Quality Quandary

By Rita Pyrillis

Feb. 3, 2016

While affordability tops the list of health care concerns among U.S. employers and employees, access to quality medical care is a leading worry for Americans living and working abroad, according to a recent survey by Cigna Global Health Benefits.
“Typically, the biggest concern is around quality, particularly for U.S. nationals where their home level of health care is of a very high standard, and that’s followed by where to go to get access to health care,” said Leah Cotterill, vice president for client management at Cigna Global Health Benefits, North America. “In European countries they may have a socialized health care system, and the concern may be: where to go, ‘Will they speak my language?’ ‘Where can I go to build trust with a doctor?’ ”

More than three-fourths of expatriates and their families access medical care while on overseas assignments, according to the report, which surveyed 2,700 people working in 156 countries.

Overseas employees were almost equally concerned with having access to emergency medical evacuation and seeing a quick turnaround on reimbursements for out-of-pocket expenses, according to the survey.

“Emergency evacuation is an indicator of confidence in accessing health care locally,” said Cotterill, a former expatriate who completed a six-year stint in the Middle East in 2013. “Employees want to know, ‘If we can’t access quality care locally, we want you to help us evacuate to the nearest center of excellence.’ It’s a fail-safe.”

During her time in the Middle East, she noted that employees had to be sent to Austria or Germany for certain scans that weren’t available in their host countries.

Offering expatriates competitive and comprehensive benefits packages is critical in keeping turnover rates low, according to Cotterill.

“Medical costs represent on average 4 percent of a total assignment cost over a three-year period, so providing competitive health benefits that eradicate concerns around access and quality is much less costly than having to reassign someone,” she said.

Rita Pyrillis is a writer based in the Chicago area.


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