Health systems are increasingly turning to virtual second opinions (VSOs) as a strategic lever to extend global reach, differentiate in competitive markets, and unlock long-term value. In this episode of The Strategy Catalyst Dispatch, we speak with Jarrett Fowler, Senior Director of Strategic and International Initiatives at NCHL and leader of USCIPP, a consortium supporting over 60 U.S. hospitals with international patient programs.
Anika Rasheed, Senior Analyst, and Jerome Pagani, Executive Director of Strategy Catalyst, unpack the insights Jarrett shares on the rise of international and domestic VSO programs. From identifying high-opportunity regions and specialties to navigating legal barriers and building scalable infrastructure, this episode offers a roadmap for CSOs evaluating where VSOs fit into their enterprise strategy. The conversation also explores emerging best practices for physician engagement, partnerships, and aligning VSO models with system strengths.
To listen to the full episode, please make sure you're logged in.
Preview of Episode Highlights
Key Takeaways:
High-Growth Global Markets for Virtual Second Opinions
Legal and Regulatory Considerations for International Expansion
Building Scalable VSO Programs Through Strategic Partnerships
Domestic VSO Programs: Physician Buy-In and Infrastructure Readiness
Rethinking ROI: VSOs as a Brand and Access Strategy
Download the audio episode
Key Takeaways
High-Growth Global Markets for Virtual Second Opinions: Health systems are seeing demand from regions including the UAE, Saudi Arabia, China, and Latin America, where patients are mobile, well-resourced, and actively seeking U.S.-based specialty care. Specialties with the strongest international appeal include oncology, pediatrics, and neurology, with virtual second opinions often serving as the entry point for long-term referral relationships and brand recognition abroad.
Legal and Regulatory Considerations for International Expansion: Successful programs address key compliance concerns early—such as cross-border data sharing, physician licensure, and patient privacy. Partnering with a local treating physician not only helps health systems navigate legal constraints but also supports clinical continuity for patients who return home after receiving care in the U.S.
Building Scalable VSO Programs Through Strategic Partnerships: Collaborations with in-country providers, embassies, or ministries of health reduce regulatory risk and improve operational efficiency. USCIPP supports systems in forming these relationships and provides access to legal analyses and benchmarking to guide safe and strategic expansion.
Domestic VSO Programs: Physician Buy-In and Infrastructure Readiness: Health systems are designing VSO programs around existing clinical strengths, using strategies like asynchronous consults, subspecialty case matching, and identifying “VSO champions” to increase physician participation. Programs must also manage licensure complexities and reimbursement uncertainty—most systems still operate with self-pay or employer-sponsored models, though payer interest is growing.
Rethinking ROI—VSOs as a Brand and Access Strategy: While in-person conversion rates vary, many systems view VSOs as a long-term investment in brand equity, access, and global reputation. For CSOs, success isn’t just about direct revenue—it’s about market positioning, clinical outreach, and strategic alignment with enterprise goals.