Medical Tourism A Tool to Control Corporate Health Costs? Dr. Jeffrey Brock President, CEO MedExtra

Medical Tourism A Tool to Control Corporate Health Costs? Dr. Jeffrey Brock President, CEO MedExtra

Medical Tourism Individual, Elective Adapting MT for corporate cost containment?

Corporate Disability A Continuum Sporadic Absenteeism Early Absenteeism < 10 days Late Absenteeism > 10 days Short Term Disability Long Term Disability First symptoms >>>>>> Return to productive work in previous job

Corporate Disability Management Sporadic Absenteeism Non-existent, administration, HR Early Absenteeism < 10 days Admin, HR,? Carrier Late Absenteeism > 10 days Carrier/DM Mgr, Treating MD Short Term Disability Carrier/DM Mgr, IME, MD s Long Term Disability Carrier/DM, IME, MD s, Legal? Different stakeholders, Administrative, Reactive to Canadian healthcare, Silos

Corporate Medical Tourism - When Sporadic Absenteeism? Early Absenteeism < 10 days? Late Absenteeism > 10 days? Short Term Disability? Long Term Disability? When does corporate MT fit? How to optimally integrate for maximal ROI?

Corporate Medical Tourism When? Timeframe 28-120d Timeframe - > 120 d Link to work Tenuous to severed STD Link to work - Severed Treating MD Running Show, Defensive, Foreign Treating to culture MD Against, Foreign to culture So When??? Specialist Not in picture, Specialist Wait Against, Foreign to culture listed, Defensive, Foreign to culture NO Worker Comfortable, No thoughts RTW, No Worker Growing comfort, $ concerns, RTW long gone on long fishing tour distant, No $ concerns, Gone fishing Family Against Family Accepting Risk of wait of PPD High Risk of PPD Growing ROI by Employer day $0, Carrier $+ ROI +ve but diminishing for Employer, -ve Carrier LTD NO

B2B Medical Tourism When? Timeframe - > 10-28d Link to work - Tenuous Treating MD Trusted, Running the show Specialist Not in picture, Wait listed Worker Trusting Treating MD, Accepting situation, No $ concerns, Thinking fishing Late Absenteeism > 10d NO Family Passive Risk of PPD Real & Growing ROI +ve but diminishing for Employer, -ve Carrier

B2B Medical Tourism When? Late Absenteeism > 10d NO STD NO LTD NO Living la dolce vita

Corporate Medical Tourism When? Timeframe - <10 d Link to work - Intact Treating MD Non-existent, Initial involvement Specialist Non-existent Worker Wants RTW, Wants help, Financial concerns Absenteeism < 10d YES Family Wants RTW, Wants help, Financial concerns Risk of PPD Reduced ROI - +ve Employer, Reduce LTD for carrier Ideal Window for Corporate MT -? How?

Corporate Medical Tourism- Design Medical Director Solution Pro-Active, Medically driven Not reactive, not administrative, not single purpose, not silo Pre-disability, Early Absenteeism < 10 days High level Care Management User friendly All parties, one stop shop 1-877... Early Medical Intervention Accelerate diagnosis locally Pro-active to & load-lightening for MD s Efficient, effective & engaged care @ business speed MT Resources Network Addressing all Employee Needs Medical, psycho-social, $, admin, RTW & goodwill Addressing all Employer Needs Claims, $, productivity, ROI, planning, RTW, workplace moral, goodwill Integrated - w/existing DM & RTW protocols Transportable - Throughout Canada

Corporate Medical Tourism Corporate Medical Director Early Medical Intervention - Locally Accelerate diagnosis - Locally Cooperative & Pro-active to Treating MD Efficient, Engaged & Effective Care User friendly for HR, CFO, Union & Employee Strong & immediate ROI Tools - MT Network Fast treatment, preferred rates Administrative DM Existing/New RTW Specialist Existing/New

Cost Savings 39 yo male Specialized heavy equipment mechanic Event : Sprained knee subsequent to tripping Initial Diagnosis : Sprained right knee Final Diagnosis : Torn meniscus Diagnostic Tests : Arthrography, MRI Specialist consult Treatment: Rest, Ice, NSAIDS, Physiotherapy, Surgery, Rehabilitation OnSide advantage: 46 weeks, $22,000 48 yo male Warehouse worker Event: Repetitive strain with arm extended above shoulder (work injury) Initial Diagnosis : Shoulder tendonitis Final Diagnosis : Torn rotator cuff Diagnostic Test : MRI Specialist Consult Treatment: Rest, Ice, NSAIDs, Physiotherapy, Injection, Surgery, Rehabilitation OnSide Advantage: 30 weeks, $22,000

Corporate Medical Tourism Applications Musculo-Skeletal Quebec, BC Gynecology Quebec, BC, USA, Costa Rica Spine USA, CoRa Select General Surgery Quebec, USA, CoRa Urology Quebec, BC, Ontario, USA, CoRa Caveats Complications Care, travel, repatriation Corporate Liability Death, injury Cost Overruns Who pays? Follow up Who?

MedExtra Medical Director Program B2B MT/Corporate Cost Containment