The return on investment from international patient programs in American hospitals

Purpose: Hospitals catering to the unique needs of international patients often make substantial investments in their international program. Research has yet to evaluate the return on investment (ROI) of establishing these programs. The purpose of this paper is to quantify the economic benefits and costs of international patient programs and evaluate the ROI of international patients for US hospitals by program maturity and size. Design/methodology/approach: Operational information about 29 health systems with international patient programs in the USA was obtained from the US Cooperative for International Patient Programs (USCIPP) Annual Benchmarking Survey. A Spearman correlation coefficient was used to test the association between international program investments and revenue. Mann–Whitney U tests were used to test whether ROI differs significantly by program maturity and size. Findings: It was found that 14 (48.3 per cent) international programs were established and 10 (34.5 per cent) programs were large in size. The median estimated organizational total gross revenue less operating expense for all programs was positive ($15.6m). Total gross revenue less operating expense was higher for large programs ($105.6m) than for small programs ($9.2m) (p < 0.001) and higher for established programs ($40.2m) than for new programs ($8.5m) (p < 0.001). Originality/value: The results suggest that hospital investment in international programs yields substantial returns for the health systems studied. New programs rely on staff from other areas of the organization while developing operational processes and relationships with providers and payers abroad. Examining the ROI can help hospitals develop a business case for an international program and understand any economies of scale from increased investment.