Non-surgical Body Contouring


1490 East Foremaster Drive, Suite 260
St George, Utah 84790
(435) 523-3370

Physician-owned, non-surgical body contouring and medical spa

SculpSure is a non-surgical, non-invasive body contouring system for the reduction of stubborn fat in areas such as the abdomen and love handles without surgery or downtime.

or visit us at
1490 East Foremaster Drive, Suite 260
St George, Utah 84790

Concierge Aesthetics & Wellness Brings a Unique 25-minute procedure that eliminates 24% of the treated fat cells without surgery.

People travel miles to treat their trouble spots that seem resistant to diet and exercise.

Save time, money, and hassles

Applicators are placed on your desired treatment area to send light-based energy, which treats and eliminates fat cells.
In the weeks following treatment, the body naturally eliminates the cells resulting in a slimmer appearance.

People report a tingling sensation as the lasers work their magic.

The treatment is well-tolerated without medication or anesthesia. You can have a treatment over your lunchbreak and go right back to work.

Most people notice results within 6 weeks of their treatment.

Our packages are designed to allow you to see the results over a six-week period as the body begins to eliminate the destroyed cells naturally. Optimal results are usually seen at 12 weeks. In between, our coaches and therapists use natural techniques to enhance your results.

At Concierge Aesthetics & Wellness, we believe that everyone should have access to quality aesthetics & wellness, no matter where they live or work.

• Nationally, more than 90% of patients are satisfied
• SculpSure works on all skin types
• There's literally no down time
• The procedure takes 25 minutes
• You can treat multiple areas at once
• Treatments are far less costly and more effective than competing laser technologies

You'll notice results that last permanently because the fat cells are permanently destroyed during the treatment.

How does this work?

Call for an appointment

Call our office at (435) 523-3370 and book a consultation to determine if you are a candidate for the treatment. You'll visit with the Physician Assistant and discuss your concerns and treatment objectives.

Choose Your Package

If you are a candidate, you'll next meet with our concierge who will arrange your appointments for the laser sessions, a nutrition consultation, a spot toning consultation and set up your next visits with our medical massage therapist.

Before & After Photos

Just like any other aesthetic treatment program, you'll have before and after measurements and photos taken to document your progress.


One treatment area

4-laser heads
$ 2175
  • Initial Consultation
  • 2 treatment sessions; 6 weeks apart
  • Nutriton and Toning Consultations
  • Weekly Soft-Tissue Mobilization by a Licensed Medical Massage Therapist
  • Before & After Photos

Medical financing for your non-surgical body contouring package is available on approved credit.


Two treatment areas

6-laser heads
$ 2675
  • Initial Consultation
  • 2 treatment sessions; 6 weeks apart
  • Nutriton and Toning Consultations
  • Weekly Soft-Tissue Mobilization by a Licensed Medical Massage Therapist
  • Before & After Photos

Most patients with a modest FICO score and  verifiable bank account and job will qualify in about 3 minutes!


Two treatment areas

8-laser heads
$ 3175
  • Initial Consultation
  • 2 treatment sessions; 6 weeks apart
  • Nutriton and Toning Consultations
  • Weekly Soft-Tissue Mobilization by a Licensed Medical Massage Therapist
  • Before & After Photos

Gift cards are available for  holiday gift-giving for any of  our services.

Other MediSpa Services


Attention to how one looks and feels using minimally -invasive cosmetic treatments to enhance one’s physical appearance

• Facials
• Skin Care
• Beauty
• Ageing


The active process of making choices toward a healthy and fulfilling life.

  • Fitness Counseling
  • Nutrition Counseling
  • Weight Management
  • Biometric Screening
  • Stress Management
  • Cardiovascular Improvement
  • Fall Risk Improvement
  • Amino Acid Counseling

Massage Therapy

  • Swedish Massage
  • Deep Tissue Massage
  • Fibromyalgia Care
  • Lymphatic Drainage
  • Soft Tissue Mobilization
  • Rapid Tension Release
  • Sports Massage
  • Relaxation Massage


Purchase a monthly or annual membership and receive discounts on services and gift cards for yourself, your friends, and your family members.

© 2021. Concierge Aesthetics & Wellness. All rights reserved..


Imagine Life Without Hip or Knee Pain

Dinner with the Doctor

Gregory J Hicken, MD FAAOS,
Board-certified, Mayo Clinic Fellowship-trained
Orthopaedic & Sports Medicine Surgeon
is a leading robotic joint replacement authority.

Dr Hicken will present an information-packed, factual contrast and comparison of the robotic total and partial knee and hip replacement options in Southern Utah.

Invite a companion and join us for a delicious, fully-hosted, three-course dinner, courtesy of St George Surgical Center, at Magleby’s in St George. 

Dr. Hicken will explain the advantages of robotic-assisted precision and accuracy for implant placement, balancing, and alignment.

You’ll learn about:

  • the types of implants being used in Southern Utah
  • understand the materials of which the different implants are made
  • learn about the radiation exposure required for surgical planning
  • the use of low / non-opioid pain management and multi-modal pain management, a technique he helped pioneer
  • how long it usually takes to return to your active lifestyle and independence
  • advanced options for infection control and wound care
  • and more!

Register today by submitting this form to reserve your seat for Dinner with the Doc

Workers’ Compensation Claim Costs Increase as Workers Mature

By Maria K Todd, MHA PhD

CEO & Founder
Mercury Healthcare International, Inc.

The 3rd edition of Aon’s biennial Health Care Workers’ Compensation Barometer report, which explores trends in frequency, severity and overall loss rates related to workers’ compensation in the health care industry. The report finds that for the 2017 accident year, health care systems will face a complex environment of emerging risks that will have a direct impact on workers’ compensation. This should be of interest to healthcare providers, insurers and healthcare organizations.

Nurses work in the hospital, clinic and home care settings.  Nurses tend to spend the most time with the patient, assuming an active role of facilitating medical care, medication, and are often the ones tending to the patient’s various needs. Due to the direct interaction with patients, it is not a surprising result that nurses are the most frequently injured workers in health care.

What we learned

  • 70% of employers surveyed have a qualified self-insured program for workers’ compensation injuries and permanent loss settlement funding.
  • 53% of American nurses are over the age of 50.
  • 65% of nurses worked shifts of 12–13 hours.
  • A majority of claims result from injuries to shoulders and back injuries – accounting for 71% of claims reviewed.  For workers over 50 years old, these injuries are 29% more costly than those 50 and under.
  • Approximately 80% of all work injuries are strains and sprain injuries.
  • The average medical cost of employees aged 51 and older is $4,300 and the total average cost of the claim is $8,200.
  • Safe Patient Handling and Mobility (SPHM) standards lower claims costs – $6,000 versus $7,800 – and have reduced the incidence of health care worker injuries by up to 95 percent.
  • The average cost of claims for health care systems where more than 25% of their staff is certified is $4,200 versus $7,300 for a system that has less than 25% of their staff certified in SPHM.
  • Health care systems will experience an annual loss rate of $0.75 per $100 of payroll, nationwide assuming a $500,000 per occurrence limit.
  • Loss rates are projected to increase at a 1% annual rate.
  • The frequency of workers compensation claims has been slowly and consistently decreasing over the past ten years.
  • Claim frequency is projected to decrease at an annual trend rate of 1% while claim severity, including medical, indemnity, and expense costs, may increase at 2% per year for 2017.
  • 50% of survey respondents use their TPA (Third Party Administrator) for pharmaceutical review. The average total cost of a claim is $5,600 versus $8,600 for those not utilizing this type of review
  • Liability payments are paid separate from the medical expense costs. These amounts are often paid for lost time from work, and travel expense to and from treatment sites.  In 2015, the average liability (indemnity payment to make one whole) was $22,600 for closed case files.
  • Average medical paid for closed case files in 2015 was $4500. Average expenses paid for closed case files in 2015 was $1360. 
  • Home care nurses had the highest average losses on lost time liability claims due to on-the-job injuries.   However, a different cause of loss is the third most frequent for the Home Health department and that is Vehicle Related claims.  This higher exposure to automobile accidents makes vehicle related claims the third most frequent cause of loss for the home health care department at 12.6% of all home health workers compensation claims.
  • Surgical nurses reported 33% of all injured nurse claims while ER accounted for 12.7% and ICU accounted for 12.1% of  on-the-job injuries
  • Healthcare is a fast-growing sector right now, and workers in this industry face a myriad of hazards on the job. Employers must measure their workers’ compensation exposure against their peers, maintain standards of practice and safety levels and reduce the overall cost of risk.

Domestic medical tourism may be an alternative worth consideration in a small number of cases:

  1. Removal of the injured worker from the local healthcare scene eliminates gossip, maintains privacy, and reduces bias in treatment and disability decisions
  2. May save money and simultaneously improve outcomes at a regional center of excellence (critical in rural and remote care settings where specialists may be scarce or limited)
  3. Employees feel appreciated and valued when their employer sends them to the best possible Center of Excellence instead of the in-house “company clinic” (even if the company clinic is excellent).
  4. Based on closed case file cost statistics, cross border health services rarely make sense or save money in this setting, and domestic medical travel may make sense in a small percentage of the surgical cases for the most severe injuries. Most cases are resolved with outpatient physical rehabilitation, bracing and splints, modest pain management, and work hardening programs sourced locally.
Distribution of Claim Counts and Incurred Dollars by Size of Loss
Size of loss % of Claim Counts % of Total Incurred
Less than $5,000 85.7% 10.5%
$5,001 to $50,000 11.0% 25.6%
$50,001 to $100,000 1.8% 17.0%
$100,001 to $250,000 1.1% 23.7%
$250,001 to $500,000 0.3% 14.2%
Greater than $500,000 0.1% 9.1%

Almost 86% of claims contributed less than 11% to the total incurred dollars.

Source: Aon, 2016


Overall impression with the study

My overall impression of the study was that it was well-developed, reasonable and informative. We congratulate Aon and its associates for the laudable work done on this biennial study.

Percent of claims by body part

Body part – injury
% of claims
Back 51.34%
Shoulder 20.06%
Wrist 6.74%
Arm 4.16%
Knee 3.98%

Source: Aon

Average severity
by Age Group

Total Cost



Medical Cost


<25 2300  1600
26-30 3000 2000 
31-40 5000 2800
41-50 7700 4100 
51-60 8100 4100
61-70 8500 4600 
70+ 9200  5700

As shown above, the average total workers compensation cost, including indemnity, medical, and expense, for the 51 and older age group is around $8,200 per claim with a corresponding average medical cost of $4,300.

Source: Aon, 2016


Self-insured risk for workers comp in healthcare organizations

For the vast majority of health care organizations, workers compensation risk involves a self-insurance program, whereby the health care system retains risk for claims up to a per occurrence “attachment point.” Systems establish a self-insured retention by qualifying under respective state laws. Workers compensation is slightly different than other lines of business in that it’s highly regulated by the government to ensure employers are able to fund their workers compensation costs. There are multiple vehicles health care systems can use to fund the retained portion of their workers compensation costs. According to the Aon survey, the most frequently used funding mechanisms are balance sheet entry, a captive, and a trust.  Commercial re-insurance coverage is usually purchased to cover amounts in excess of the attachment point subject to a per occurrence policy limit. the listing of these insurers is then included on Schedule A of the Form 5500.

29% of employers fund their deductible or retention through captives and 19% use a trust. The remainder use balance sheet entry.

In a typical large deductible program, the commercial re-insurer provides coverage up to a certain per occurrence policy limit and then seek reimbursement for the deductible portion of the claim.  Aon identified that about 30% of healthcare organizations have a large deductible program and 70% have a self-insured retention.

The selection of attachment points and insurance limits is the product of negotiation between insurers and insureds. The system’s risk taking philosophy and claim history are all important factors in the determination of attachment and limit. For smaller health care systems, having less than 750 physical hospital beds, do not have retentions or deductibles higher than $1 million, however, for larger systems, having greater than 750 beds, approximately 40% have retentions greater than $1 million.

No mention of how lasered claims were handled by the commercial reinsurers.

Program management, contracting authority and settlement in direct supplier relationships

Administering a workers compensation program involves developing, maintaining, and managing the program. Employers approach the workers’ compensation program management in a variety of ways. The employers who are self-insured are responsible for establishing standards and procedures for all matters relating to workers compensation, including provider contracting, claim investigations, settlements, and litigation. They are also responsible for effective communication with all parties involved, including employees, managers, insurance carriers, medical personnel, and even lawyers.

  • 34% use a TPA for legal bill review. This function is solely to examine legal bills associated with workers compensation claims. 
  • 13% use a return-to-work vendor (an outsourced case management service)
  • 5% use a nursing hotline before treatment
  • 48% use pharmaceutical review outsourced service

Many states use a utilization review service to determine if a proposed treatment for an injured worker is necessary and/or appropriate. In California, this step is mandatory for every treatment request.

Who handles the program management?

  • Various means 22% (TPA, ASO, etc.)
  • Risk Management Department 39%
  • Finance 0%
  • HR or Legal 39%


Finding ROI on Wellness is No Easy Task

By Maria K Todd, MHA PhD

CEO & Founder
Mercury Healthcare International

At EBA’s Workplace Benefits Summit Wednesday in Nashville, Tenn., Winston Ball, chief operating officer for hubbub health said, ““To find ROI [on wellness] can be very difficult today. You may need 1-3 years of claims data. You need to be able to compare claims data from year to year and compare claims data that has not served wellness either.”

He’s right. Every day when we work on new corporate medical travel administration program development for self-funded employers, we find ourselves poring through past claims data, predictive modeling reports and plan beneficiary assessments to determine “if” and “why” someone employed by the company or recently retired would want to enroll into a comprehensive medical travel program for executive checkups, or surgery and medical care away from home and how our client can hone in latch onto that reason.

We don’t approach any client with a one size fits all approach or even the assumption that a medical travel program is right for a particular group. Not without the data to back up the assumption and model predicted outcomes.

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What’s Missing from the Wellness Success Strategy

1) Visible leadership by company executives, middle management and at the water cooler gossip level.

2) A clear message from the company that a culture of wellness and optimal health is important to bottom line performance, raises, productivity, absenteeism, presenteeism and work injury prevention.


Michelin North America executive Barry Cross announced in September 2016 that the tire company intended to recruit a chief medical officer to keep its employees “as healthy as genetically possible.”  That’s not something we see often enough.  Most employers that call us to investigate the potential of a medical travel program can’t even access their past claims data from their TPA.  When we ask why not, they tell us that the TPA won’t release it for review –  not by them, not by anyone.

In this day and age, for a self-funded health benefit plan to accept a “no” answer to that request, is just plain ludicrous. It is grounds for termination of the contract with the TPA or ASO… but only if your Service Agreement contract with them enabled you to request and receive the data in the first place.  Many plan administrators and benefits managers overlooked that little detail in their Service Agreement with the TPA or ASO or PPO.  Then when they need it to analyze their own claims data or have it analyzed by us – they meet with fierce resistance.

Why? Because perhaps the TPA, ASO or PPO knows that it isn’t doing its level best to bend the cost curve – but doesn’t want to make it easy for the employer to examine and determine that there’s room for improvement.  I have faced this resistance for the past 20 years when working with client employers, unions and associations on corporate medical travel administration and plan design.

Plan Administrators have a fiduciary duty to ensure to ensure that patients receive quality care, at the right time, in the most appropriate setting and to save trust fund or corporate funds earmarked for the health benefit program. If they cannot access the data, how can they be compliant?  Surgeries account for 30% of total medical spend, according to our analysis of many employer accounts. Sometimes, the dollars aren’t different, but the quality and clinical outcomes are better if the care is sourced at the same price a few counties over, or a few states away or across the country.

The decision Michelin Tire has made to create a sustainable culture of health that yields long-term positive return on investment is only the beginning of a 10-15 year transformation of the company’s approach to benefits, compensation and retirement for its 22,000 North American employees. To this, they have also added 4 worksite health centers. Michelin spends about $250 million a year on total healthcare, which includes four family health centers with annual operating budgets of $5 million. If they can save $1 over the operating costs and sunk costs for startup of those for worksite health centers, they are in the black.   These four centers aren’t the typical grungy public health clinics either.  The Michelin Family Health Centers, located in Greenville, South Carolina, Lexington, Kentucky, and Ardmore, Oklahoma, offer 30-minute appointments to employees. Michelin describes the centers as “concierge medicine,” which is becoming a growing trend in the benefits package for employers.

For the past 13 years, Mercury Healthcare International has advocated for this integrated approach: worksite health centers, concierge level care that drives patient engagement, prudent local health services procurement complemented by a corporate medical travel program where it makes sense to do so. We’ve developed a few worksite health centers, evaluate several others that were not feasible for one reason or another, about 430 concierge medical practices in the USA and abroad, and we built the first and only globally integrated health delivery system® for corporate medical travel services in the world. This concept by Michelin proves that American employers are interested.  Michelin has moved the needle on ROI in a positive direction. Through the centers, along with gym reimbursements, free medication for condition management and on-site gyms, Michelin reduced metabolic syndrome by 12% in three years.  They plan to add telehealth for reinforcement.

Bending the cost curve

Despite spending $250 million a year,  Michelin, like many other large companies, is struggling with rising healthcare costs. Cross said his company is seeing $32 to $40 million in medical increases annually, a trend that most employers are finding to be unmanageable.  For Michelin to see a benefit through medical travel that would reduce costs by $10 million a year, it needs to have 667 cases with an average savings of at least $15,000 per case across its 22,000 North American lives.  Can it be done?  It depends on what the past claims spend data indicates.

Individual digital health engagement – Patient Generated Health Data (PGHD)

Yup, its a new acronym!

Patient-generated health data (PGHD) is health related data created, recorded, or gathered by or from patients (or family members or their caregivers) to help address a health concern. PGHD include health and treatment history, biometric data, symptoms, participation in wellness activities and lifestyle choices. Some is recorded by a device and some is language-based information supplied by the employee or plan beneficiary.  PGHD combined with mobile remote monitoring can also be used in the medical travel setting to reduce complications and readmissions, and measure health status between the care discharge at the destination and the continuity of care back home – especially where complex chronic conditions such as CHF, COPD, NIDDM, reactions to new medication regimens, and hypertension are involved.

The Pew Research Center maintains a website where their research related to health and healthcare is posted. The Health Fact Sheet found there includes the following information:

  • 60% of U.S. adults say they track their weight, diet, or exercise routine
  • 33% of U.S. adults track health indicators or symptoms, like blood pressure, blood sugar, headaches, or sleep patterns
  • 12% of U.S. adults track a health indicator on behalf of someone they care for

A November 2015 survey, conducted by Pew, found that 68% of U.S. adults own a smartphone and use health apps on it. Another study by Accenture (2016) reported that the use of health applications has increased from 16% in 2014 to 33% in 2016.

Health Risk Assessments Coupled with Executive Checkups as Medical Travel Incentives

A health risk assessment is a questionnaire, usually brief, that is used to capture information about health risks. A HRA may be provided online by a health plan or a healthcare information or wellness site.  They are actually better when conducted in person, in front of a qualified health practitioner as part of a comprehensive executive checkup – done all in a day, at a pleasant destination and perhaps coupled with a team building exercise, a training conference, or a bleisure vacation.

A HRA includes lifestyle data and sometimes quality of life data. Typical questions pertain to smoking, alcohol and drug use, UV exposure, diet, exercise, and seat belt use. Poor behaviors related to these items increase risk for illness and premature death and higher health costs. A HRA will usually include the date of last checkup, Blood Pressure, Total Cholesterol Level, High Density Lipoprotein (HDL), LDL cholesterol, date of last vaccinations and date of latest cancer screenings.  Coupled with a mandatory executive checkup for corporate executives, companies can avoid major health surprises, intervene sooner to mitigate acuity and chronic disease, or start succession planning if they find a serious condition was overlooked and is now at the late stage of irreparable health harm.  The information gleaned from HRAs can result in improvements in quality, care coordination, patient satisfaction, patient safety, rapid intervention and cost savings.

Companies that are able to invest and transform healthcare will be better equipped to control rising costs

At Mercury Health Travel, we’ve been coordinating corporate medical travel for decades. What we discovered didn’t take any special insight, just a willingness to call out what we say time and time again.   Most companies are unable to efficiently manage employee benefits programs in the face of rising healthcare costs because they lack effective tools and continue to do the same things over and over and over again, resulting in higher costs, reduced employee health, and lower productivity.  Perhaps a different approach is in order?

As I said before, many companies “wing it” without data that they should have access to from their ASO, TPA or PPO plans. Others rely on outdated third-party reports, siloed systems, and manual processes to make decisions and administer programs. Many companies require plan beneficiaries to navigate through complex health plan websites instead of a straightforward, role-based internet that only shows them relevant information about their personal eligibility, benefits and coverage. Without required data, no company is going to invest in any medical travel program analysis or feasibility study. If they cannot measure their healthcare costs and baseline performance, they cannot quantify results and categorize them as worth continuing or abandoning the program in favor of trying something else.  That “something else” and “bright shiny object” syndrome has most benefits managers fatigued.

The new Higowell medical travel program we helped to design with our partners in Ireland and Germany is not limited to medical travel benefits management. It can serve as a full scale, health benefits platform can enable decision-makers and employees alike, creating opportunities to increase wellness and employee retention while reducing costs and coordinating care across an integrated health delivery system like the one developed by Mercury Healthcare International. What’s exciting is how little the Higowell system costs. An employer can have the system up and running, tested and in service for less than $100,000.

About 30% of employers we’ve interviewed have no plan to tackle rising healthcare costs

To fail to plan is to plan to fail. The remaining companies we’ve spoken with either plan to transfer more cost share to the beneficiaries or cut benefits. These two flawed strategies will hit them in other ways: risking negative outcomes in employee health and wellness and the ability for companies to attract new talent.  Rising healthcare costs also drain company resources and their ability to invest and pay better salaries.  This, in turn, reduces the ability to be a competitive employer and attract the best talent.  As employees get “bummed out” about benefits, even if the work is stimulating and personally gratifying, they begin shopping and updating their LinkedIn profiles to be more attractive to recruiters. When they leave, they take company secrets, methods, company paid training, new skills and best practices and  carry them to competitor organizations.

A system like Higowell, enables both continuity of care and case management for a nurse and a corporate medical director, like the one Michelin will hire, to make decisions, manage programs or investments, create wellness campaigns or administer benefit programs in real time.  Over 70% of employers we’ve spoken with currently rely on data supplied by their TPA, ASO or PPO without any benefit of verification and audit because the raw data is not available to them, even when they ask. These are often sent out quarterly, and it is then too late and too difficult to remember what was done that caused the costs. Fewer than 5% of employers we’ve spoken with receive reports more frequently than once each month. They cannot react to short term trends in spending on healthcare.

“Fewer than 5% of employers we’ve spoken with receive reports more frequently than once each month.”

Employers also find it impossible to properly manage demand for mental health services, because HR and the EAP provider aren’t aware of the health impact stemming from lack of timely access to care for their employees until months later. If they were made aware of this trend in real time, they could steer employees toward available benefit programs and cost effective treatment – in person or through telehealth. The lack of these inputs hinders advancement and improvement in managing healthcare within self-insured companies.

About one-out-of-five employers are currently able to use internal analytics tools to manage benefits programs and investments in this way. Again, much of this constraint stems from lack of access to data because someone else with a self-serving contract is in a position to restrict access to it and prevent the employers from making good benefits decisions that are unique and innovative for their company.

Fiefdoms of the Health Data Warehouse

The hired data custodians have negotiated contractual restrictions and deals to protect their fiefdom in a bizarre conflict of interest that maintains the TPA, ASO or PPO’s status quo and protects them from having to keep up with innovation or risk losing the account. Without data that is timely, the employer cannot call out the TPA, ASO or PPO and say, “I want something different.” or “Let me see what’s happening with such and such utilization.” That’s especially true if the employer isn’t getting data until it is months old, and then cannot challenge the data because all they get is a pretty report, and not source citations and statistics and trend reports in a timely manner.

Going forward – what’s next?

At Mercury Health Travel, we believe that we can help employers work around the data access and decision-making process. First, we don’t want to hoard their data and reports. We want to review them with them every month to check in and see how we can save them money and raise quality. First, by integrating data sources across silos, bringing reports in-house, and using analytics tools, our clients will gain the real-time insights required to manage their programs effectively whether their program is across the nation, across the county or across the ocean.  We want to help them examine and identify healthcare costs and quality problems before they occur and evaluate the levels of plan beneficiary engagement and success of programs – including a medical travel program, if warranted, on an ongoing basis. We pledge to help them improve decision-making capabilities starting with an examination of current business processes, technology, and skills to leverage the wealth of data available.

We talk with employees to see if they are in for a medical travel option. We make sure that any program we design for an employer, labor union or association is going to take into consideration employees’ individual needs and provides them with contextual, relevant information – not scare them by allowing them to think that they will soon be forced to get their healthcare in some distant developing country where the message is a bird song – “cheap cheap”.  We don’t just say “here’s your new portal software”. We have the ability to test the user experience before we install it on a beta pilot program with only one or two conditions, surgeries or focus areas.

We don’t offer a one size fits all medical travel program. Each one is custom designed for the client and its workforce, and costs far less than most employers imagine and can integrate biomarkers, telehealth, worksite health centers, and medical travel to augment the employers current leased network arrangement from a local or national TPA, PPO or ASO. The days of doing the same thing over and over and over again and just paying more are over.


Bleisure Travel Tips for Busy Road Warriors

by Maria K Todd, MHA PhD

CEO & Founder
Mercury Healthcare International

Want to save money on your next vacation travel opportunity?

Many websites share tips and hacks about how to save you money on vacation. Most don’t share this one.

“Bleisure travel” is the combination word for when someone combines or extends a business trip with leisure stopovers and extended stays to play while off the clock.

With a little smart planning, your work trip can underwrite some if not all of your next vacation. Here are a few tips to get you started.

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Loyalty Programs

Join ’em all. Whether for hotels, airlines, or websites, join every one and place the entire list of membership ids and passwords in your contact file under “Travel Programs”. That way they are all in one place and with you wherever your contacts go.

Fly Premium Economy

If your employer permits premium ticketing for long-haul trips ask if this is okay.  In preparing your preemptive argument, keep in mind that when an international business class ticket is listed at full price for $6500, your corporate travel agent will likely get some discount. So don’t embarrass yourself with a screen grab of that page from a website and expect anyone to base permission on that. Ask the corporate travel desk what the negotiated discount rate of the ticket would be, get a written memo to that effect. Then go shop premium economy for two. While it is a win-win for both company and employee if they permit you to do the swap, many companies just say now and drop those savings to bottom line. Be warned, though – leg room is critical on long flights. Even in premium economy, wear support hose, drink water and walk around hourly if possible. Buy an annual travel policy for about $440 from Allianz just in case you get a DVT or experience a health problem while traveling.

Stay Over the Weekend

My first time I did this was to explore the Oregon Coast. I was supposed to return from my speaking tour from Eugene on Friday evening. Instead, the flight was so expensive I asked if I could fly home on Monday – or to my next speaking location on Monday from Portland. The difference was more than $1000. The seminar company said “of course”. I kept the car, returned in Portland instead of Eugene, and found three lovely hotels for Saturday and Sunday night. I stayed in my Thursday night hotel an extra night to avoid an extra move after speaking all day.  On Saturday, I woke up late, ate breakfast, checked out and headed to the coast. I drove up the coast, stopped wherever I wanted and when I got tired and hungry I stopped without reservations and had a blast. At Astoria, I made a right turn. I chose a hotel near the airport, did a quick load of laundry at a laundromat, repacked my luggage, and continued on to my next three stops on my speaking tour.  When I turned in my expense sheet, I listed the stayover charges for gas, food, and lodging and car rental. It was less than the $1000 and the seminar company didn’t flinch. They were happy to save about $400 of the $1000. Now that I own the company, I allow staff to do this anytime it makes sense.


Travel to a Destination Where you Can Schedule an Executive Checkup


If you have a funded HSA or HRA account, and your company has already covered the cost of your airfare for a conference, meeting or client visit, consider scheduling your Executive Checkup at your destination.

Need help? We can arrange it for you almost anywhere in the world.

Pull out your HSA or HRA debit card to pay for the medical services, and at least two nights’ accommodation and reasonable related expenses. Use your personal credit card for all other incidentals.  No more running around town on 14 different days to get blood work, mammogram, pap smear, and other diagnostic tests done – and in many locations abroad your whole checkup may cost less than your copay back home.  If your company offers an executive or senior management perk and covers this for others, ask if you can submit the bill on your return.  Be sure to bring home copies of all your medical records. Michelin employees and many at other companies can now earn up to $2000 a year as a health reimbursement arrangement for a biometrics scan. Scans are scans, and they are no different whether they are done in Boise or Bangkok – except Bangkok will probably be more fun — and less expensive.

Check out this story from a small business owner who took advantage of our Executive Checkup program for his team and spouses

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“Comprehensive, Efficient and Professional!”
… an excellent experience for all our company executives and their spouses … saved us more than 100 hours …pure genius! We can’t wait to pick another location for next year!”

Marc Coselli
Miami, Florida

More Self-funded Employers Evaluating Medical Travel

Francesca Glenn, MHA

Corporate Communications
Mercury Healthcare International – Denver CO

More and more small to medium U.S. companies are joining the large employers and labor unions in examining medical tourism as a value-based solution for their self-funded health benefit plans. In recent years, the media has reported program implementation by Pepsico, WalMart, Serigraph, Lowes Home Improvement and Delta Airlines. But small to medium enterprises (SMEs) like B&H Photo, North Carolina furniture manufacturers, glass blowers, shipping companies are commissioning feasibility studies to determine if a corporate medical travel benefit makes sense for them.

“One interesting trend is where the companies are located” says Maria Todd, CEO of Mercury Health Travel.  “The calls we are receiving come from benefits administrators at companies located in rural areas where employees have limited local access to healthcare. Often, the closest health facility is a small critical access hospital with 25 or fewer beds, located 35-60 miles of where they live and work. They are already accustomed to traveling for tertiary care or complex diagnostic services that require expensive technology. They are already resigned to the fact that they must travel to access specialists that may not be present in their area.

Another interesting trend she reports is that they are strongly committed to “Buying American” and have no interest whatsoever in including foreign destinations in their networks.

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“One interesting trend is where the companies are located” says Maria Todd, CEO of Mercury Health Travel.  “The calls we are receiving come from benefits administrators at companies located in rural areas where employees have limited local access to healthcare.”


“For decades, employers have covered the cost of health travel to centers of excellence and tertiary research facilities through their benefit plans.  Today more of them are re-examining the option to travel to a designated provider out of their immediate area for more common elective procedures, Todd explains.”

In the past, these services were coordinated by the TPA or insurer, and referrals were made only for very specialized treatment, usually associated with high-dollar claims or life-saving treatment and limited clinical trials.  But now, with most self-funded employers’ ability to use predictive modeling and access their own primary big data, employers are now able to scrutinize value for money, outcomes, patient satisfaction, and in turn, steer plan beneficiaries to designated Approved Providers more easily.

“That’s changing now. For one thing, employers report that aren’t all that impressed with the TPA and ASO network choices or negotiated rates.” Todd explains. “Through disintermediation (direct contracting bypassing the ASO or TPA and their monthly network access fees) employers are negotiating direct deals with health facilities and professionals with whom they have chosen to do business. They negotiate steerage (directed volume), rates, and often negotiate bundled case rates for the cases they’ll steer in the direction of the out of town provider.”

…employers report that aren’t all that impressed with the TPA and ASO network provider choices or negotiated rates.

Instead of waiting for a special programs (burn care, transplants, and long-stay, complex cancer treatment, for example) to be operated by the TPA or ASO or their reinsurer they call on Mercury Health Travel to help them design an exclusive program that meets their plan’s needs.

We offer our clients a simple and straightforward three step process:

  1. Feasibility: Is it likely to work? Where’s the proof? This comes from an assessment of plan beneficiary culture and primary data. Past claims and predictive data are examined for a complete assessment. At Mercury Health Travel, we include a consulting medical epidemiologist on the assessment team if the company doesn’t already have one on retainer.
  2. Program Design: Creating the shortlist of candidate Approved Providers from the Mercury Health Travel network – or going straight to providers they want to approach, setting up the benefit design, travel and logistics, and integrating the medical travel benefit with the routine local care services already available.  We accompany them on site inspections at candidate provider clinics and facilities and in assist them in contract negotiation meetings with hospital executives and staff physicians.  We also examine HRA and HSA program integration possibilities for special circumstances.
  3. Program Documentation: We help them to complete any needed tweaks to their SPD and wrap documents. A “wrap” document is a drafting device used to supplement already-existing documentation. More specifically, a wrap document provides the information required by ERISA by incorporating (or “wrapping” itself around) the benefit program or TPA/ASO network provider contract. When a wrap document is utilized, the basic benefit plan remains part of the plan document. The “wrap” document and the existing SPD or contract together comprise the complete plan document.

Once Mercury Health Travel consultants and the employer establish the program framework, actuaries and underwriters may be called upon to examine costs and risks and utilization assumptions. “Some employers want that final level of review. In past years, they always did. “Now, over the past 6 years or so, with access to their predictive modeling and claims data, if they start with a small scope pilot program, they often skip this step and save the plan assets to pay for those reviews” says Todd.

Once the three step process is finished, the program is prepared for launch. Mercury Health Travel prepares a custom beneficiary mini-portal that explains the benefit program. The portal contains information about the program, the “why” story which explains why it was developed, who should use it, where they can go, and what they can expect if they decide to travel for care.  A step-by-step procedure is posted. These pages are inexpensive to add to an existing employee benefits intranet that the employer may already have in place. If an employer has no benefit portal at all, Mercury’s team can build out the entire portal for them. The entire information portal can be designed, edited, tested and completed in 30 days or less.  Much of the same information is condensed and used to prepare pay envelope and employee newsletter informational pieces.

Simultaneously, the care management team onboards the new account and prepares for case management. Onboarding an account involves preparing a portal licensed to the client. We helped designed this first and only medical travel case management software, but we don’t own it.  The client purchase a license for their own installation of the software and has the option to take it to any care coordination provider if they choose not to work with us. Some employers have an internal care coordinator in-house. Todd explains, “Most decide to work with Mercury Health Travel for the medical travel case coordination even if they have routine care coordination for local care through their TPA for three reasons: Most TPAs and ASOs aren’t set up for medical travel benefits administration, the TPAs and ASOs cannot process the privately negotiated bundled case rates, and the employer and the healthcare provider mutually decide that the exclusive negotiated case rates should be protected from being shared outside the relationship.”  If they decide to segregate the rates and bundled claims processing, the employer meets with and negotiates with Mercury’s partner TPA, located in Kansas.

Once in operation, the portal can be used for both regular medical travel and workers compensation case coordination. The software interfaces with the benefits portal to allow medical records uploading and other protected information. The software is designed to be HIPAA, PIPEDA (Canada) and EU compliant and supports the case management and care continuity activities.   One software installation can serve employees anywhere in the world, whether its a manufacturing plant in Europe, an oil rig off the coast of West Africa, a scientific research center in Antarctica, or the corporate headquarters in Silicon Valley. While this entire preparation phase all sounds complicated, it is very methodical and be accomplished from first call to first case, end-to-end in about 120 – 180 days.

Finally, at the time a plan beneficiary decides to use the program, one call starts the process and the case managers coordinate care and monitor and measure outcomes. Employers receive detailed reports that explain the savings, patient satisfaction, and clinical outcomes on a periodic basis. The clinical outcomes and patient satisfaction incorporate tools such as HCAHPS (the Hospital Consumer Assessment of Healthcare Providers and Systems) and other measurement tools created by developed by RAND Corporation to measure and explain variations in patient outcomes through a generic, coherent survey.  These measures rely upon patient self-reporting to the case manager at specific intervals across a multi-year event horizon. The measures are widely utilized by managed care organizations and by Medicare for routine monitoring and assessment of care outcomes in adult patients.

Local and Global Workforce Employers

Companies that employ global workers are often very interested in medical tourism and health travel by necessity. Often, they deploy workers to remote locations where health services are in short supply or non-existent.  As a result, they are no stranger to medical travel and health tourism concepts, and are often already familiar with the process. For years, they have depended on international private medical insurance (IPMI) supplemental coverage as an adjunct to local public health programs operated in the host country, or local supplemental private medical insurance that widens the scope of providers, clinics, and hospitals available to the employees, both expatriates and local nationals, and perhaps also for their dependents. These policies, like those in the USA, can run the entire range of value and cost, and are often expensive to purchase. Most IPMI programs are not set up to include elective medical travel benefits coordination for employer groups. They are also not viewed as medical tourism insurance policies.

About Mercury Health Travel

Only one company in North America currently offers this level of service to self-funded employers. Mercury Health Travel, started working on disintermediated deals between employer self-funded health benefit plans and healthcare providers since 1977. It has grown and transitioned from a simple consumer medical tourism facilitation company to the largest, privately-held medical tourism network in the world.  It maintains provider and supplier relationships with over 6000 inspected hospitals, over 9000 ambulatory surgery centers, 850,000 physicians, and 65,000 ancillary providers (home health, medical equipment, dialysis, physical therapy, etc.).

standingmktMaria Todd, the company’s founder and CEO worked for one of the largest HMOs in the United States as their director of provider relations network development and contracting operations. She designed the network so that employers could choose their short-listed providers at locations throughout the USA and in 120 countries. Over the past few years, she completely remodeled the brand approach to medical travel benefits administration. In addition to her HMO and managed care background, Todd is a former surgical nurse, hospital exec, and in the 1970s was a travel counselor and field inspector for America’s largest leisure travel organization, with more than 1000 full service travel agency offices in the U.S. and Canada. With the new approach, Mercury Health Travel focuses solely on corporate health travel administration for self-funded health & wellness benefit plans offered through employers, unions and membership associations.

What was once a much costlier PEPM network leasing model has been reconfigured into to a less expensive approach that leverages the company’s experience in corporate medical travel administration. The new approach requires less owned infrastructure, fewer employees to hire resulting in lower overheads and better efficiency. Mercury Health Travel works as a solutions provider for many healthcare benefits consultants and benefits advisers, eliminating the need to employ and train full-time sales representatives.  Accounts are onboarded more quickly, and it costs less to administer the program. In turn, Mercury Health Travel passes those savings on to its clients.

Learn if a corporate medical travel program can save you money.


What’s Different about Mercury Health Travel

  • Clients choose their selected providers either from our existing network of of Approved Providers or any other provider they choose to approve and empanel.
  • Mercury Health Travel acts as the buyer’s agent and assists in the negotiation discussions and helps the providers and employers to develop exclusive case rates.
  • Contracts are negotiated directly with providers. Rates are proprietary and based on the business opportunity in each specific case which often results in better pricing than the prices negotiated with ASOs, TPAs and PPOs.
  • Steered volumes result in lower prices than those advertised in medical tourism articles and advertisements found on the Internet for “one off” consumer business.
  • Mercury Health Travel charges for its value added case management instead of embedding 20-30% referral commissions in provider rates – a common practice of most medical tourism companies.
  • No PEPM network access fees. If the system is not being used, there’s no ongoing cost.
  • Mercury Health Travel focuses solely on corporate health travel administration for self-funded health & wellness benefit plans offered through employers, unions and membership associations.
  • Consumer medical tourism inquiries are referred to trusted colleagues in the USA, Canada and Europe who specialize in business-to-consumer medical tourism.
  • Mercury Health Travel operates a global executive checkup program designed to assist corporate executives and senior level managers to arrange comprehensive screenings required by employers. Sometimes those who run the show can’t find the time to mind their health. With an eye toward prevention, these one- or two-day examinations attempt to accommodate busy schedules while supporting the long-term wellness and productivity of a firm’s key players.  Designated checkup locations are available on 6 continents.

Bundled Case Rates for Surgery

by Maria K Todd, MHA PhD

Founder and Executive Director
The Center for Health Tourism Research

For an employer that wants to contract with a hospital or medical travel provider in another city or state, bundled case rate examples in this article give insight into what’s likely to be acceptable if the employer prepays the estimated case rate up  front and settles on any additional incidental costs within 10 days’ time from discharge.  

Many employers and insurers are still paying north of $50,000 for these cases after network access fees, fee schedule payments for claims, together with rehab, medications, implants, pre-op testing and imaging, and more. Some are already paying for travel, they’re just traveling to places that may still be more expensive.  

With Mercury Health Travel, employer and labor unions gain insight into what’s possible with regard to savings, and where to find providers willing and ready to negotiate bundled case rates and deliver quality care.

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Bundled Case Contracting with Commercial Payers

Along with care coordination and risk-based shared savings, an increasing number of PPOs, HMOs and other third-party payers are contracting with providers for bundled payment initiatives.

Humana – partners with providers to incorporate bundled payments with hip and knee replacement surgeries much like the CMS Comprehensive Care for Joint Replacement Model. Retrospective modeling is the system they are using which is where fee-for-service where providers are paid as usual, but at the end of a performance period, the cost of the bundle is reconciled versus the cost target and savings are evaluated and shared. This method is very confusing and gives most of the power for decision making to Humana. They only charge you for down side risk and limit the upside risk and keep the savings for themselves.  Contracting this way is problematic for providers because they can’t access the cash, have to take great pains to negotiate fair and equitable terms, and Humana as the power to do whatever it wants because it has possession of the cash and arguing rights without a requirement to provide transparency about how the math was done unless you remember to add that transparency requirement and a time frame to deliver it on request, to your contract.

Cigna – is working to implement value-based care payment strategies including episodic bundled payments for hip and knee surgery as well as maternity care. Cigna’s transition to value-based care began in 2008 when it launched its first patient-centered medical home pilot with Dartmouth-Hitchcock in New Hampshire.  Cigna plans to implement its value-based alternative payment models in a similar fashion to CMS. Cigna takes on the same goal as CMS to ensure half of their healthcare spending is in alternative payment models by 2018.  But don’t assume that the programs are identical at every touchpoint.  They call their program Cigna Collaborative Care which now includes value-based arrangements with 160 primary care physician groups, as well as more than 70 value-based arrangements with specialty practices in the fields of obstetrics/gynecology, orthopedics, gastroenterology, general surgery and cancer care. They recently announced several new Cigna Collaborative Care arrangements for cancer treatment. Other specialty initiatives include episodes-of-care arrangements for maternity care, hip and knee surgery, gallbladder surgery and colonoscopy, as well as pay-for-performance maternity care arrangements. Cigna also plans to launch episodes-of-care programs for cancer care and heart surgery. We’ve also started seeing inklings of new initiatives in psychiatry and psychotherapy services that place providers at risk for outcomes.  The company also has value-based collaborative arrangements with 101 hospital systems comprising more than 370 hospitals.

Our physician, hospital and ASC clients are concerned about bundled payment risks – and they should be

Physicians may find bundled payments a challenging form of reimbursement since there may be costs associated with a patient’s treatment that are out of their control. Hospitals and ASCs are at even greater risk. For those entering into deals with CMS directly, there should be a sigh of relief because of the transparency of applied policies, metrics, data sharing and appeal that’s available.  In the commercial setting – maybe not exactly.


The Centers for Medicare & Medicaid Services (CMS) has invested its time and resources into expanding upon bundled payments. The federal agency introduced the Medicare Bundled Payment for Care Improvement (BPCI) initiative in October 2013.  In that program, a number of different medical facilities, including post-acute care centers, hospitals, and physician groups participate under 4 different demonstration projects. Payments are tied to multiple services Medicare beneficiaries receive during an episode of care. The first system consists of paying hospitals for an inpatient, acute care stay. The second and third models are based on a retrospective bundled payment platform that looks at spending against a set price for an entire episode of care.  

The difference between this program from CMS and look alike programs from commercial payers is that not all commercial payers adopt all the rules, formulas, or applications of policy. So while something may appear the same on the surface, the iceberg of variation lives under the surface. And unlike CMS each is P-R-O-P-R-I-E-T-A-R-Y, meaning you don’t get the same policy transparency and due process you get through CMS. While CMS uses an Administrative Law Judge (ALJ) to settle disputes with the program – a dispute with a commercial payer requires providers to submit disputes to litigation, arbitration or mediation and often without the necessary transparency for the arbiter to make decision. Remember, no subpoena duces tecum is used in arbitration. Put your subpoena language inside your contract language so you have it when you need it.

CMS also initiated the Comprehensive Care for Joint Replacement (CJR) model to cover the expenses of hip and knee replacement surgeries among Medicare beneficiaries. Through bundled payment models, hospitals, physicians, and post-acute care centers are meant to work in coordination to treat a patient before, during, and after a joint replacement surgery in order to receive payment for an episode of care.  With hip and knee replacement surgeries becoming one of the most expensive and most common operations among Medicare beneficiaries, it is understandable that CMS has pursued an alternative payment model to cover these expenses.

Bundled pricing primer for self-funded and self-insured U.S. employers and labor unions

People are working past the age of 65, and in those cases, Medicare becomes the secondary payer. In 2014, more than $7 billion was spent just on the hospitalizations associated with joint replacement surgeries.  With a domestic medical travel program, employers and labor unions that are self-funded for their healthcare claims can opt to choose high performing providers outside their local area and tap into other domestic providers willing to offer bundled case rates to steer cases to their hospitals and ASCs that may be located in less expensive rural markets.  For that reason over all others, plan administrators may be curious to find out if a bundled pricing program can be implemented for their company. We can help you to determine and decide for yourself.

Median case rates paid by Medicare in 2013 (weighted, n= 36 million cases) for the following cases can give you a hint at what prices are being paid nationwide:

  • Total Hip Replacement  $15,000
  • Partial Hip Replacement $15,000
  • Total Knee Replacement $14,000
  • Total Ankle Replacement $20,000

For an employer that wants to contract with a hospital or medical travel provider in another city or state, these numbers give an idea of what’s likely to be acceptable if the employer prepays the estimated case rate up  front and settles on any additional incidental costs within 10 days’ time from discharge.  Many employers and insurers are still paying north of $50,000 for these cases after network access fees, fee schedule payments for claims, together with rehab, medications, implants, pre-op testing and imaging, and more. Some are already paying for travel, they’re just traveling to places that may still be more expensive.

Interested in developing bundled surgery case rates as a provider or a payer? Contact Us Today for Help.


Maria Todd is a trusted adviser and expert specialist to hospitals, clinics, governments, healthcare business owners, investors, and independent professionals. Clients call on her to help them do a better job of marketing, branding, or contracting with insurers and employers, and to grow their business.

Maria is the CEO of Mercury Healthcare International, in Denver, Colorado and the founder of Mercury Health Travel, the leader of the Health Tourism Practice Group of Mercury Advisory Group, the Executive Director of the Center for Health Tourism Strategy, its research and education resource center, and a Board Member and Advisor at Higowell, the world’s first health tourism operations platform. She has been recognized as an Academician with the Ukrainian Academy of Rehabilitation and Human Health and is a member of the Scientific Committee of Termatalia in Spain. She is also a Board Member at Global Health Connections, a nonprofit organization associated with the University of Colorado MBA-HA program. She is the author of 15 internationally-published business improvement books in healthcare administration and health tourism. 

Invite Dr Todd to speak at your next event.  She presents a compelling workshop of interest to tourism and economic development officials, foreign investors, healthcare strategists, and suppliers on Opportunities for Economic Development through Inbound Medical Tourism Sector Development.

Employers shift employer focus to retention in times of talent wars

By Maria Todd

CEO & Founder
Mercury Healthcare International

Shift your focus to retention with a corporate-sponsored medical and wellness travel benefit option, worksite health clinics, and onsite fitness centers.

Call us! We can help you assess the feasibility, estimate costs and build out the program for you.

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Employers shift focus to talent retention

When salary increases are an impossible budget item, employers get creative. The most attractive and affordable alternatives often include developing and executing attractive employee programs that are appreciated by top talent and their families. Industry reports indicate that 50% of employers identify their high potential employees through an assessment that extends beyond a formal performance evaluation. To keep them engaged, many employers offer additional training and development opportunities to these employees that go beyond the programs available for other employees.

In an improving economy and job market, employers may be at risk of losing their top tier talent without taking the time to deliberately identify those ‘at risk’ employees and seeking alternative ways in which to engage them, such as high-potential programs, career development opportunities, and non-cash recognition programs. A corporate medical travel program for surgery and wellness benefits option is one way to add a unique option that will appeal to top talent, but it may not always be pointed in the direction of overseas destinations.

Talk with us about surgery and wellness options across the USA. (800) 209.7263