Puerto Rico and Maryland are exempt from readmission penalties, and are still covered by Medicare. Links for Puerto Rico are below.
Foreign hospitals and doctors have their own payment systems for their residents, but still have prices for US travelers. They are not covered by Medicare, so hospital stays abroad do not incur readmission penalties, and do not count as costs in Accountable Care Organizations. Some US and international private insurance pays for foreign care. In any case costs are often much less than in the US, and specialized hospitals can give better care. Some of the best offer luxury as well as ordinary care.
Kiplinger (2017) says the book Patients beyond Borders, and its website have reviews of hospitals. I have not seen the book, but the website shows the size of each hospital, and often the total patients treated, though not the number of times doctors do any particular procedure, nor other measures of quality. You may have to ask.
Medical Travel Agencies (listing does not mean recommendation, and you may find others)
NA=US Average not available to calculate percent. See link for costs abroad
Doctors identified 25 procedures and tests which may be wasteful, since they usually have low value for patients. They were given to 25% to 42% of Medicare beneficiaries each year, depending on definitions, but they only cost 0.6% to 2.7% of total Medicare costs.
High spending at end of life?
In the United States,
Vox quotes economists that the US health care prices per item are abnormally high. So other countries get more health care for less cost:
"When you’re paying the highest prices in the world for basic services, for scans and drugs, it will undoubtedly be a struggle to provide all citizens with health care...
A 2018 JAMA article compares insurance systems, and a 2008 JAMA article shows the same cost issues in 2004-6, with US doctors' salaries double the level in other countries.
DailyKos has more detail on the range of costs.
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