Insurance companies have noticed an exodus of U.S. patients to hospitals abroad, BusinessWeek reported.

In 2007, about 750,000 U.S. citizens traveled out of the country for major medical care and the number is expected to grow to 1.5 million in 2008, the report said. In 10 years, the number could swell to 16 million patients traveling abroad each year, the Deloitte Center predicted.

Insurer Aetna Inc. began a pilot program for what is known as "medical tourism" this year. Two other companies, Cigna Corp. and United Health Group Inc. are studying the concept, BusinessWeek reported.

Cost and quality of care are the two overriding concerns. Joint replacement surgery that costs $65,000 to $80,000 in the United States cost $8,000-$10,000 in India, said Razia Hashmi, chief medical officer for Anthem National Accounts.

She also said healthcare would be in compliance American Medical Association medical tourism guidelines and Blue Cross/Blue Shield Association standards, BusinessWeek said.