Medical Travel Today

THIS WEEK IN MEDICAL TRAVEL TODAY
Volume 2, Issue 31
by Amanda Haar, Editor

Welcome to the final issue of Medical Travel Today for 2008. And it's a big one.

In addition to our regular features, we have a PERSPECTIVES piece from Ruben Toral in which he shares his observations and thoughts from the recent Consumer Health World Conference. In addition, we have two great SPOTLIGHTS from both inside and outside the industry:

Sherry Kaufield of the Joint Commission International discusses the organization's latest initiative to ensure patient safety worldwide.

Chris Robbins of Arxcel, a prescription benefit management company, addresses lessons that the medical travel industry could learn from the experiences of those involved in medical re-importation.

Plus, there's plenty of industry news to share—from the latest moves by Aetna to expand its international reach, to the increasing impact medical tourism will have on the global health care landscape.

It should be plenty to carry you through the holiday season and when we resume publishing on January 9, 2009.

I hope you all have a safe holiday wherever and whatever you're celebrating. My sincere thanks to everyone who has contributed to this publication's success over the past year. Your generosity of time and information is what makes it all possible.

NOTE: This is the last issue of Medical Travel Today for 2008. Our first issue in 2009 will publish on Friday, January 9.

Dear Ms. Haar:

Thanks so much for this month's PERSPECTIVE article and interview with Dr. Amy Bozwaylo, a chiropractor who leads an integrated health care team in Saudi Arabia. Her story is both interesting and inspiring, and provides the perspectives of a dedicated woman who has successfully dealt with adjusting to the customs of a different culture while solidifying her career as a chiropractor. In a society dominated by traditional medicine, she is definitely making a difference and bringing options to local citizenry.

Thanks to your publication for helping to tell a story about the best kept secret in healthcare: chiropractic. At the Foundation for Chiropractic Progress, a not-for-profit organization that is raising awareness of chiropractic care, we are trying to bring this message to a wider audience. Through Public Service Announcements, press releases, and other activities, we are advancing this great profession. In fact, future football Hall of Famer Jerry Rice is now sharing his positive story about how chiropractic helped him to excel in the sport of football.

The chiropractic profession has been around for more than 100 years but very few people have seen its benefits. We are trying to tell this story, and you have been helpful by publishing the experiences of this exemplary chiropractor.

Gary Cuneo
Chief Operating Officer
Foundation for Chiropractic Progress
www.yes2chiropractic.org

Ruben Toral is a recognized leader in medical tourism and health care globalization. Formerly group marketing director for Bumrungrad International, Toral is widely recognized as one of the driving forces behind medical tourism and Bumrungrad’s position as the world’s premier medical tourism destination. Now owner and operator of a health care marketing company, Mednet Asia Ltd., Toral has extensive health care experience.

Toral shares his perspectives on the growing industry with Medical Travel Today on a monthly basis.

There is definitely change in the air. Canvassing speakers and attendees at the Consumer Health World Conference in Washington D.C. last week, it is clear that U.S. employers and insurers are finally buying into medical tourism. Just don’t expect to see any patient movement until 2010. It’s a case of hurry up and wait.

Despite rising awareness, widespread press coverage, and increased U.S. employer and insurer interest, there is a high probability that medical tourist volumes will drop in 2009. Blame this on two factors. One, the global economic downturn is forcing consumers to cut back on all non-essential spending, and that includes elective surgeries. Two, implementing new plan design requires long lead times.

As David Boucher, CEO of Companion Global Healthcare, explains the sales-implementation cycle for new benefit design is normally 12 to 18 months. Plan designers are pitching new products today for implementation in 2010, which effectively means that overseas hospitals may not see insurance patients until the 1st or 2nd quarter of 2010. The year 2010 will create the trickle but not the long-anticipated stream of medical tourists that everyone is waiting to see.

This is actually good news for the international provider community because they still have a lot of work of to do—particularly in the areas of liability, continuity of care, quality standards, and outcomes reporting. If there is any one single issue that is constraining adoption, it is liability. Hungry as they may be for lower cost health care options, U.S. employers will simply not bite on medical tourism if they perceive the liability risk as being too high.

At one panel session, representatives from Kellogg, the State of Colorado, and Whirlpool underscored the importance of liability protection as a condition of their adoption. At another, Dale van Demark and Kevin Ryan, attorneys with Epstein, Becker and Green, along with Dave Arvola, senior vice president with Lockton, outlined strategies that overseas providers should be looking at to help manage risk and liability. Their message was clear: plan now while you have the opportunity.

Quality standards and continuity of care are no less important. International providers need a credible system of uniform standards that take the quality issue off the table. Peter Hayes, director for Health and Wellness for Hannaford Brothers, a Maine-based supermarket chain, believes that by publishing outcomes data, international providers will gain a strategic upper hand over U.S. providers that have been reluctant to share that data.

Engaging U.S. physicians is one of the biggest opportunities and challenges in solving the continuity of care issue. U.S. physicians remain largely unaware of international options, and Joseph Heyman, M.D., chairman of the Board of Trustees for the American Medical Association, challenged the industry to do more to educate U.S. physicians. A good start would in working with leaders like Michael Parkinson, M.D., president of the American College of Preventative Medicine, and Marcy Zwelling, M.D., the incoming president for the Society of Innovative Medical Practice Design (SIMPD). Both are intelligent, patient-centered physicians who understand the transformative power globalization will have on the U.S. health care system.

The year 2009 is the time to create structural bridges that enable medical tourism. The recession is proving a blessing in disguise for medical tourism because it is bringing more employers to the table, and that in turn is forcing benefits design companies and insurers to develop new global products. We are entering the calm before the storm.

Laura Carabello, publisher of Medical Travel Today, attended the open forum at the Consumer Health World Conference hosted by the International Medical Travel Association (www.IMTA.org) and provides this overview of the presentation by David Boucher, CEO of Companion Global Healthcare.

Boucher describes medical travel as a disruptive innovation that may take seven to eight years to fully mature. The prime forces that are driving change can well be characterized as a “perfect storm.”

Boucher asserts that robust market opportunities exist. Providers agree they need outcomes measures and standards, such as post-surgical mortality rates, patient satisfaction scores, complication rates, and other benchmarks. Furthermore, the industry is getting the blessing of prominent thought-leaders such as Arnold Milstein, M.D., and others.

He points to published articles that promote strategic imperatives, including the need for long-distance triage services to meet the significant increase in the number of U.S. employers who are inquiring about medical travel programs. Payers, including fully insured organizations offering programs for large employers, as well as individuals and small groups, want lower cost packages and intend on offering traditional benefits plans with travel options.

Providing value to self-insured employers will drive the industry forward because competition is now a global phenomenon. Today, he points out that large numbers of patients are suited to long-distance travel for complicated procedures.

Boucher explains that there are still product gaps in medical travel. The continuing-care process in the United States is not yet fully built, although he is confident that the medical community will soon respond. There had been risk for employers to pursue these options, although Employer E&O and liability products are now emerging. Employers are still concerned about unintended consequences of surgery and are looking to the insurance community for solutions.

“Rising tides float all boats,” advises Boucher, urging international providers to continue to pursue quality services that meet payer and consumer expectations.

Sherry Kaufield, M.A., FACHE
Executive Director, International Services
Joint Commission Resources, Joint Commission International

Recently the Joint Commission International (JCI) issued The International Essentials for Quality and Patient Safety™.

The Essentials Framework is a guide to the hospital risk points that have the greatest impact on patient care. Intended to help organizations design and implement risk reduction programs, the Essentials highlights five main areas of risk:

Leadership process and accountability
Competent and capable workforce
Safe environment for staff and patients
Clinical care of patients
Improved quality and safety

Medical Travel Today recently had the opportunity to speak with Sherry Kaufield of the JCI about this important initiative. The following is an excerpt of that conversation.

Medical Travel Today (MTT): What drove the JCI to create the Essentials?

Sherry Kaufield (SK): We’ve actually been working on it for the past 12 months or so. And even before that we were talking about the idea of having something available for organizations that would offer guidance and be a resource to help ensure patient safety but that could also be implemented easily and have big impact. That was the goal.

But ultimately a big motivation for us was the statistics.

Each year one million people die as a result of medical errors. Another one-in-ten is seriously harmed by errors. Those numbers are hard to ignore, especially as we continue to see these kinds of stories in the headlines.

Having those statistics in front of us, and as we continue to provide efforts to organizations worldwide in a more intense way (preparation for international accreditation), we set out to create a useful quality and patient safety tool that over time became the Essentials.

MTT: What was the process for creating the initial framework and final document?

SK: Joint Commission Resources has three international advisory councils that we consult with regularly in the Middle East, Asia Pacific, and Europe. They help us with standards development issues and offer advice and ideas about the program and services we provide or might consider. The nice thing about our councils is that they’re made up of individuals from those geographic areas, so they accurately represent the health care needs of their region. We talked with our advisor council members, and they provided input based on their experience, background, and cultures. It’s similar to the approach we use in other educational work, only looking toward our goal of reducing risk for patients.

We very much wanted to be sure we were building in what was necessary to meet the needs of the various regions of the world. We had a good idea of what we wanted to accomplish through the service or framework. We wanted it to be simple to understand and easy to implement. That is, people could look at the risk areas and criteria and figure out if their organization had what they needed in order to improve quality and reduce patient risk. The goal is to have people use the tool, so it was very important to us not to complicate it.

There are approximately 20 to 30 people on each advisory council, and we had another 50 to 100 people from both our staff and our consultant group who offered input. By the time the Essentials was offered to the public, there were many people who were a part of the process of bringing the effort forward. Their contributions ranged from offering opinions, providing research and information, and reviewing what we put forth in various draft forms.

MTT: How did you reach the decision to create a tool as opposed to an accreditation program?

SK: We discussed that issue at length.

We’re always looking at how we provide services and what might be the next evolution of our work. We didn’t feel that it was necessary at this time to create another accreditation-type program.

We wanted this effort to be less intense; we wanted to offer something that many organizations, regardless of their current level of quality or patient safety, felt they could approach and strive to accomplish.

As you know, the accreditation process can be daunting to organizations without a lot of structure or resources, and by resources I mean money, people, and facilities.
Our goal was to get this tool into the hands of as many hospitals as possible and make it simple to understand and use. We feel that the Essentials does that.

MTT: How have the Essentials been received thus far?

SK: We’ve had more than 200 downloads in the two weeks since we released the Essentials. That’s really inspiring to us.

What’s also encouraging is that people from all over the world are downloading the Essentials. We can track them to the United States, the Middle East —actually that was an area of heavy interest—Colombia, Cypress, Egypt, France, Hong Kong, Italy, Beijing, and numerous other locations.

MTT: The initial press release regarding the Essentials noted that Mexico would be the first country to “demonstrate this product to other countries.” Can you tell me first how you came to select Mexico and, secondly, specifically how they are going to demonstrate the Essentials?

SK: Actually, there are three countries involved in the demonstration projects: Mexico, Palestine, and China.

The way they came to the forefront is that we sent out invitations for ministries of health around the world to participate. The ministries of those three countries came forward immediately. We do have others who are also very interested. But I’m very happy we’ll be starting the demonstrations in those areas because we’ll be able to gather information on how the Essentials can be applied in three very different geographic and cultural areas.

In terms of the demonstration projects, we’ll be working with these ministries over approximately 12 to 18 months to assist them with education, implementation, and data collection. We’re still solidifying our methodology for the demonstration projects because ultimately we want to help organizations customize their response for the best result in their organization. What each group needs to do really depends on where they are in the process of quality assurance.

For instance, some organizations may want guidance on how to organize a risk-reduction effort; some may need to focus on different types of data gathering and management, and so on. Organizations with quality management departments may need different types of assistance than those without them.

Some very small hospitals in some countries of the world may have few standardized processes and systems, while on the other end of the spectrum there are large organizations that follow many standards, perhaps both national and international, and that are very familiar with issues that affect quality and patient safety.

However, every organization will use the same Essentials framework to evaluate their performance. For each of the five Risk Areas being assessed, there are 10 criteria to be evaluated. Each refers to something very specific about that risk area.

We’re available as a resource to anyone who downloads the Essentials. We want to make sure that they understand the purpose of the tool, how to use it, and to offer our assistance if they have questions. We want to help organizations who are motivated to improve quality and patient safety to move toward their goals.

MTT: Will you be providing participating organizations with some sort of confirmation of completion?

SK: No. Since this is not an accreditation process where we actually go to each facility and view their work, we don’t really have a means for confirming that organizations meet the provided criteria in the Essentials. All we know is what they tell us. Because we’re not validating their data, we’re not providing any confirmation or certification. If an organization chooses to publicize that they follow or have met the JCI Essentials, that’s really up to them. But we would encourage patients or interested individuals to ask for evidence of that claim.

MTT: What will be the process for re-evaluating the Essentials in the future? Who will be involved, etc.?

SK: Well, in the process of the demonstration projects and as organizations work with the Essentials over time, we’ll be looking to learn if there are any problems in understanding what the criteria are and how to assess whether or not criteria are being met. That will help us understand on an on-going basis if there are issues that impact the usefulness of the tool to provide safer care for patients.

We see this is as a very dynamic tool, and we’re willing to make changes that will make it better. We’re very excited about this methodology, and we’re going to do everything we can to support it in the field.

MTT: How do you see the Essentials impacting medical travel?

SK: I don’t think the impact will be apparent very quickly in the medical travel arena. But it will really depend on what organizations do. Organizations that assess their performance against the Essentials framework, evaluate their results, and then make changes to reduce risk and improve patient safety will ultimately provide safer care. People who travel want to go to health care facilities that focus on safe care.

We hope that as awareness of the Essentials broadens in the health care field everyone’s awareness of risk and risk areas will be heightened. We want not only health care professionals, patients, and family members, but the general public as well. The risks we’re focused on in the Essentials are the ones that hurt patients. We want to do everything we can to reduce them.

To download the International Essentials of Health Care Quality and Patient Safety™, click here.

About Sherry Kaufield
Ms. Kaufield joined Joint Commission Resources in 2005 with more than 30 years of experience in healthcare. Sherry oversees JCI international consulting and education services in more than 80 countries, collaborating regularly with JCI regional managing directors in Singapore, Dubai, Milan, and Ferney-Voltaire, France.

Sherry has advised both domestic and international health care organizations in the areas of standards compliance, accreditation readiness, and quality improvement. She has traveled extensively and worked with multiple clients in Europe, the Middle East, Asia, Africa, and Latin America. Clients include individual organizations, health care systems, Ministries of Health, Health Authorities, and other government bodies. Sherry regularly serves as a faculty member at international JCI practica and other educational events. She is a consulting editor and contributor for the publication, “Joint Commission International Accreditation: Getting Started,” and many other JCI resources.

As a former chief operating officer and corporate compliance officer of a 400-bed tertiary Medical Center and Level I trauma center, Sherry has expertise in operations; business development; public relations and marketing; and the development and implementation of multi-hospital system performance improvement and strategic planning initiatives. Her background also includes consultation to non-profit healthcare and other organizations in the areas of board leadership and development.

Sherry earned a master’s degree in Psychology from Vermont College and is a Fellow in the American College of Health Care Executives.

SPOTLIGHT
Chris Robbins

Chris Robbins,
President and CEO
Arxcel

Recently Arxcel released its 2008 Prescription Benefit Research Survey aimed at identifying and tracking prescription benefit trends. By gathering the opinions of high-ranking executives overseeing corporate areas, such as human resources, compensation and/or employee benefits, the study examines perceptions regarding the causes of high prescription benefit costs, potential solutions for slowing continuing cost increases, and premium/co-pay price points.

While the study did not ask any questions directly related to medical travel, Arxcel company founder and CEO, Chris Robbins sees parallels between medical travel and the prescription drug industry.

Medical Travel Today recently caught up Robbins to hear more about those parallels.

Medical Travel Today (MTT): Let’s start with what parallels you see between the industries and what you might have learned from the survey that’s relevant to medical travel.

Chris Robbins (CR): There are a couple of very interesting things we learned in the survey worth sharing.

But first, for me, I see an immediate correlation with the re-importation of drugs from Canada and internationally and medical travel. Medical travel is similar in that a big driver of people going abroad is cost. That’s the same for people who go abroad for prescription drugs. They’re willing to go wherever necessary to take care of their health needs in a manner that’s affordable to them.

In the survey, we found a lot of employers who are actively looking for solutions to keep prescription cost down without compromising quality of care for their employees. For example, a lot of employers are looking to incentivize the use of mail order pharmacies to control cost. This is not unlike medical travel in that they’re looking for centers of excellence. The concept of employers looking to provide incentives, or in some cases, mandates, so that patients use the method with the best outcome and lowest cost…it’s really the same idea but different application.

We’re also seeing employers recognizing the value of patient education. This is important in all aspects of healthcare and, I think, bodes well for medical travel. Employers are looking for employees to be active participants in the choices about their care and are, for what I perceive as the first time, looking at the overall coordination of employee care. They’re starting to really see how all the pieces work together. It’s no longer a silo mentality.

That bigger picture view is leading to new ideas and ways of providing coverage or care. Like the mandates I mentioned. Now of course it’s harder to mandate travel abroad but maybe we should look at that approach.

The markets that we’re interested in are the same as the medical travel markets—the uninsured and the under-insured.

You know many small employers battling with costs are now eliminating drugs under their plan. The average person spends $50 to $60 a month in prescriptions. If you’re uninsured, you could have yourself a pretty big bill. And if you’ve got family members with prescription needs, well, that’s an even bigger bill.

MTT: I see where you’re coming from in the parallels. What do you think medical travel could learn as an industry from what you’ve already witnessed with drug importation?

CR: I think it’s important to be alert to the stumbling blocks. We saw a lot of backlash with re-importation from Canada from physicians in the United States who didn’t like the process. There’s a lack of control of patient care when patients go elsewhere for part of their good health equation. The pharmacists, of course, also don’t like losing business either.

I suspect doctors won’t like this (medical travel) for the same reasons. But there’s
always going to be bad-mouthing when something eats into somebody’s pocket book.
I think the biggest challenge is the integration of data. The kind of data that answers questions like ‘how do we prove that increased drug spending reduces health care cost?’ We don’t have that data.

As long as data is available as it relates to getting a procedure done abroad versus here at home, then you can prove your value proposition. I think every sector of the health care market struggles with data collection, but given that your industry’s so young, it would be great to find ways now to get that taken care of so you can prove your proposition.

The idea of one medical record is also important. Whoever the treating physician is needs access to the full scope of the patient’s history and current care. In the prescription world, we had the issue of physicians not being aware of all the medication a patient was taking. If someone was getting their prescription filled in Canada, that information wasn’t necessarily making it back into the U.S.-based system. You didn’t have a full medical record. That’s as important to medical travel as it is to prescriptions. It’s really the same. The issue of portability will have to be resolved for all. And sooner rather than later…

I think the biggest positive we saw in the survey is the whole trend toward consumerism. More and more employers are saying, ‘I’m not going to define benefits. I’m only going to define the contribution. It’s up to you how and where you spend it.’ We’re now seeing more high deductible plans, reimbursable plans, and consumer-directed plans. The idea is: here’s your pile of money, make choices that work for you. That might mean get an over-the-counter drug or go abroad for your care. The employee now gets to decide.

About Chris Robbins
With more than 20 years in the health care and managed care industries, Chris Robbins formed a consultancy, Arxcel, which specializes in pharmacy benefit management for employers, third-party administrators, and managed care organizations. The focus of Arxcel is to provide excellence in prescription benefit management for the health care industry while maintaining the quality of the benefits offered.

With his extensive experience on the vendor side of managed care, Chris recognized the need for intermediary support that would help direct and improve the prescription drug benefit portion of health plans and employers. Arxcel assists with sales, plan design, educational issues, proposal development, and account management while assuring that the prescription drug benefit aspect of the program is viewed as a valuable and essential feature.

Chris's insight into the complex managed health care field stems from his extensive immersion in the health care and managed care disciplines. Chris's background in the healthcare industry includes working with insurance plans, HMO's, hospital organizations, drug utilization review firms, and pharmacy benefit managers. Arxcel's network and expert counsel enable the company to provide quality advice and counsel to all of their healthcare clients.

An example of Arxcel's work with one client was very successful. Chris helped to develop the company's marketing plan and rolled out their product line in the Northeast region of the United States. In only 18 months, Arxcel was able to develop more than $25,000 in monthly profit and build the company's book of business to more than $4 million. Chris has continued his reputation for ensuring quality while controlling costs as a consultant with many organizations throughout the country. Prescription drugs account for more than 15 percent of health care expenditures annually, and that percentage continues to rise.

Chris and Arxcel carved out a niche in the health care field in order to assure that patients have access to the most affordable and highest quality prescription drugs, while assisting the sponsors of prescription programs to meet their members’ needs.

INDUSTRY NEWS

Healthy Travel Media Launches Second Patients Beyond Borders Singapore Edition

Washington, DC — 8 December 2008: Healthy Travel Media and SingaporeMedicine jointly announce the launch of Patients Beyond Borders: Singapore Second Edition at the Health Care Globalization Summit in Washington, DC.

The 250-page guidebook features a fully updated, revised, in-depth overview of Singapore's hospitals and clinics serving international patients, and it now includes 16 pages of color inserts showcasing Singapore's world-class facilities and attractions.

A top medical travel destination, Singapore attracts more than 410,000 international patients annually and expects 1 million by 2012. Boasting 13 JCI-accredited healthcare facilities, its healthcare system was ranked the best in Asia and sixth best in the world by the World Health Organization.

“With its world-renowned cancer research and regenerative therapies, women’s and pediatric specialty clinics, and specialty centers in cardiology, orthopedics, neurosurgery, ophthalmology, dentistry, and more, it’s easy to see why Singapore is the preferred choice for many considering medical travel,” says author Josef Woodman.

As the number of uninsured and underinsured Americans grows, travel abroad for treatment is rising dramatically, with international hospitals reporting 15 to 40 percent increases in American patients. More than 180,000 Americans will cross borders for healthcare this year, a number expected to nearly double by 2010.

"The combination of excellent health care infrastructure, availability of skilled professionals, and the latest technology has enabled Singapore to remain on the cutting-edge of health care services delivery,” says Jason Yap, M.D. director of Healthcare Services for the Singapore Tourism Board. “This latest release of the world’s best-selling medical travel guide gives patients even greater planning and travel information when selecting Singapore as their destination of choice.”

About SingaporeMedicine

SingaporeMedicine is a government-industry partnership committed to strengthening Singapore's position as Asia's leading medical hub and an international destination for advanced patient care. Led by Singapore's Ministry of Health, SingaporeMedicine is supported by the Economic Development Board, International Enterprise Singapore, and Singapore Tourism Board.

Felicia Tan
Tel: +65.6831.3505
Email: Felicia_TAN@stb.gov.sg
Web: www.singaporemedicine.com

About Healthy Travel Media

Healthy Travel Media, based in Chapel Hill, N.C., publishes books on medical and wellness travel. Patients Beyond Borders is available through booksellers everywhere and distributed by Publishers Group West (www.pgw.com).

Medical Tourism-A Ray of Light Amongst Gathering Gloom

The multi-billion dollar medical travel sector could become an important new source of demand when traditional demand drivers are under increasing threat. According to Jones Lang LaSalle Hotels’ (http://www.joneslanglasallehotels.com) most recent research, FocusOn: Medical Travel – fad or focus for hotel operators and investors?, the medical travel sector has potential to develop into a lucrative niche market for hotel operators and investors.

The medical travel industry is driven today by Asia, particularly popular destinations such as Thailand, Singapore, Malaysia, and India. “These countries are developing first-class facilities with highly skilled medical specialists, many of whom trained abroad,” says Mark Wynne Smith, CEO for Europe, Middle East & Africa at Jones Lang LaSalle Hotels. He adds, “International tourists are attracted by the high-quality and relatively low-cost healthcare offered.”

With destinations such as Eastern Europe, Turkey, and Dubai getting in on the act, this market is poised for rapid expansion in the future. As travelers become more discriminating, they will continue to seek out hotels and resorts that offer a complete array of amenities. Medical spas, medical travel, and rehabilitation at desirable destinations will play a large role in the new generation of spa resorts. “In Dubai alone, there are at least 120 spas, health clubs, and clinics offering wellness services. By 2015, the United Arab Emirates could be amongst the top spa destinations in the world with an estimated 200 hotels offering world-class facilities,” says Smith.

Stakeholders must ensure that the medical travel industry offers accessible, affordable, and high-quality care to cement the reputation of this fledgling sector and allow the traveling public to make informed choices about their medical care. There is enormous potential for partnerships between hotel chains, property developers, airlines, insurance companies, and financial institutions. “These partnerships are vital as medical travelers need the security and peace of mind provided by purchasing an all-inclusive package for their trip,” says Smith.

“Medical Tourism has the potential to become a significant tourism segment with investment opportunities ranging from large scale hotel developments adjacent to city hospitals or specialist offerings with some minor modifications to existing product. In either scenario, the amount of incremental capital expenditure will depend on the size and opportunity within the market and should be a key consideration for any investor,” concludes Smith.

Research and Markets: Global Medical Tourism Trends Will Have an Increasing Impact on the Healthcare Landscape in Developed Countries around the World

DUBLIN, Ireland, Dec 08, 2008 (BUSINESS WIRE) -- Research and Markets (http://www.researchandmarkets.com/research/414657/global_medical_tou) has announced the addition of the "Global Medical Tourism" report to their offering.

The wealthy citizens of developing countries have frequently traveled to the United States and Western Europe to seek the expertise and gain access to advanced technology available at leading medical centers. Recently, a trend categorized as "medical tourism" has emerged, wherein citizens of highly-developed countries choose to bypass care offered in their own communities and travel to developed areas of the world to receive a wide variety of medical services in order to save money. Medical tourism is fundamentally different from the traditional model of international "medical travel," where patients generally journey from less-developed nations to major medical centers in highly-developed countries for medical treatment that is unavailable in their own communities.

This report focuses on the medical tourism trend that will have an increasing impact on the health care landscape in industrialized and developing countries around the world. The term "medical tourism" does not accurately reflect the reality of the patient's situation or the advanced medical care provided in these destinations. Nevertheless, it provides an unambiguous way of differentiating the recent phenomenon of medical tourism from the traditional model of international medical travel. This phenomenon is driven by marketplace forces and occurs outside of the purview and control of the organized health care system. Medical tourism presents important concerns and challenges as well as potential opportunities. This analysis will examine the international locales that are experiencing a dramatic increase in medical tourism, with particular emphasis on Asia, Eastern Europe, and Latin America.

Key Topics Covered:
Introduction: American Patients on a Shopping Spree for Global Medical Care
Record Number of British Patients Flying Abroad
Which is the Best Shopping Center for Medical Surgeries and Medical Travel? International Healthcare Accreditation Global Players in Medical Tourism
Medical Tourism in Latin America
Medical Tourism in Europe

For more information visit http://www.researchandmarkets.com/research/414657/global_medical_tou
SOURCE: Research and Markets

Beware Eye-Op ‘Tourism’, Warns LasikSurgeryRX.com

WEBWIRE – Thursday, December 11, 2008— LasikSurgeryRX.com (www.lasiksurgeryrx.com), a Lasik eye surgery information site, has today issued a stark warning to patients considering traveling abroad to save on medical bills, urging them to ‘fully consider’ the potential dangers and pitfalls of traveling abroad to receive medical treatment.

LasikSurgeryRX.com, which provides patients with information and resources relating to Lasik eye surgery to help better inform their decisions, has warned that inferior medical care, a lack of formal medical regulation and unhygienic conditions often encountered by traveling patients could pose a serious health threat.

Steve Brice, a spokesperson from LasikSurgeryRX.com (www.lasiksurgeryrx.com) warned patients to thoroughly research and seriously consider their chosen medical practice abroad, before agreeing to and paying for the procedure.

“Medical tourism is growing in popularity, with more and more patients looking to foreign shores to save a few dollars. While there can be cost savings, the difficulties with medical tourism lie in the patient’s inability to check out the practitioner, his qualifications, and the availability and standard of essential operating equipment and space. Without doing a thorough background check into both the surgeon and the medical system of your chosen country as a whole, you could be jeopardizing your safety.”

“This isn’t a problem specific to Lasik surgery – it’s applicable to all non-essential medical treatments that push patients overseas. Before you go, make sure you know and trust the qualifications of the surgeon and his experience and reputation before committing to surgery.”

LasikSurgeryRX.com provides information for patients on a range of issues surrounding Lasik eye surgery and traveling abroad to save on the costs of treatment domestically.

About: LasikSurgeryRX.com (www.lasiksurgeryrx.com) is a Lasik surgery resource site, providing the public with invaluable information and resources on the procedure, risks, and implications of having Lasik eye surgery. Focusing on providing accessible materials to patients and would-be patients alike, LasikSurgeryRX.com is leading the way in helping informed decision-making amongst those considering eye surgery.

Aetna To Expand Footprint In Dubai: Appointed By The Dubai Health Authority To Provide Health Management Programs And Services

HARTFORD, Conn., December 11, 2008 — Aetna (NYSE: AET) announced today that it has been appointed by the Dubai Health Authority (DHA) as one of the health care management companies (HMCs) to provide health management programs and services to outpatient care practices (OCPs), also known as primary health care practices, in Dubai. These outpatient clinics, responsible for managing and directing the care of the local population, are a central part of a new government-sponsored, capitation-based health care system aimed at promoting access to high-quality, affordable, basic healthcare to Dubai residents. Implementation of the new system will begin in January 2009.

The Government of Dubai currently offers select health programs to its 1.5 million residents, more than a million of which are expatriates working a wide range of jobs. Under the new system, residents must register with an OCP to access and receive basic health services. It is estimated that roughly 300 to 500 clinics will join the system in 2009.

Aetna is one of only two HMCs appointed to assist OCPs in leveraging the opportunities the new system provides. Aetna, in partnership with Gateway Healthcare, will provide administrative, financial, and other value-added services, including the management and flow of funds to OCPs, negotiation of arrangements with hospitals and specialist clinics, and development of care and disease management programs for use in the clinical setting. This will allow OCPs to continue their primary focus on patient care.

"We are extremely pleased to have been appointed to this position by the Dubai Health Authority," said Ronald A. Williams, Aetna chairman and CEO. "We have a range of skills that can support the government's goal of strengthening healthcare delivery in Dubai."

Aetna's proven experience in managing health care quality and cost to a budget, through effective contracting and procurement techniques, was a key component of the company's successful bid. Aetna's international division, Aetna Global Benefits® (AGB), coordinated the overall effort and will build the organization by leveraging its existing infrastructure in Dubai.

According to Martha Temple, president of Aetna Global Benefits, "Our goal is to help create a primary care-focused health care system in Dubai dedicated to providing comprehensive individual-centered care. We will work consultatively and collaboratively with the independent outpatient care practices, Dubai Health Authority, and other stakeholders to develop an appropriate and targeted plan that will meet the needs of the people of Dubai."

AGB currently provides comprehensive health benefits coverage for close to 400,000 ex-patriates, third-country nationals, and key local nationals in more than 100 countries, including the United Arab Emirates. In 2007, AGB acquired Goodhealth Worldwide, a leading provider of international private medical insurance for expatriates and high-net-worth individuals. Goodhealth Worldwide, through its partnership with a locally licensed insurance company, Royal & SunAlliance, currently provides private health benefits coverage in the United Arab Emirates.

In addition, AGB remains committed to providing advisory and support services to Primary Care Trusts and other health authorities in the United Kingdom. Similar to its efforts in Dubai, AGB can assist these organizations in improving patient outcomes and reducing overall costs through various services that include data management and decision support, and care and resource utilization management.

DESTINATION

Robin Elsham is busy preparing for a trip to East Asia. We look forward to his upcoming first-hand reports from Korea and Taiwan. In the meantime, you may access previous stories at the following links.

MEDICAL SPOTLIGHT: Recovery Retreats

Some medical procedures require an extended recovery period. Because the hospital setting isn't always a necessary or desired location for recuperation, recovery centers -- both independent and hospital-affiliated -- are often suggested.

Recovery centers vary dramatically in terms of setting, scope of care, and staffing.
According to Will Garin, Vice President of Marketing for BridgeHealth International, Inc., "We select centers that are of high reputation, as they are often initially recommended by our medical providers in the area, and have then been personally reviewed by our staff.

"The overall level of quality of the accommodations, understanding of, and concern for international patients, staffing, English proficiency, access, price, patient feedback, and other criteria are taken into account."

While some centers are actually set in a hotel, spa, or private home, others simply resemble a high-end hotel and others feel more like a tropical retreat. Rooms typically include an adjustable hospital-style bed, television, private bath with accessible shower and tub, and telephone. They may also include internet connection, a mini-refrigerator, a small kitchen, a guest bed or pullout couch, and a sitting area either indoors or out.
Most centers offer medical services regulated under the care of licensed health care professional. Some are staffed with round-the-clock medical personnel while others may charge extra for nursing care.

Garin reports, "Each of the facilities we work with has nursing staff available, although a nurse is not on staff 24/7 at all facilities and occasionally there are extra charges for the nurse, depending on the care necessary. Some facilities do have round-the-clock nursing staff for which they do not charge anything additional. The owners of many centers we use are fluent in English and work on site with other staff members who are English fluent."

While many recovery centers aim their marketing at cosmetic surgery patients, most are also equipped to handle a variety of types of clients. Garin says many of the centers they use fall into that category, noting, “While they do have many cosmetic clients, they also care for a number of orthopedic clients because the facilities can accommodate them well. Often, everything is on one floor, and there are no stairs for them to climb."

Depending on the facility and the type of post-surgical offered, guests may receive on-site physical therapy, occupational therapy, speech therapy, and therapeutic massage as prescribed by their provider. In addition, some facilities offer more traditional spa treatments including facials, hot stone therapy, Jacuzzi tubs/hydrotherapy massage, pedicures, etc. If a patient stays at a center in advance of their procedure, some centers will provide a complimentary massage the day before to help them relax.
Costs for centers vary. For example, a BridgeHealth patient recovering in a standard suite in Costa Rica could pay between $75 to $99USD per night while their non-surgical companion might pay between $55 to $75USD per night. Larger suites, which may accommodate up to four guests, often run $275USD per night.

Garin adds that the benefit of staying at a recovery center goes beyond the physical.

"Centers benefit the patient in that they feel safe away from home and know that they are being supported even while away from the hospital," says Garin. "Many clients travel alone, which can be a very scary thing, especially post-surgery. It’s also nice because they can meet other people (generally from the United States) who are traveling for medical purposes and feel more a part of a group, rather than a foreigner in a strange country. It’s also extremely comforting for them to know that there is a nurse on staff that they can communicate with and ask questions during their recovery rather than being scared and waiting until their next follow-up appointment with the provider. They have the security of knowing that there is someone there to help them get food and transport, which can be somewhat complicated post-surgery and without speaking the same language."

Is there a topic you'd like to see covered in our MEDICAL SPOTLIGHT? Please let us know. Send your thoughts to ahaar@cpronline.com

UPCOMING EVENTS

Date Set for Healthcare Travel Exhibition & Congress in Dubai: January 26-29, 2009

With the health care travel industry poised to play an important part in Dubai's growth strategy, the Institute for International Research (IIR) Middle East, the organizers of the first medical tourism conference in the United Arab Emirates (UAE), which concluded in Dubai, recently have reported high levels of interest from a potentially huge international market.

"Research unveiled at the event indicated a global market of around two million medical travelers a year and an industry constrained by hospital capacity and lack of consumer familiarity with medical travel," says Sietske Meerloo, marketing manager at IIR Middle East and organizer of Healthcare Travel Exhibition & Congress.

IIR Middle East is also the organizer of the Arab Health exhibition and congress, the region's premier event for Middle East healthcare that takes place in Dubai 26-29, January, 2009.

“Large numbers of hospitals and clinics around the world are attempting to tailor their health services to cater to medical tourists," Meerloo added. "Several major insurance companies offer a travel component in their policies and governments are looking closely at policies to take account of the trend."

The health care event was officially opened by Haidar Al Yousuf, M.D., transition director at the Dubai Health Authority, who highlighted the importance the Authority is placing on the future of medical tourism.

"As we look to develop our domestic health strategy, we also want to develop a joint strategy with our colleagues in the Department of Tourism & Commerce Marketing (DTCM), for the future of health tourism in Dubai," says Dr. Al Yousuf. "The health care sector in Dubai will become an increasingly attractive place for international health care investors, providers, services, facilities, and other health care professionals."
PlanetHospital, a California-based leader in medical tourism, used the event as a platform to announce the official opening of its Jeddah Saudi Arabia office to serve inbound and outbound medical tourists from the Arabian Gulf region.

"The Gulf has the potential to drive growth in medical tourism," says Mohammed Alarifi, managing director for the new operation. "It is not only a destination from where patients seek medical care abroad but is also becoming a medical tourism destination itself thanks to major hospital developments throughout the region."

The American Hospital Dubai also had high visibility at the event. There was "a lot of exchange of experience among colleagues from around the world," says Naser Saleh, director of marketing and sales. “On the conference side, the sessions were very informative."

Gary Miller, CEO of Health Travel TV, says the event had been important for them. "We have a unique product, and we’re the only broadcast media here dedicated to this area," he says. “I’m coming back to Arab Health in January."

Organized in association with the International Medical Travel Association, the Healthcare Travel Exhibition and Congress was supported by the UAE Ministry of Health and the Health Authority of Abu Dhabi. Platinum sponsors were Singapore Medicine. Gold sponsors were the American Hospital Dubai and Dubai Health Authority.

For details about Arab Health events, please visit: www.arabhealthonline.com

Asia’s Biggest Landmark Healthcare Congress – Global Health Conference (GHC) 2009—Announces Its Agenda

Disease management will directly impact the future models of care. But what shape and form these models will take is of question. Will we see more of specialized hospitals? If so, where will they be located? How will innovative ‘disruptive’ technologies help the future health care cities and hospitals cater to and deal directly with new disease management?

The future of health care delivery lies mostly in disease-based intervention programs. The health care cities and hospitals of the future will greatly benefit from a clearer understanding of how to effectively integrate disease management into future facilities and core competencies to be built.

Another contributing factor that will shape future care models is the growing number of highly valued patients globally – many of whom are crossing international borders in search of quality care and access. How should hospitals convert their centers of excellence to cater to this growing sector? How can they adequately build capacity and expertise to ensure they are able to meet new and growing demands?

Leaders in global healthcare will be tackling these issues head-on at Asia’s biggest landmark health care congress, Global Health Conference (GHC) 2009, which will feature two co-located events, “Healthcare Cities & Hospitals of the Future” and “Crossing International Borders” (February 23-26, 2009, Singapore).

For more information on the event, please visit www.magenta-global.com.sg/healthcare or kindly contact:
Attn: Ms Catherina Koh
Conference Director
Magenta Global Pte Ltd
DID: (65) 6391 2539
Email: catherina.koh@magenta-global.com.sg with subject code “GHC-MTT”

For media inquiries, please contact:
Nathalie Visele
Director
Shamal Marketing Communications
Dubai, United Arab Emirates
Tel.: +9715 04576525
E-mail: nathalie@theshamalgroup.com

Thailand Convention & Exhibition Bureau to Sponsor the 2009 World Medical Health Tourism Conference in Phuket

Thailand Convention & Exhibition Bureau (TCEB) is set to sponsor the World Medical Health Tourism Conference: A New Way Forward, which will be held in Phuket, Thailand, September 2009.

TCEB’s participation and sponsorship in this internationally diverse networking event will aim to promote Thailand on an international scale as a medical tourism destination and a preferred venue for international meeting, incentive, convention, and exhibition (MICE) events.

The whole of Phuket Island is getting behind the conference, which will cater to more than 1,200 delegates. Local supporters range from local community groups, tourism operators, and many of the major hoteliers and resort owners, namely Woraburi Phuket Resort, Millennium Resort Patong, The Moevenpick Resort, Karon Beach Resort of Kata Group, Aquamarine Resort, Cape Panwa Hotel, and Andaman Seaview Hotel group.

Phuket, dubbed as the medical tourism hub in Asia, is the ideal location to hold the conference because of its infrastructure, capacity to host a massive number of international guests, and the availability of cutting-edge technology and internationally trained medical experts manning their world-class medical facilities.

Sometime within the next month the floor plan or layout for exhibitors at the venue, Hilton Phuket Arcadia Resort & Spa, will be published online and application forms will be available for the exhibitors to download from the Web site. Many pre-conference and post-conference activities have been planned for the conference, which early estimates expect to bring a windfall to Phuket of about U.S. $10 million over the two-week period. Interested parties are advised to visit the conference website: www.sosmedicaltourism.com for more information.

Alternatively, for more information call + (66)76-289-800, to request a printable registration brochure by email sosmedical@sosmedicaltourism.com or sosmedical@ymail.com