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Taking Care of Your Expatriate Workers' Health-Care Needs

Clearly, today’s multinational corporate leaders are investing in their global business strategies to maximize growth opportunities and increase stability through geographic and market diversification.

More than $1.33 trillion was spent on global business travel in 2017. The number of expatriates worldwide is expected to grow from 66.2 million in 2017 to 87.5 million by 2021. And the expense of those assignments can be steep. From the complexities of planning to project initiation to ongoing overseas support, expatriate costs sometimes reach more than three times a person’s total compensation for the year, according to a 2015 CFO.com article.

With this commitment should come the assurance of full support to internationally mobile employees (IMEs) and their dependents. Compensation and benefits managers, in particular, need to determine the ideal portfolio that attracts, retains and engages the right talent for the right jobs. IBM Corp., for example, says providing health care no matter where the assignment helps achieve the top priority of employee sustainment. “IBM believes it is paramount to support our employees and their families wherever they are in the world by ensuring that their needs for quality health care are met,” said Barbara Brickmeier, vice president of human resources at IBM.

Benefits managers can tailor offerings to specific needs of internationally mobile employees by planning in advance for virtual visits that take into account cultural & communication challenges.

In a 2017 Mercer study, nearly 40% of multinational employers revealed one of their most pressing challenges is ensuring that their IMEs don’t feel shortchanged in terms of the benefits simply by accepting international assignments. Another 2017 study, from Cigna, reported that 50% of expatriate employees believe their employers aren’t meeting their duty of care requirements — safeguards and preparations for their safety, well-being and health — for their global assignments.

Overseas positions certainly bring a level of logistical complexity, and employers must plan adequately and provide comprehensive guidance about insurance coverage and the member’s available health-care services. There is a lot more pressure on employers to “level the benefits playing field” among U.S. employees and those on assignment abroad, said Heather Towery, M.D., medical director and vice president of Clinical Strategy for Teladoc Health, a global provider of virtual care. “U.S. employers have historically provided very rich health benefits in this country but not outside of it," Towery said. “Today, they’re seeking equivalency for their employees around the globe, putting a lot of effort into benefits in terms of quality,” she says. “Ultimately, that’s how they’re able to be successful.”

Identifying Relevant Options

Health-care systems vary significantly from country to country, and member coverage by U.S.-based insurance companies outside the United States is often spotty. Many health plans, including Medicare, do not provide coverage abroad, or only offer partial health coverage. While some credit cards provide travel insurance, most don’t include medical coverage or support as part of that insurance. Unfortunately, long paths to care bring high costs — hospitals, urgent care centers or even doctors’ offices can be very expensive for nonresident foreign workers.

Virtual care can now bring the convenience of familiar medical service for employees working or traveling abroad. IMEs and their family members have a reliable and reputable care option for general nonemergency health concerns wherever they are in the world, which eliminates the stress and uncertainty that language and cultural barriers typically bring to medical care experiences in unfamiliar overseas environments. Often, employees with a health concern don’t know where to begin or from whom to seek care. By solving navigational and access challenges through a virtual care solution, employers can deliver security and support for maintaining wellness.

The Lay of the Land

One doesn’t often consider how many health issues can arise over the course of a multiyear assignment. For the average employee with spouse and children, there will no doubt be an assortment of infections, rashes, bouts with the flu, sore throats and stomach bugs. Imagine coming down with an illness, feeling foggy and weak, then facing the bewildering health-care maze of a new country, where your first language may not be that of the physician.

“Our clients, who include large multinational employers, have told us first-hand about the experiences of their employees,” Towery said. “It has proven to be very unnerving for people from the U.S. who are overseas on assignment. They aren’t familiar with the differences and the intricacies in an international health-care setting.”

Many travelers and expatriates simply delay or bypass general care because they’re unsure about where to go, observed Towery, noting that the specific roles of family physicians and specialists vary from country to country, as do care delivery methods. Even in instances when a member would typically self-treat a minor illness, complications can arise. For example, in the United Kingdom, acetaminophen is named paracetamol, which often confuses Americans who are shopping the local pharmacy shelves.

“Suppose a member has had a fever and cough for a number of days. She may try to go buy the medicine that works for her on U.S. soil, but many of the over-the-counter (OTC) medicines you’d get here are rebranded or named something different entirely overseas,” Towery said. “How does she know what to do?”

In those instances, it is valuable to have a partner to help members navigate the local health-care landscape.

Finding Familiarity

In addition to regional variations in health-care delivery practices, language barriers create challenges in securing trusted medical support. When a member seeks hospital care for a minor illness, coordinated care from an unknown provider may be complicated, making misdiagnoses and treatment misunderstandings common. While a member may speak the country’s primary language well enough to engage in casual or even business conversation, medical vernacular is a whole different story, Towery pointed out. “In a foreign country, not only is the language different, the ‘medical-ese’ is different. When you’re in another medical system, you need a doctor who’s speaking in your native tongue to help you figure out what’s the most appropriate course of action.”

When members have trouble securing this type of dialogue, they may turn to hotel staff to translate advice, do their own internet searches, or reach out to third-party travel medical insurance hotlines for often-complex navigation. In all these instances, IMEs and their loved ones experience uncertainty about what steps to take and how much it will cost them while they are at their most vulnerable.

Instead, employers should provide a virtual solution that delivers high-quality, trusted, physician advice that’s in line with employees’ specific cultural and linguistic needs. With a service such as Teladoc Health’s Global Care Services, the patient’s uncertainty about medical care shifts from “how” to “now,” with members able to select to receive care in their native language.

With virtual care that’s sensitive to cultural needs, recommendations for navigating the local health system can bring not only wellness but peace of mind in uncharted territory to a globally mobile workforce.

Opening Access

Technology advancement over the past decade has trans-formed this once unfathomable care path into a reality. When multinational employers proactively consider innovative care options before sending their teams overseas, lower costs and less stress naturally follow. The result is that new access provides employers with the confidence that their most valuable assets — their employees — are taken care of. Digital communications tools and worldwide connectivity have enabled the best medical minds to treat a variety of conditions in a range of complex environments.

Benefits managers and their virtual health partner can tailor offerings to meet specific needs of IMEs and their families by planning in advance for virtual visits that take into account cultural and communication challenges. For instance, the company can immediately demonstrate an “I have your back” assurance by including details on their global-friendly virtual care offerings as part of the orientation programs and information typically offered to prepare their IMEs for temporary relocation or overseas travel. Reminder emails throughout their assignment that they have innovative health tools available to them are just as important once they are in-country.

Instilling that support, confidence and connection sends a little piece of home to a foreign land so the employee can focus on the matter at hand. Through the pairing of advancements in technology and health care, multinational corporations are leveraging the best medicine has to offer for their most valuable global assets — their employees.

First Aid Kit Translations

KYLKLAMP: Ice Pack (Swedish)

HÅNDRENSNING: Hand Sanitizer (Norwegian)

CINTA IMPERMEABLE: Waterproof Tape (Italian)

BANDAGEN: Bandages (German)

LINGETTES ANTISEPTIQUES: Antiseptic Wipes (French)

MANTA DE SEGURIDAD: Emergency Blanket (Spanish)

AĞRI KESICILER: Pain Relievers (Turkish)



Kelly M. Bliss Kelly M. Bliss is chief client officer at Teladoc Health.

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