Because hip and knee replacement surgery is so expensive in Alaska, one insurance company, Premera Blue Cross Blue Shield, is paying air fare and hotel for members to receive the same treatment in Washington State at a lower cost. Jeff Davis, president of Premera in Alaska said that his firm has researched which procedures are safe for travel and can be performed less expensively in the Seattle area.
Alaska Insurer Pays for Medical Tourism – To the Lower 48!

According to Rosemary Shinohsara, writing in the MedCity News, Premera has more than 100, 000 members and about half of the Alaska insurance market. “Clients are really looking for options that maintain quality and get better control of costs, ” Davis said.
Going to Seattle for procedures will be voluntary for the patients and, at the beginning, will only be offered to some of Premera’s Alaska clients—about 32, 000 members including dependents. The travel benefit will be available for certain procedures, including knee and hip replacements.
Other groups are also looking outside Alaska for solutions to significantly higher in-state medical costs. The National Education Association’s (NEA) Alaska health plan, with 17, 000 members in 27 school districts, contracted with a company called BridgeHealth to find doctors and hospitals outside of Alaska for such surgeries as knee and hip replacements, said Rhonda Kitter, the NEA health plan’s chief financial officer. The organization will set up and organize the trips for those who want to take advantage of the service.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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