GMMI

Global Medical Management

Monica Rummelhoff – Executive Director, GMMI, Inc. spoke to ITIJ about their views on seasonal price hikes

Which countries are your top ten high-volume traditional trip travel locations, and why?

GMMI specialises in cost containment solutions in the US, so many of our top international markets are in the western hemisphere, but we have members all around the globe, including in Europe and APAC. Within the US we do most of our business on the coasts.

How does your local knowledge of these locations help your customers?

The patient is always our number one priority and one of our main goals is to provide worldwide, cashless access to quality care. GMMI benefits from our group’s extensive global footprint and this network gives travellers access to ‘boots on the ground’ that can assist them in any and all geographical locations; it also empowers us to medically evacuate a patient to a different provider if they would benefit from a better equipped facility or if they’re experiencing a complex condition. Strong, established, local representation guides these decisions and also helps us proactively direct patients to reputable providers. As we know, provider relationships are key and we evaluate them regularly, negotiating reasonable fee schedules in addition to visiting and reviewing the facilities themselves to make sure they’re meeting the right standards.

We know that some clinics in high-volume travel areas charge patients differing prices depending on the time of year, and even because of where they are from. Why does this happen and is there anything assistance companies can do to help mitigate these differing prices?

We do see these practices and they’re largely driven by a lack of regulation in the respective market. It’s yet another reason why local representation is so important, not just in terms of containing costs but also in terms of ensuring quality of care. If you’re dealing with predatory pricing, your membership may also be subject to inadequate care, and an accumulation of additional and avoidable costs as a result. Steering patients to quality providers is the best way to mitigate these risks, but if a member finds themselves at an out-of-network facility, we will do our best to verify that the facility can properly care for the patient. We will also work with the provider to arrange a direct billing agreement, so the patient and their family do not have to worry about up-front payment.

How much has worldwide inflation affected things?

Inflation is real. Medical providers around the world, including in the US and especially in the APAC region, have revised and updated their price lists due to rising inflation rates and costs overall. We have been receiving updated lists from multiple providers in our network, so we’re not only prepared for higher costs, but we’re also comparing prices against what is usual and customary for the region. We’re leveraging this knowledge in contract and claims negotiations, in addition to employing the other strategies that we have to help our clients keep costs down. Another thing to keep in mind is that inflation is impacting quality of care. Staff shortages in combination with pressure for additional savings is resulting in longer wait times for patients and increased barriers to access. This is another reason why working with the right cost containment partner and assistance provider is going to help. We can provide members and travellers with flexible low-cost solutions such as incentivised urgent care clinic visits and telehealth consultations. Our in-house medical team can also step in to provide oversight and make sure the patient is being take care of. Ultimately, we’re going to make sure we’re delivering on what we at GMMI call the five rights of care: the right care, at the right time, with the right provider, for the right price, and the right outcome.

How can technology help with communication strategies for customers when something happens?

Responding to a situation in real time and the skilled coordination of a response aren’t only essential tasks, they’re challenging tasks, and that’s why developing the right technological solutions can really make a difference, both for providers and for members. When you’re dealing with a more significant or urgent medical problem, having a person on the other end of the phone, someone who understands you and knows how to help, is the most important thing. As a provider, you want to be available in these situations because you want your customers to not only know that they should call you, but to want to call you because they have the confidence that you’re going to get them the help they need and make sure they’re taken care of.