U.S. The Cleveland Clinic, on the other hand, exclusively targets Middle Eastern patients by offering Arabic translation of its text and video archive on its website.
The hospital has also opened representative offices in Weston, Florida; Toronto, Canada; and Abu Dhabi in the United Arab Emirates (UAE). Seeing the high traffic from the Middle East, in 2014, the hospital signed a 15-year partnership with the UAE to open an acute care center in Abu Dhabi, where patients could avail themselves of the same standards they were offered at its facilities in the U.S. For the Cleveland Clinic, the opportunity to expand its presence to the Middle East meant building a new revenue stream.
“We look at it as our petrodollars coming home to Cleveland,” the Cleveland Clinic’s CEO, Dr. Toby Cosgrove, told Reuters at the time of the announcement. “It’s money coming back to us.”
These expansion plans come at a time when U.S. health care facilities are facing intense competition from Asian countries, such as China and India, that offer cheaper medical treatment options. Whether their international investment strategy will globalize U.S. health care for good remains to be seen.