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By Monica E. Oss

July 20, 2010

Reading our recent coverage of policy changes regarding the expansion of provider options by Georgia’s Department of Behavioral Health and Developmental Disabilities (DBHDD), I was struck by how the effect of geography is diminishing in our field.

The Georgia story is straightforward. DBHDD recently decided that it was in the best interest of its citizens to give them a greater choice of service providers and, as result, opened up the State to out-of-state provider organizations — “State of Georgia Opens DD Service Network To National Providers.” Sort of a new model of CON (certificate of need). Instead of having health policy analysts decide how much service capacity is needed, this is a consumer-centric model, allowing individuals to vote with their feet.

The bigger story is less straightforward. Geography as a market factor is melting away due to two unrelated, but synergistic, factors – consumerism and technology. Consumerism is a big piece of this story. In addition to having the capacity to ‘actively choose’ health and human service options and provider organizations in our own backyard (as the State of Georgia is facilitating), we have also learned that consumers will – given the right incentives – travel to get services. Hence the entirely new medical tourism industry, with centers of excellence popping up across the globe (including in the U.S.) We now have intercountry and intracountry medical tourism happening. U.S. “tourists” travel to India for heart surgery, Mexico for dental work, England for stem cell treatments, and Brazil for plastic surgery. They also travel to the Mayo and Cleveland Clinics and Johns Hopkins.

Then, enter technology. Professionals and consumers are connecting virtually via telehealth services, remote monitoring, and smartphone applications. No one needs to travel. For some services, in some situations, it is just what the consumer wants.

The implications of the Georgia story are two-fold.  Short-term, there is an opportunity for entrepreneurial  professional organizations to open up in Georgia.  Long-term, geography is no longer the primary market attribute of health and human services.


Monica E. Oss
Chief Executive Officer, OPEN MINDS


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