Medical tourism: Trends for 2012 and beyond

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled: "Medical tourism: Trends for 2012 and beyond"

Medical tourism: Trends for 2012 and beyond
Christmas is over, the New Year is upon us, so it’s time to dust off the crystal ball and put forward our take on what’s in store for medical tourism in 2012 and beyond. We’ve looked at the future of medical tourism from three perspectives – the market, the patient and the industry 

The market

The global economic downturn and medical tourism
Forecasts for the global economy are not encouraging....recession in Europe, anaemic growth in the US and slow growth in the emerging market economies is anticipated for 2012 (Morgan Stanley: 2012 Outlook). If you are in the medical tourism sector, you need to understand some of the fundamental trends that affect businesses and markets in a recession.

• In the mature, developed economies (e.g. USA, Europe) continued unemployment and pressure on disposable income will influence demand in 2012. Consumers will minimise or reduce spending on healthcare where they can. This does not mean that hard pressed consumers will be flocking abroad for their operations to save money. Many will delay treatment, or in the case of “optional surgery” such as cosmetic surgery, they may not be able to afford it at all. Domestic prices for surgery will be driven down as hospitals apply marginal costing and prices to fill empty beds. In areas of treatment, where the need for treatment is “income-inelastic”, demand for medical tourism services will remain strong.  Patients will continue to dig deep for services such as infertility treatment, stem cell treatment, and for surgery which is essential, life-saving or life changing.
• In emerging markets (such as Russia, China), the growth in incomes (and freedom to spend) is outstripping the development of domestic healthcare services and this may drive demand for medical tourism and present new opportunities.

The big question is whether corporate or insurer paid medical travel will get off the ground in 2012. Will employers and insurers see medical travel as a realistic and credible option to reduce healthcare costs. And will their client and subscriber base actually “buy in” to the medical travel option if it is offered to them?

Medical tourism..... global healthcare or regional medicine?
In 2012, there’s a risk that we get distracted by the trumpeting of “global healthcare”. It’s a nice turn of phrase, but in the real world, medical tourism is about regional medicine and cross-border healthcare; this is not going to change in 2012. In fact, the boundaries of medical travel may be drawn in, as travel costs increase. As travel costs climb, the concept of long distance medical tourism becomes less attractive. The imposition of hefty departure taxes in countries such as the UK, Germany  and elsewhere will reduce the cost advantages of some destinations.

If you are in the medical tourism business, ALWAYS remember that, for most patients, going abroad for treatment is a decision of last resort. AND that the further a patient has to go... further from their own country....further from their own culture... the greater is the actual and perceived risk. The patient needing major surgery who takes a five hour flight to a country with a different language and a different culture is a comparative rarity.

So is it medical tourism boom.... or bust?
The honest answer to this one.... is probably neither.  In recent years, we’ve listened to the hype........

.........to find out more about "Medical tourism: Trends for 2012 and beyond", read the full medical tourism article at IMTJ.

Protecting your medical tourism brand on the internet...beware the "brandjacker"!

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled: Protecting your brand on the internet...beware the "brandjacker"!"

The internet is a great place to market your medical tourism services but because it is difficult to police, it can be easy for a domain name speculator to hijack your brand. Businesses can find that having spent years developing and investing in a brand, one day along comes a domain name speculator or “brandjacker” who aims to profit from the brand value and customer loyalty that legitimate marketers have built.
“Brandjacking” is difficult to combat; the internet crosses international barriers. When someone hijacks your brand or trademark by registering domain names that are clearly related to your business, it can lead to complex and lengthy legal action to protect your marks. There is a set of guidelines about domain name registrations and dispute resolution published by ICANN (the Internet Corporation for Assigned Names and Numbers) that may be of help. See their Domain-Name Dispute-Resolution Policy .

There’s nothing wrong with registering domain names that you may want to use in your existing or future business activities. I met a group of UK doctors once who had registered over 5,000 domain names related to various types of medical procedure. This was in the early days when you paid over $100 for a domain name! In our web publishing business, we own around 130 domain names... not that many... most of which are in active use for our sites. The problem arises when people start registering multiple domain names:

• To obstruct the activities of an existing business by incorporating their brand or trademark into a domain name.

• To divert visitors from an established web site (often by registering mis-spellings of domains).

• To sell the name back to the brand owner at a premium. 

.........to find out more about "brandjacking" in medical touris, read the full article at IMTJ: Go to Protecting your brand on the internet...beware the "brandjacker"!

Believe what your customers do...not what they say!

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled: "Believe what your customers do...not what they say!"

A recent article in Harvard Business Review, “Four Simple Low Resolution Innovation Tests” highlights the problem faced by anyone who is considering investment in the medical tourism business. How can you know whether people will actually buy your service i.e. whether patients will actually travel abroad to use your services?

Much of the “research” conducted in the medical tourism sector is about what people say they will do.... not about what they actually do. For example, the 2009 Gallup Survey in the USA is frequently used to support the “booming medical tourism market” hypothesis.

The report on this Gallup poll was headed “Americans Consider Crossing Borders for Medical Care”. It found that “up to 29% of Americans would consider traveling abroad for medical procedures”.

Now the key words here are “will consider”. It does not say “will travel” or “have travelled”. And there lies the problem.......

.........Read the full article at IMTJ: Go to "Believe what your customers do...not what they say!"

Medical tourism: After the gold rush

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post on "Medical tourism: After the gold rush"

Last year, I blogged about “Medical tourism...lessons from the California gold rush”. It’s taken me a while to write the postscript to this, but I finally got around to it last week when I spoke at the European Medical Travel Conference in Barcelona. (You can download my presentation “Medical Tourism: After the Goldrush” as a pdf file on the IMTJ web site).

In my gold rush analogy, I describe how in 2005/6, medical tourism became the next big thing.

In Google News for 2006, you’ll see headlines appearing like these:

• “One million medical tourists flocking to India”
• “Bumrungrad attracts more than 400,000 foreign patients each year”
• “Philippines is set to cash in on the $3-trillion global medical tourism market”
• “Half a million Britons travel for treatment....”
  

News stories appeared around the world about a surge in medical tourism. The first prospectors for “medical tourism gold” appeared - medical tourism agents and facilitators, overseas hospitals and clinics were seeking their fortune in the world of medical tourism. The tales of medical tourism gold began to multiply. Estimates of the number of medical tourists were in the hundreds of thousands, the millions, and then the tens of millions. Few medical tourism prospectors questioned the validity of these claims of the discovery of a rich vein of income or whether it was sustainable.......

.........Read the full article at IMTJ: Go to "Medical tourism: After the gold rush"

Comparing quality in medical tourism

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post on Comparing quality in medical tourism.

How does a medical tourist make a valid comparison of a doctor, hospital or clinic in one country with a doctor, hospital or clinic in another? The simple answer is that he or she can’t. And the truth is that it may never be the case (well not in my lifetime).

In the hypothetical world, we talk about patients making informed choices about treatment....about how we can provide them with the information that they need to compare healthcare providers and make valid decisions about which one is the “best”, the “safest”, the “highest quality”. But even if someone is only interested in treatment within one country, this may be impossible. In a country such as the UK where there is a national publicly funded health system it becomes more of a possibility. In the UK, there are quality indicators, performance measures, and outcome data that are collected in the same way and analysed in the same way across all healthcare providers (whether they are public or private hospitals). So, patients can make reasonably valid comparisons of healthcare providers.

However, in many countries which are promoting themselves as medical tourism destinations, there may be no strategy or system for collecting data on quality, performance and outcomes on a national basis. So, making an “informed choice” even within that country becomes a virtual impossibility.

.........Read the full article at IMTJ: Go to Comparing quality in medical tourism.

A new dawn for cross-border healthcare in Europe?

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post on "A new dawn for cross-border healthcare in Europe?"

A new dawn for cross-border healthcare in Europe?
Will European hospitals see a surge in patient numbers following the approval of the EU Directive on Cross-Border Healthcare by the European Parliament recently?

I would like to say...Yes! But the reality may be a little different. So....let’s take a look at how the EU Directive may (or may not) change the way that healthcare works in Europe and more importantly whether it will give a boost to the medical travel sector.

Consolidation of existing patient rights
The EU Directive does not give patients any rights to cross border healthcare that they don’t have already. It doesn’t introduce any new rights. These rights have already been established by the European Court of Justice. What the Directive aims to do is to establish a framework within which cross border healthcare will operate and to set the rules regarding how patients will access care and what kind of treatment they are entitled to. The new rules should be in place by 2013 (in theory....).

The Directive will end the uncertainty about the kind of treatments that patients are entitled to elsewhere within Europe and it will also allow domestic healthcare systems to maintain control of the patient’s entitlement to cross border healthcare. But the Directive does present opportunities for hospitals and healthcare providers to generate revenue from patients from elsewhere in the EU.

But overall, there will not be an overnight change and we are unlikely to see a surge in the number of cross border patients within the EU.

Within the UK, there are already well established procedures for National Health Service patients who wish to exercise their right to cross border care under existing EU law. Every NHS trust has (in theory) a procedure in place to deal with requests and to manage the process. See “NHS Choices - Planned treatment abroad”. Last year, it is believed that around 500 British patients exercised their right to cross border healthcare and underwent treatment abroad that was funded by the NHS.

.........Read the full article at IMTJ: Go to "A new dawn for cross-border healthcare in Europe?"

The medical tourism numbers game... Part 2

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here, in future. Here's an extract of the latest blog post on "The medical tourism numbers game... Part 2"

The medical tourism numbers game... Part 2
Back in May 2008, I blogged on “McKinsey and the medical tourism numbers game..." and commented on their strange way of counting (or not counting) medical tourism numbers. Given the latest study on medical tourism numbers, “New study numbers US medical tourists in thousands not millions”, reported in IMTJ, I thought it was time once again to address the thorny issue of....how many medical tourists are there?

Defining the medical tourist
Before you can begin to count medical tourists, you have to be very clear about what it is you are counting. This is one of the greatest areas of confusion in the business sector.

So, what is a medical tourist?

In my view, a medical tourist is someone who travels outside of their own country for surgery or elective treatment of a medical condition. If we apply this narrow definition, we DO NOT include:

• dental tourists
• cosmetic surgery tourists
• spa and wellness travellers
• "accidental" medical tourists (business travellers and holiday makers who fall ill while abroad and are admitted to hospital)
• expatriates who access healthcare in a foreign country.

Read the full article at IMTJ: Go to "The medical tourism numbers game... Part 2".

Is medical tourism safe?

To keep things simple, this blog is moving to the IMTJ web site. You can find the Health Tourism Blog here, in future. Here's an extract of the latest blog post on "Is medical tourism safe?"

A significant proportion of medical tourism and medical travel is driven by people seeking established and proven treatments in countries where the cost of the treatment or operation is much lower than in their home country. Within this segment of the market, the focus of patient safety is upon the hospital, clinic or doctor who is carrying out the treatment. Can the patient be confident that the healthcare provider has the necessary expertise and experience to carry out the procedure? The question... “Does this treatment actually work?” does not arise.

For proven treatments, the hospitals, clinics and doctors (and medical tourism facilitators) can reassure the patient by providing proof of qualifications, accreditations; experience and so on.... and in some cases may be prepared to provide data on clinical outcomes. Unfortunately, this is all too often lacking. Patients are often asked to take on trust the claims of the healthcare provider, particularly in those countries that do not have national standards and systems for the collection of comparative clinical outcome data or independent review and analysis. Even an international accreditation such as JCI is not a guarantee of quality, nor an assessment of how good a hospital actually is at delivering safe and successful treatments.

So, in established areas of medical travel such as cosmetic surgery, dental treatment and elective surgery there is still much work to be done to convince potential medical tourists that treatment abroad is a safe option (or at least as safe as within their home country).

Read the full article at IMTJ: Go to "Is medical tourism safe?"

Predicting future demand for medical tourism: Health tourism blog is moving to IMTJ

To keep things simple, this blog is moving to the IMTJ web site. You can find the Health Tourism Blog here, in future.

Here's an extract of the latest blog post on "Predicting future demand for medical tourism".

The latest data on hospital activity within the UK National Health Service provides a useful indicator of where future demand for medical tourism may lie. One of the advantages of the UK public health system is that with one provider....the NHS, and one payor....the NHS it means that an enormous amount of meaningful data can be captured about the state of the nation’s health, about demand for health services and about how the health profile of the population is changing.

Like many developed countries with established health systems, the UK is facing the challenge of meeting the needs of an ageing population at a time when there is massive pressure to reduce or put a hold on public spending, and in effect reduce expenditure on health services. All UK hospitals collect data in the same way (well almost...) and the data is collected centrally by the NHS.

The following data is taken from the recent report “Hospital Episode Statistics: Admitted Patient Care – England 2009/10”, published by the NHS Information Centre.

Take a look at how demand for NHS hospital services has changed over the last ten years. First let’s examine the age profile of patients admitted to UK hospitals:

In 2009/10 there were:

• 16,806,200 hospital stays, a 38 per cent rise on 1999/2000.
• 1,939,190 stays for patients aged 0 to 14; a 15 per cent rise on 1999/2000.
• 7,333,110 stays for patients aged 15 to 59; a 29 per cent rise on 1999/2000.
• 3,642,940 stays for patients aged 60 to 74; a 48 per cent rise on 1999/2000.
• 3,837,990 stays for patients aged 75 and over, a 66 per cent rise on 1999/2000.

Read the full article at IMTJ: Go to "Predicting future demand for medical tourism".

Comparing the costs of (accidental) medical tourism

Whereas much of the attention in the medical travel sector is focused on medical tourism (i.e. where the primary reason for travel is some form of surgery or treatment), a more established and mature market sector is the provision of healthcare services for the tourist or business traveller who falls ill when abroad.

The structure and maturity of this sector means that it is far easier to gather comparative data such as the cost of healthcare and actual treatment in different countries. Cost management is in the hands of the international insurers, the travel insurance companies and the assistance companies who negotiate prices with hospital providers worldwide.A recent analysis of travel insurance claims, published by the UK based travel insurer, Sainsbury’s Travel Insurance, provides an insight into the variation in hospital costs across the world and the rising trend in hospital costs.

According to their analysis:

• In 2009, a record number of people needed medical treatment whilst abroad.
• The most expensive country for inpatient hospital treatment was the United States, with the average hospital visit costing £6,000.
• The average cost of hospital treatment in a foreign country has climbed to £2,040 over the last 12 months, an increase of 6.25% year-on-year.
• The most significant increase in treatment costs were seen in Turkey (+10%), the USA (+10%) and Spain (+7.5%).
• Over the summer months (May to September), the most common reason for hospitalisation was gastroenteritis with the average bill for inpatient treatment amounting to £1,200.
• The most expensive hospital bills were for those who suffered a heart attack abroad, resulting in medical expenses that averaged £12,500.

It’s interesting that the international assistance companies who deal with these "accidental" medical tourists have shown little or no interest in entering the medical tourism business. They have everything in place to become the world’s number one facilitator and blow everyone else out of the market:

• They have a network of “approved” hospitals around the world.
• They facilitate treatment for thousands of international patients in foreign countries every day.
• They have call centres to deal with patient enquiries.
• They have extensive technology and systems to manage the patient process.
• They have people on the ground in major destinations who can provide local support.
• They have comparative data on treatment outcomes and comparative costs in hospitals around the world.

So, why haven’t companies like Europ Assistance, Mondial Assistance and AXA Assistance entered the medical tourism market and used their expertise to attain a dominant market position?

The answer is probably quite simple. The medical tourism market is just not big enough to be attractive to them, nor worth the hassle. Which is good news for the existing operators...but puts the medical tourism market opportunity in perspective compared to the long established international assistance market.