The JCI is one of the groups responsible for accrediting hospitals abroad. To date, the organization has accredited some 360 international hospitals, says Wilson. The accrediting body has noted an increase in hospitals overseas seeking JCI-accreditation, a trend possibly driven by medical tourism, she says.

"The thing I find heartening, due to medical tourism or otherwise, is the increased number of hospitals around the world asking to have someone to take a look at them and decide whether they are providing quality care and protecting their patients," says Wilson. "That's a good trend. If the motivation is medical tourism, I'm neutral on that."

JCI-accredited hospitals, explains Wilson, offer a sense of safety and security to medical tourists.

"For the most part, individuals who need a procedure done, whether it's cosmetic surgery or a hip replacement and there isn't enough insurance to cover it in the United States, they don't want to do it blindly," she says. "They want some proof that the place they're going to has a good standard quality of patient care...[JCI-accreditation] provides assurance to international patients that somebody [objective] looked at this organization and it meets certain standards."

"With the transparency of facilities, in terms of pricing and quality of services, increase in the number of internationally accredited facilities and the proliferation of information on the Internet, it is expected more patients will have the tools they need to make educated choices for value in health care service delivery," said Stephano.

As medical tourism becomes more popular, health insurers are beginning to include global coverage in their plans.

"A lot of companies are taking a closer look at [medical tourism]," says Robert Zirkelbach, spokesman for America's Health Insurance Plans.

Health insurance providers need to look into issues such as ensuring safety and quality care and how best to follow up with patients whose caregivers are overseas.

"If someone is getting a complex procedure overseas...follow-up care is necessary," says Zirkelbach. "One [question] is how do you ensure follow-up with the primary [doctor] or surgeon? If the surgery is overseas, how do you ensure that?"

It is not the policy of Blue Cross Blue Shield of Texas to cover members who travel abroad only for elective procedures at a lower cost. But the agency will cover certain procedures if they have been preapproved by the employer paying for the care. However, if a surgery or procedure is not approved by the U.S. Food and Drug Administration, the insurance company will not pay for the care, regardless of employer permission.

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