I Couldn't Navigate the Healthcare Industry -- So I Built a Company That Could

By Ruth Lycke, CEO of China Connection Global Healthcare, Marshalltown, Iowa
I had a debilitating stroke in 2001. It left me numb on one side, impaired both physically and cognitively. And though I could live, it was hardly what I considered a normal life -- after three years of therapy I still couldn't string together clear sentences. As my recovery plateaued, so too did the insurance company's willingness to pay for treatments.

So I decided to seek out the best treatments in the world for stroke victims, and, as it turns out, that search led me to China. After just five months of rehab at the First Teaching Hospital in Tianjin, I experienced a full recovery.

There are so many patients in the American healthcare system who are told there's nothing more doctors can do for them. After my treatment in China, I realized that was only a half truth -- American doctors might not be able to do much more, but doctors on the other side of the world can help. I wanted to make sure patients had access to them.
Shifting the paradigm
My company, China Connection Global Healthcare, provides patients like me with access to treatments for a number of challenging, long-term problems -- orthopedic and cardiac issues, multiple sclerosis, cerebral palsy, Parkinson's, and other neuro-degenerative diseases, including strokes -- by helping them find care in China.

We're in an industry called "medical tourism," which refers to pairing travel to a vacation destination with medical treatment. Most people in the industry place more emphasis on where you want to vacation than where you'll find the best treatment. That's pretty much backwards. If I need an operation, I want a doctor with the best success rates -- not one who lives in a beautiful part of the world with gorgeous, sandy beaches. To help patients, and eventually insurers, refocus their priorities, we had to shift the industry's paradigm.

So we refer to our style of healthcare as "destination healthcare" -- it's a term that resonated with both me and our COO. After all, we all practice destination healthcare already. Distance is the only difference among driving to your local hospital, flying to another part of the country or flying to another part of the world -- distance and cost, that is. And since people have long been flying to Johns Hopkins or the Mayo Clinic to get the best care, why not fly to China, where they have some of the best hospitals in the world for some of the most challenging conditions?

Learning from experience
The reason "why not" is because the insurance business is opaque to most individuals. I learned this firsthand after getting released from the hospital following my stroke. While in the hospital, the insurance claims are handled at an institutional level -- hospital to insurer. Once I was released, however, I was filing claims on my own. One misstep, like filing the wrong form, could send me down the wrong path. Then it would take forever to get back where I wanted (and needed) to be.

What's more, the U.S. insurance industry considers truly debilitating strokes to be "futile cases." In our system, people with strokes don't get better; they plateau like I did or get worse. But hospitals in China don't see it that way at all. The hospital I found in Tianjin has the world's best patient outcomes and success rates for treating victims of strokes. They also treat 30,000 new stroke cases a month -- that's 1,000 new cases every day.

To provide patients with better access to destination healthcare, we needed to get the insurers on board. Before my stroke, I was a nurse practitioner and paramedic. I was familiar with the provider side of healthcare -- but not with the intricacies of insurers and claims procedures. So I hired a COO who was. In fact, I'd go so far as to say he's one of only a dozen people around who really understand how the insurance system works and can explain it to others. His insight has been invaluable as we've learned how to provide insurance companies with the proof and reassurances they need to essentially condone the outsourcing of certain treatments.
Nowadays, when a patient wants to improve they can come to us to find out about their options. We then talk to the insurance companies about the cost effectiveness of getting treated in China versus at an American institution. The patient benefits because she gets the best care and doesn't have to wade through insurance red tape by herself. Meanwhile, insurance companies benefit because they get improved patient outcomes at a fraction of the cost. The win-win situation has contributed to our success: We employ 11 people, and we expect our annual revenues to grow from $2.5 million in 2009 to more than $4 million in 2010.

China Connection Global Healthcare wouldn't exist if I hadn't had my stroke, or if I'd settled for the poor quality of life that seemed to be my only option. But I did have a stroke and I chose not to settle. And because of that, I've been able to help so many people who may otherwise have been forgotten.

-- As told to Peter McDougall

Resources

• Read Chinese Connection Global Healthcare's white paper on key considerations for destination healthcare.
• Learn more about destination healthcare from the Medical Tourism Association.