Currently, approximately 750,000 U.S. employees are traveling outside our borders to receive lower-cost health care services - generally surgeries - in foreign hospitals, and experts predict the downward economy and climbing patient responsibility for health care costs will combine to make medical tourism even more common.

"I am a firm believer that 2009 will be the year of medical tourism in the United States," affirms Jonathon Edelheit, president of Medical Tourism Association.

"With the severe economic crisis we are in and severe health insurance crisis, employers and consumers simply cannot afford to overlook the significant 50% to 90% savings that medical tourism has to offer. As employers start raising deductibles for health insurance, this simply makes medical tourism incentives much more attractive to patients."

Indeed, research shows that the average plan deductible for single coverage now is more than $1,000.

Further, knee replacement surgery (one of the most popular within the United States) ranges in cost from $40,000 to $50,000, yet can be performed in Costa Rica for about $10,000.

With such fiscal realities, employers are beginning to partner with medical tourism vendors to help their employees achieve the significant savings of receiving medical care abroad.

One such company is USNOW, which recently employed the benefits of Surgical Trip for its thousands of workers.

Surgical Trip - in conjunction with the Medical Tourism Association and medical tourism firm Healthbase - facilitates domestic and international health care options to employer-clients.

USNOW, a patient advocacy firm founded in 1994, offers its employees limited medical plans, and more complex, costly procedures were not included in the company's benefit plan.

By employing Surgical Trip, USNOW will be paying around $14,000 for surgeries like knee replacements and dental surgeries, including travel expenses, with no out-of-pocket cost for employees.

USNOW President David Lindsey is optimistic about the change.

"We think we'll be on the cutting edge by using surgery abroad, as opposed to sites within the United States," he says.

Experts predict that as more employers find themselves financially squeezed, many will begin to look to medical tourism options to cut the bottom line - something they might not have considered a few years ago when business was profitable.

When asked whether he had been influenced to begin the project in light of a flailing economy, Lindsey answered with a definitive yes.

Treated 'like queens and kings'

For employers that embrace medical tourism, the next hurdle is getting employees to do the same - overcoming misperceptions about the quality of foreign facilities and providers, and assuaging fears about language and cultural barriers during a time when patients are vulnerable.

However, some experts say, it may not be as hard of a sell as some employers might think.

All of the hospitals that Surgical Trip coordinates with are accredited by the Joint Commission International. Their facilities and caregivers have been fully examined by the facilitator.

Staph infections - a common adverse effect from surgery - are markedly fewer (by about 50% to 60%) overseas compared to in the United States.

"If you dig down you find that these [medical sites] are accredited, and the majority are far more accredited than U.S. facilities," Lindsey says.

To help communicate the safety and savings of using Surgical Trip, USNOW provides employees with brochures explaining example rates of savings, videos of foreign hospitals and physicians, and testimonials by other members.

USNOW also plans to send letters to workers' homes for those who would have surgery in the future.

However, Tom O'Hara, president of Surgical Trip, says word of mouth will be the most powerful communication tool for medical tourism. Once the first USNOW medical tourists return and share their experiences around the watercooler, their co-workers will realize they'll be treated "like queens and kings due to the doctor/nurse-patient ratio," he says.

Over time, Lindsey predicts that the industry will continue to build new products and see positive outcomes. His benefits peers seem to share his opinion. A recent Deloitte study, "Medical tourism: Consumers in search of value," predicts that more than 20 million Americans will be participating in medical tourism by 2017, as consumerism grows along with a demand for transparency in prices and quality of care.

Domestic medical tourism also expanding

Employers and employees need not adopt an international medical tourism plan to achieve cost-savings for surgical procedures and other health care services. Domestic medical tourism also is a growing area that employers may want to consider.

Although the largest savings can be found abroad, it's possible to find cheaper surgery by travelling outside one's region, often to rural America, says Jonathon Edelheit, president of the Medical Tourism Association. Hypothetically, he explains, a hospital in Jacksonville, Fla., may accept a 5% discount from a company's limited medical plan, while a hospital in Ft. Lauderdale may be willing to negotiate a 50% discount.

Helping employers connect patients to lower-cost care within the United States is Healthplace America, which offers a benefit that supplements an employer's health plan with a specialty network of U.S. doctors and hospitals that offer competitive, fixed-rate pricing for prepaid patients. As a result, the firm states, employers can see 30% to 50% health plan savings on major medical procedures, including heart surgery, joint replacement, spine surgery, cancer care and bariatric surgery.