Jonathan Edelheit, Principal and Founder Global Healthcare Resources, sat down with Cigna International’s Jai Verma to discuss Cigna’s B2G initiative, their role in expanding medical tourism and how governments and insurance companies can collaborate to improve the healthcare received my medical travelers and locals. The following excerpt of the interview has been edited for concision and clarity.
Jonathan Edelheit: Can you please tell us a little about your background and role at CIGNA?
Jai Verma: I work as the Senior Executive Officer and Global Head of B2G (Business to Government) segment at Cigna, and I’m responsible for the strategic development of the company’s work on government services globally.
I work with our distribution and operations teams around the world to build a center of excellence for Cigna’s B2G business, which provides health coverage for diplomatic missions and government-sponsored students and citizens traveling for treatment around the globe.
Before this, I was responsible for managing the distribution for Cigna in the Middle East and North Africa.
JE: Can you please tell us a little about Cigna, and why it is a global leader?
JV: Cigna is a Fortune 100 global health insurance and services company providing superior quality healthcare, clinical management, and wellness solutions to over 95 million customers through our 40,000 employees across 30 countries around the globe.
We work with customers to help them lead a healthy life with personalized health and wellness products and services that meet their various needs.
At Cigna, our global reach guarantees our clients 24/7 customer support, multilingual call centers located in nine global locations, specialized clinical services, and access to one million medical and healthcare professionals and facilities worldwide.
JE: What does your division in Cigna do, why was it created?
JV: Cigna’s Business to Government (B2G) segment plays a crucial role in helping us expand our footprint globally, as we are one of the few global health service companies with a specialized government offering. Cigna’s B2G services include customized, compliant health coverage solutions for diplomatic missions, government-sponsored students and government-funded citizens traveling abroad for care.
The division was created due to the unique opportunity available to cater to the travelers who incur medical emergencies unexpectedly while traveling outside their country of residence.
JE: You have watched the medical tourism industry develop over the past decade. How has it grown up and where is it headed now? Why are you so optimistic?
JV: Medical tourism is growing across global markets with estimated annual revenues of $50 to $65 billion and yearly growth of approximately 15 to 20 percent.
Many Asian countries like India, Singapore, Thailand, South Korea and China are investing millions of dollars to support the increase in demand for access to quality care across borders.
On the other hand, by the year 2030, elderly individuals are projected to account for one in six people alive, with estimated an estimated increase of 56 percent. That is a growth of 901 million to 1.4 billion, apparently a growing market.
By 2050, the number of people over the age of 80 will reach 434 million, more than tripling between then and 2015. With these figures, we can see the vast potential market for medical tourism.
However, the existing infrastructure in some countries will not meet the growing demands of this population. Patients with higher disposable income will be able, and willing, to travel across borders for care.
JE: What will be Cigna’s unique proposition in medical travel?
JV: Our capability as a global health services provider guarantees our clients and customers the best quality and most cost-effective health and wellness solutions across the globe. Our customers come first, and Cigna personnel are always available to assist with claims, find a doctor or locate the nearest hospital from our extensive global provider network.
Additionally, we are uniquely in a position to provide the best-in-class technological solutions for our customers through dedicated apps and web portals, bringing greater ease and flexibility to the health and wellness experience Cigna offers.
JE: What do you see as some of the leading challenges and opportunities for health insurance companies to adopt policies that cover members globally?
JV: International tourism is at an all-time high, with as many as 46 million tourists recorded to have traveled internationally last year. These tourists journey either on holiday or to relocate for new jobs. This demonstrates an opportunity for global health insurance companies to tap.
However, lack of awareness about the benefits of global health insurance for several emerging markets continues to be a challenge. There needs to be concerted effort to realign the perception of affordability over need-based health services, which can only occur with a consistent and focused effort to educate and inform. At Cigna, we have been able to build a considerable presence across global markets using this approach.
JE: How is the role of government payers changing in medical travel? Are the old referral models dead? What do you predict this model will look like in the future?
JV: Across the world, governments – specifically ministries of health – chooses to send their citizens abroad for treatment, which is especially true of Middle Eastern governments. However, given the recent macroeconomic trends, namely the slump in oil prices, there is growing motivation to look for solutions to optimize public spending.
From our experience offering global coverage for governments around the world, we see that it is increasingly in their interest to streamline and control overseas treatment costs. However, there is also interest in ensuring quality treatment for the citizens at home.
Balancing the two elements of price and quality can only be possible when you have the support of an insurer that can provide economies of scale. At Cigna, this is where we can offer a unique healthcare experience.
Looking at other trends in this space, we see a consistent change in healthcare behaviors the world over. In the Asian markets, we know that there is an inclination to look inwards to their fast-developing healthcare infrastructure for treatment.
The erstwhile centricity on the U.S. markets for healthcare is decreasing. Notwithstanding, there will be cases of people going to the U.S. to benefit from the specializations and expertise available there.
JE: How will Cigna innovate in this space?
JV: Cigna is one of the few global health service companies with a specific B2G segment. The work we have done to improve and tailor our B2G solution, which currently benefits several government stakeholders worldwide, is a strong testament to our capabilities to innovate in this segment.
Keeping with our culture of innovation, we will continue to bring about advancements in our B2G services that will improve the health and well-being of the people we serve.
JE: How will new technologies like telehealth solutions, wearables, patient management systems influence the future of medical travel?
JV: New technologies will provide opportunities to transform every step of the patient’s healthcare journey. Wearables, patient management systems and the like will empower patients to take control of their health and revolutionize how doctors and patients share information, interact, and make treatment decisions.
Patients can have greater access to data about their bodies and are more involved in their overall health and wellness. This technology also enables medical professionals to improve their knowledge and capabilities through the exchange of best practices.
This seamless access to data will also enable patients and providers to surpass borders, allowing, for example, a doctor in the U.S. to treat a patient in the UAE. Meaning that medical travel is reduced given the potential for remote patient care.
However, with the rise in easily accessible information made possible through technology, we expect patients to stand a better chance at finding the right treatment within their country or abroad, especially for chronic conditions.
JE: Is there a role governments should play in working with insurance companies to attract patients to their country?
JV: Throughout Europe, the Middle East, and Asia, the volume of international patients has been growing over the past 15 years with developing countries gaining a more significant market share. Healthcare spending is on the rise across the globe, and governments increasingly realize the importance of investing in healthcare to drive patients to their country.
In the UAE, more and more private players are being encouraged to enter the healthcare sector. These investments are necessary to make the nation raise its attractiveness for medical tourism.
Taking Dubai as an example, their annual revenue from medical travel is set to increase by 13 percent every year for the next five years. Countries that focus on building the right quality of care for the right cost and supporting infrastructure will win in this space.
Governments also play an essential role regarding regulations, which support patients traveling to their country for care. Malaysia, for example, is one of the few countries where the government actively supports and promotes medical tourism.
The number of medical tourists has risen dramatically, with 770,134 health tourists arriving for treatment in the country in 2013, making it one of the major healthcare destination countries within the region.
JE: How important is it for Cigna that its members receive the best care and have a fantastic patient experience?
JV: Our goal is to understand and serve individual needs to help patients achieve what matters most in their life. Our patients are unique, and we are committed to providing them and their families with professional care that is both compassionate and personalized.
Health and comfort for our patients is our number one priority. While we do our best to care for patients, we also provide additional services such as clinical management assistance, second-opinion services, and medical evacuation to meet the specific needs of our customers and clients.
