Aphora Health™

Aphora Health™
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FAQs

Frequently Asked Questions

Aphora Health is a global healthcare services company created by a group of executives with decades of experience in the healthcare provider and health insurance sectors who are deeply committed to improving people’s lives. The company’s vision is to improve health equity and lower costs by bringing global healthcare to US markets.

Aphora Health brings destination healthcare directly to consumers who pay for their own healthcare and self-insured employers, along with their plan members, through its network of accredited healthcare providers, with a clinically focused, high-touch customer service model at a fraction of the typical cost.

The company’s offerings target expensive specialty medications, high-cost elective surgeries, and cosmetic/non-covered procedures, bringing accessible, high-quality services at significantly lower cost.

Millions of Americans cannot afford high-cost surgeries and expensive specialty medications when in fact they have health insurance. Many are trying to stretch their paycheck to cover housing and food and the ability to pay as much as $5,000 – $10,000 out of their pocket to meet deductibles and cost sharing is not possible. As a result, average wage workers put off getting the care that they need. Aphora Health is committed to changing this inequity in our system.

The market opportunity for medical tourism, or what we refer to as destination healthcare is growing at an astronomical pace and projected to hit $77B this year with millions of Americans seeking care outside the US annually.

At Aphora Health, we focus on two lines of business. First, our Direct-to-Consumer line, who are clients that self-pay for the healthcare services typically not covered by health insurance plans. There is some competition in the DTC market with companies like ours largely focusing on those self-pay consumers. We launched our service in the DTC market in November in select markets where there are direct flights to our premier medical facility in San José, Costa Rica. Our focus in this line of business is largely on cosmetic, non-covered health care services where there is increasing demand for lower cost, high quality services and we are excited to see interest in the Aphora offer.

Aphora will differentiate itself through the employer line of business focused on the 177M employees of self-funded employers where there is considerably less competition today in the medical tourism market. Self-funded employers fund their own health care claims expense for their employees which represents an ever-growing percentage of a company’s operating expense. These self-funded employers are looking for ways to reduce healthcare costs without sacrifice to quality, which is what Aphora Health delivers.

Available in mid-2024, our employer offering consists of three components. Our voluntary, non-covered offering allows employers to provide a lower cost option for sought-after services, such as cosmetic, medical and dental services typically not covered by the health plan. Employers can meet this growing demand without increasing the cost of their health care program. The second component of our employer offer is our Pharmacy program, which enables employees needing often lifesaving, high-cost medications access to these drugs at a fraction of the cost. Pharmacy costs represent some 24% of employer health plan spend and our program provides significant savings to the employer and employee. The third component of our employer offering is the medical/surgical component, which includes procedures in Orthopedic, Cardiovascular, Bariatric, Neurosurgical and Oncology medicine. Employers can elect one or all of these service components to benefit from the lower health plan expense and improved employee health and satisfaction benefits.

Self-funded employers today spend some $550B a year on healthcare claims and few cost containment programs can yield the savings we offer those employers. Introducing Aphora as an optional care delivery approach means employees will be less likely to put off needed healthcare services while at the same time, employers save significant dollars.

The healthcare cost crisis continues to build here in the U.S. Employer costs are forecast to increase another 8.5% in 2024 with family coverage expected to jump to over $24,000 per year.

Millions of Americans cannot afford to get the healthcare they need or desire with 1 in 5 having accumulated significant medical debt. Many in fact have health insurance but can’t afford the high deductibles and cost sharing that can add up to as much as $5000 – $10,000 for a surgery.

Aphora Health makes healthcare more affordable through our contracted network of high-quality international medical facilities and physicians in medically advanced and desirable destinations in the world. Costs are often less than half compared to the U.S.. Improving affordability and increasing access to care is what Aphora is all about.

Many people do not realize that there are hospital facilities and doctors outside the U.S. with quality and outcome results equal to or better than the U.S. We have identified and assessed these facilities and have built our select network with quality health care delivery as our primary focus. All of our facilities have received and maintain accreditation through well respected accrediting bodies, such as Joint Commission International who require these facilities to meet high quality, safety and service delivery standards. And, many have affiliations with leading medical institutions in the U.S. like John’s Hopkins Medical Center. Our clinical team visits each of these facilities and maintains ongoing relationships to monitor performance to ensure only the best for Aphora Health clients.

The Aphora Health solution includes a hyper-focused emphasis on safety for our clients and their traveling companion. We select destinations that are safe for travelers and monitor the travel safety constantly through real-time, state-of-the-art tools and resources. Even more importantly, our Care Navigators in coordination with an experienced travel services firm develop itineraries that include escorted, door-to-door transportation as well as lodging in some of the most desirable and convenient areas where our contracted facilities are located. Aphora clients trust the experience of the Aphora team to arrange all travel needs — a key component of the Aphora difference.

Aphora clients enjoy the simplicity and peace of mind they receive by having our Care Navigators serve as their guide and partner throughout their care journey. We have developed a technology platform and leveraged resources that help us efficiently educate and serve our client’s needs. Our client portal allows for easy communication and is a repository for key client information. The Aphora clinically trained Care Navigators form a relationship with our clients and become their trusted resource throughout the care journey.

At Aphora, we provide a personal experience that builds relationship and instills confidence with those we serve. Our clients have an inititial consult with their Care Navigator who educates them about the Aphora clinical services available through our contracted providers and what to expect throughout the care journey. Care Navigators obtain the needed clinical and other information about their desired medical service and talk with clients about their preferred destinations to match the clinical expertise of our curated network with the desired travel experience our clients and their companions are looking for. We provide our clients with opportunity to have a virtual visit with their care provider as part of the selection process to learn and ask questions. When the client decides to move forward, we coordinate all the travel and logistics for the patient and their companion and guide them through the entire care experience. Our Care Navigators are there for our clients before, during and after the procedure as a first point of contact for anything our clients may need. 

Aphora Health offers high quality, lower cost services covering a wide array of some of the most costly health and dental services available today. Through what we call our “hub and spoke” model for provider contracting, we look for the best hospital facilities with strong outcomes and experience in international care delivery in desirable destinations as the provider “hub”, then look within that same area for other providers offering other components of the Aphora service offering, such as cosmetic and dental services, which we call the “spoke”. This approach establishes us in those key markets and allows us to leverage travel and accommodation arrangements to best serve our clients and the companions travelling with them.

With the increasing rise in healthcare costs in the U.S., expected to rise 8.5% in 2024, more than doubling the previous two years increase percentage, employers and consumers alike are seeking lower cost alternatives while still maintaining high quality care delivery. With that in mind, Aphora has developed a service offering that includes some of the highest demand and highest cost procedures to improve access and affordability.

Our offering of medical/surgical services spans some of the most common surgical procedures in Orthopedics, Cardiology, Bariatrics, Neurology, Oncology, and General Surgery. Plans of treatment for these services are arranged with highly skilled surgeons whom our clients have an opportunity to meet during the selection process. Stays for international services are longer than the U.S. to allow for adequate post-care services and recovery before traveling home.

Pharmaceutical costs are an increasing portion of health plan spend for employers representing some 24% of health plan costs, up 3% from the prior year. This reality makes the Aphora Pharmacy offering high-cost medications a highly sought after component of our program. Approximately 20 high-cost medications from the same manufacturers as those used in the U.S. are included in our offering at a fraction of the cost. Our pharmacy program will help thousands receive the much needed, and often life-saving medications in a high-quality and safe manner.

An increasing number of Americans are seeking elective services such as cosmetic procedures and dental services and Aphora includes these services in our offering. Through our direct-to-consumer program or a voluntary offering by employers, these sought after services can be obtained by high quality facilities and professional providers at 50-70% lower cost compared to the US. These services that make us feel better and look younger are often out of reach of the average person, but Aphora makes it affordable, safe, simple with outcomes on par or better than the U.S.

Some specialty services, many of which are not covered by medical plans, are also included in the Aphora offering. Services such as In-vitro Fertilization, gender affirming care and wellness medicine are also offered within our network of contracted providers making these important services more affordable.

All of the Aphora service offerings include the support of an Aphora Care Navigator who supports the client throughout their care journey and does all the coordination so the client can focus on feeling better and looking great!

There are several factors that contribute to lower cost of healthcare services outside the United States. First, we see that in general, the cost of living and cost of goods and services outside the U.S. is significantly lower, which translates into lower medical costs as well. As a result, we see medical staff salaries, including physicians, hospital costs and other related health care services significantly lower outside the U.S. This lower cost structure also extends to services like diagnostic testing and pharmaceuticals. We also see impacts from the profit margin demands on health care systems in the U.S. coupled with the high cost of malpractice insurance in the United States contributing to the cost gap as well. The bottom line is that an increasing number of U.S. citizens are unable to afford needed care in the U.S. and recognize the high-quality care available in other countries at a fraction of the cost.

Our primary focus is developing an international network of high-quality providers to improve access and affordability to health care services for our clients. Over time, we may extend that focus to include domestic centers of excellence in our network to provide high quality, lower cost services within the U.S., but that is not the primary focus and business model of Aphora at this time.

To date, Aphora Health investors are individuals in the healthcare, health insurance and technology markets who have a proven track record of identifying successful investment opportunities in early-stage companies like Aphora Health that end up having a big impact on unmet market needs. Individual investor names are confidential.

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