Benefis offers deep discounts to Canadians, cash payers

The stand flipped over. Reese, 61, grabbed onto the vehicle to break his fall and ended up tearing his rotator cuff. He went to the doctor and had an ultrasound done. Reese was told it would be four to five months before he could see a surgeon and probably an additional month to month and a half before he could have surgery to fix the tear.

"He just felt that wasn't acceptable," said Ken's wife, Jane.

Jane Reese had seen an ad in the local newspaper for Benefis Health System in Great Falls. She called and was told Ken could get in for surgery in two to three weeks.

He ended up contracting an infection, which delayed the surgery, but in December, the Reeses traveled to Great Falls and Ken underwent shoulder surgery at Benefis.

"We've been just so very, very pleased," Jane Reese said.

Several years ago, Benefis started getting more inquiries from Canadian patients wanting to have surgeries done in Great Falls.

In 2007, Benefis set up a package pricing system that allows Canadian patients to pay an all-inclusive fee that includes their hospital stay, physician bill, anesthesia and other costs.

"When you come down, you pay that price up front," said Stacy Allen, clinical navigator at Benefis.

Because patients pay up-front, the package price is offered at a discount, Allen said. Benefis offers that same discount to any patient, local or Canadian, who pre-pays out of pocket.

In 2007, Benefis also created Allen's position of clinical navigator. Allen is the point of contact for Canadian patients. She helps arrange their doctor appointments, schedules surgeries, helps with hotel reservations and basically walks them through the entire process.

"They are coming to a foreign country," Allen explained. "They're not familiar with our health system."

While the program has grown over the years, Canadians still represent a fairly small portion of Benefis' business.

"I'd say it's less than 5 percent at this point," Hill said.

In 2011, about 50 Canadian patients received treatment at the hospital.

"I think it's a business that will continue to grow," she said.

The wait time patients face in the Canadian health care system is one factor in that continued growth.

For the Reeses, who are wheat and mustard farmers, waiting six months for surgery would have been devastating for their business.

Ken Reese's surgery cost them about $10,000, but that was money well spent considering they would have had to hire someone to help on the farm, Jane Reese said.

"It was just worth it," she said. "We're way money ahead by having this surgery done."

Graham Good, who ranches in Alberta's Cyprus Hills, had surgery for a herniated disk at Benefis last June.

"I couldn't get anything done up here, and I was having lots and lots of pain," he said.

Good, 29, saw an ad for Benefis in the Medicine Hat News. He decided traveling south for surgery and paying out of pocket was worth it because he was in so much pain.

"I couldn't work, I couldn't sleep, I couldn't walk," he said.

When Good saw a doctor in Great Falls, the doctor told him if he had waited several months to have the surgery done in Canada it would have caused permanent nerve damage.

"I'm quite thankful they were willing to see me," Good said of Benefis.

Patients can write off some of the cost of surgery done in the United States and can sometimes be reimbursed from the Canadian health system as well, Allen said.

His end cost was less than he expected, Good said.

The rise in Canadian business is also due to medical tourism becoming more common worldwide, Hill said.

"There's just so much more visibility of health care now," she said.

The patients who end up at Benefis are likely shopping worldwide.

"We're competing with Turkey and India," Hill said.

Patients look for the best price, but also look at outcomes and infection rates.

"They're well-educated consumers," Allen said.

Like shoppers and vacationers, the number of Canadian patients coming to Benefis closely follows the exchange rate.

Good's drive time to Great Falls is about four hours each way, and he made the trip three times: for a pre-visit, surgery and post-visit. But even with all the travel, Good is glad he opted to have the surgery done in Great Falls.

For one thing, the US healthcare system is not on the road to becoming like Canada's any time soon (though I wish it were). For another, those with large amounts of cash will always have the option of going somewhere to get served first as long as capital exists.

On a related note, my grandmother was diagnosed with a lung cancer and had it removed within a month and a half of confirmation of the diagnosis... in Canada... for free. If she'd been in the US our family would be dealing with hundreds of thousands of dollars in debt.