– Donna Ferguson awoke in the resort city of Cancun before sunrise. She wasn’t headed to the beach. Instead, she walked from her hotel and into Galenia Hospital.

Later, an American surgeon, Dr. Thomas Parisi, stood by her bed and used a black marker to note which knee needed repair.

U.S. hospital costs are so high that it made financial sense for both a highly trained orthopedist from Milwaukee and a patient from Mississippi to leave the country and meet at an upscale Mexican hospital for the surgery.

Ferguson, 56, gets her health coverage through her husband’s employer, Ashley Furniture. The cost to Ashley was less than half of what a U.S. knee replacement would have been. That’s why employees and dependents who use this option have no out-of-pocket co-payments or deductibles; in fact, they receive $5,000 from the company, and their travel costs are covered.

Parisi was paid $2,700, or three times what he would get from Medicare.

In a new twist on medical tourism, North American Specialty Hospital, known as NASH and based in Denver, has organized treatment for U.S. patients at Galenia Hospital since 2017.

Parisi, a graduate of the Mayo Clinic, is one of about 40 U.S. orthopedic surgeons who have signed up with NASH to travel to Cancun on their days off to treat U.S. patients. NASH is betting that having an American surgeon will alleviate concerns about going outside the country, and persuade self-insured U.S. employers to offer this option to their workers.

The high prices charged at U.S. hospitals make it relatively easy to offer surgical bargains in Mexico: In the United States, knee replacement surgery costs an average of about $30,000 — sometimes double or triple that — but at Galenia, it is only $12,000, said Dr. Gabriela Flores Teón, medical director of the facility.

I. Glenn Cohen, a law professor at Harvard, called the model a “clever strategy” to attack some of the perceived risks about medical tourism. “It doesn’t answer all concerns, but I will say it’s a big step forward,” he said.

NASH’s strategy has its skeptics. Irving Stackpole, a health consultant in Rhode Island, said only a limited number of Americans were willing to travel abroad because most perceive the care won’t be as good.

Officials at Ashley Furniture, where Ferguson’s husband, Terry, is a longtime employee, said they had been impressed. “We’ve had an overwhelming positive reaction from employees who have gone,” said Marcus Gagnon, manager of global benefits and health at Ashley, which has 17,000 employees. Ferguson was the company’s 10th insured person to go to Cancun.

Ashley also has sent about 140 employees or dependents to Costa Rica for treatment, and together the facilities have saved the firm $3.2 million in health costs since 2016, he said.

Ferguson’s knee started causing her trouble two years ago. “I had a friend say, ‘You are nuts for doing this,’ but Dr. Parisi trained at Mayo, and you can’t do any better than that,” she said. “Even if I had to pay, I would come back here because it’s just a different level of care — they treat you like family.”