Research from Kogod School of Business marketing professor Kelli Frias finds that cross-border healthcare along the US–Mexico border is not driven by medical tourism, but by routine consumer decision-making. Border residents integrate medical visits into weekly activities, motivated primarily by transparent pricing, accessibility, and trust. The findings highlight how predictability and reduced administrative friction shape healthcare behavior, offering lessons for US healthcare systems seeking to improve affordability, patient trust, and consumer-centered design.
Research from Kogod School of Business marketing professor Kelli Frias shows that cross-border healthcare is less about travel and more about navigating a system where predictability and affordability drive everyday decision-making.
Along communities that line the US–Mexico border, a distinctive healthcare pattern has persisted for decades—one that challenges common assumptions about why individuals seek medical services outside the United States.
For many families, visiting clinics, dentists, or pharmacies in nearby Mexican towns is not an exceptional event or a planned medical trip. Instead, these visits are embedded into weekly routines and often paired with grocery shopping, family visits, and other everyday errands. Cross-border healthcare functions as a familiar and efficient circuit, where medical care is simply one stop among many.
Research from the Kogod School of Business at American University highlights how this behavior reflects practicality rather than novelty. Mobility across the border is normalized, and healthcare decisions are shaped by lived experience rather than destination-based motivation.
A central finding of Frias’s research is the outsized role of price transparency in shaping healthcare behavior.
Within the US healthcare system, patients often face uncertainty around costs, even when insured. Estimates can vary widely, billing structures are complex, and final charges frequently remain unclear until well after care is received. This unpredictability creates stress and undermines trust.
In contrast, healthcare providers in Mexican border towns typically offer clear, upfront pricing. Patients know what services will cost before committing to care. This predictability reduces financial risk, restores a sense of control, and builds trust between patients and providers.
Cross-border healthcare operates as an informal yet highly functional system aligned with consumer needs. Clinics, pharmacies, and dental offices are often located within close proximity, allowing patients to access multiple services efficiently.
Administrative barriers tend to be minimal. Walk-in appointments are common, wait times are shorter, and the overall experience emphasizes accessibility rather than bureaucracy. Cultural and linguistic familiarity further strengthens patient comfort and reinforces long-standing provider relationships.
Frias’s research underscores that trust in this system is built through repetition, reliability, and shared community norms, often spanning years or generations.
As policymakers and industry leaders in the United States grapple with rising costs, administrative complexity, and declining patient satisfaction, the border healthcare model offers meaningful insight.
Patients consistently demonstrate that they value clarity, efficiency, and respect for their time. When domestic systems fail to deliver these qualities, individuals seek alternatives—even when those alternatives involve crossing an international border.
This research challenges the notion that patients are passive healthcare consumers. Border residents are shown to be highly strategic, weighing costs, evaluating provider reputations, and making informed decisions based on experience and familiarity.
Although rooted in border communities, these findings have national relevance. As debates around healthcare affordability, price transparency, and consumer empowerment continue, this research provides a clear example of how people respond when systems fail to meet basic expectations.
Kelli Frias is an Associate Professor of Marketing in the Kogod School of Business at American University. She joined the Marketing faculty Fall of 2019. Dr. Frias received her Ph.D. in Marketing with a minor in Law from the University of Arizona. Her research interests include marketing strategy, price formats, interfirm relationships, and price-quality relationships in healthcare. She is an Ewing Marion Kauffman Foundation Fellow and recipient of nearly $2 million in National Science Foundation grants, a $1.2 million grant from Blue Cross Blue Shield of Texas, and the VentureWell Foundation. She has published in journals such as Organization Science, Journal of Marketing, Journal of Macromarketing, Journal of Brand Management, Journal of Racial and Ethnic Health Disparities, and Journal of Consumer Affairs. Her teaching interests include marketing strategy, brand management, and marketing and law. She has previously worked in grocery retail, labor relations, and as a consultant in branding and labor disputes.