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THIS WEEK IN MEDICAL TRAVEL TODAY by Amanda Haar, Editor Greetings, In the meantime consumer perception of medical travel is also evolving. Without a lot of guidance from the industry, consumers are doing their own research and making their own choices about what arrangement feels the safest (financially and physically) and simplest for them. It will be interesting to see which group most effectively rises to the challenge of promoting their approach. If you'd like to share your thoughts on the evolving role of facilitators, please send them to ahaar@cpronline.com Cheers, Amanda Haar, Editor
SPOTLIGHT: Sarkis Khoury, M.D., Global Medical Excellence
Editor's Note: Early this year, the California-based company Global Medical Excellence (GME) introduced an innovative approach to medical travel. Through GME's website, patients can select the U.S.-board certified physician they would like to travel abroad with them to have the procedure performed at one of GME's partner hospitals, all of which are accredited by the Joint Commission International (JCI). Medical Travel Today recently spoke to the GME's chairman, Dr. Sarkis Khoury, to learn how the business model works for patients, hospitals, and physicians. Medical Travel Today (MTT): Let's start with how you became involved in research on medical travel. Dr. Sarkis Khoury (SK): I'm a Professor at the University of California focusing mostly on international markets. I've been researching medical travel since June 2009. At some point it occurred to me that health care costs are perfect candidates for arbitrage. MTT: Can you explain the principals of arbitrage? SK: Certainly. Essentially it's the opportunity to buy an asset at a low price then immediately sell it in a different market for a higher price. So, for example, if gold cost $500 in the U.K. and $475 in New York a person will arbitrage the prices. They could buy gold in the U.S. and then sell it in London for a nice, risk-free profit. This eliminates artificially high prices. Generally, differences in prices across markets can't be sustained unless there are limits imposed on arbitrage or risks attached to them. When it comes to health care, there are obvious differences in price. An open-heart surgery that costs $150,000 in the U.S. might cost $10,000 in India. That price differential is not going away anytime soon largely due to the U.S. government's interference in arbitrage. Medicaid and Medicare will not reimburse for care abroad. That forecloses a huge segment in the market made up of the elderly (heavy users of medical services), the poor, or working poor with inadequate exercise or diet. I am perfectly convinced that government policies limit access to quality, inexpensive care, which can bend the “cost curve.” Not to say there aren’t any risks with medical travel. An individual who attempts to just arrange their own travel takes on risk. You could have doctors operating without insurance. The hospital may not have appropriate coverage. There's the issue of your records; will they be secure? Then there is the quality of the care itself and the challenges of language. If you don't speak the language you might not get the attention you need or deserve. And then there's the risk of post-operative complications. The last issue is the doctor-risk issue. There are questions about what if he or she is not up to the standards or is poorly trained. People are typically looking for doctors with the best American medical education. All of these are very serious risks and many of the companies engaged in medical travel are not mitigating these risks. That's a large part of why Global Medical Excellence (GME) was started. MTT: What does GME do differently that mitigates those risks? SK: GME arranges for U.S.-board certified surgeons to travel to a destination to perform procedures at a world-class facility. They work only with quality physicians and quality facilities, that is to say JCI-accredited, essentially mitigating most of the bigger risks. I truly believe the long-term potential of the industry is very good as walls erected by government regulation and poor information begin to crumble. MTT: How many physicians does GME work with and are they all U.S.-based? SK: GME currently has a roster of 40 physicians and are in massive negotiations with many, many more. They anticipate having 200 on board by the end of June. GME is working with some of the best doctors in the United States and Europe. The vetting process takes a while, but once they're through they're added to the roster and included on the Web page. MTT: How exactly does GME recruit physicians? SK: At this point in time, most physicians are familiar with medical tourism but not necessarily familiar with this model. GME sends them literature about how it operates and why it has "excellence" in the name. I cannot stress enough how important this transparent and comprehensive approach is to the care they provide. They are looking out for the entire welfare of the patient and not just their wallet. For that reason, "excellence" is not just a word, it is their modus operandi, and they want to be sure to deliver it to the patient. That's the biggest message to the surgeons they are recruiting. If they buy into the approach, they will sign a contract. A big focus of contract discussions is the fact that a U.S. surgeon is only obligated to respond to a request to operate overseas if it is advantageous to him or her. GME is also negotiating with various IPAs to get the affiliation to happen on a bigger scale. MTT: So what happens? Someone needs a new hip and you call a doctor to go abroad? The patient can make their choice based on their desire to have a specific physician and/or get a surgery scheduled based on the urgency of their need. After the patient’s first visit to the website, one of the patient relations managers reaches out to them by phone to discuss their needs and the GME approach. If the patient chooses to work with GME, a formal relationship begins and close contact is maintained with the patient throughout the period, the trip, and beyond. GME also communicates with the doctor to determine their availability and schedule. Once they have the appropriate number of patients who want a given procedure, GME makes the arrangements. The doctor, of course, reviews patient files in advance, then flies abroad, and meets the patients there. That one doctor then performs all the agreed upon surgeries. This approach makes it economically feasible for the doctor and the company. I also want to mention that GME has dedicated care managers who speak perfect English in offices situated in the hospitals with which GME has an agreement. They work one-on-one with patients and the surgeons throughout the experience. This is very different from how many other medical tourism organizations operate. MTT: Where are your physicians currently operating and what types of procedures are they performing? SK: Currently GME is facilitating procedures in India and Lebanon simply because they offer the absolute best quality of care in the Far East and the Middle East. In Lebanon, for example, GME has an exclusive agreement with the American University of Beirut and Clemenceau Medical Center, the only two JCI-accredited hospitals in Lebanon. This agreement makes GME the only North American medical travel company bringing patients to these facilities. GME also coordinates plastic surgeries in the United States when requested. Here the patient may pick the preferred surgeon or enter MEDEXSM- an exchange where all GME-affiliated plastic surgeons bid on the surgery. GME offers a full range of procedures, from heart, spine, and orthopedic to neurosurgeries and bariatric. Most of the queries are in the areas of orthopedic, spine, bariatric, heart, and plastic surgery, with plastic surgery being the most popular. About Dr. Sarkis Joseph Khoury Dr. Khoury has been a regular commentator and had extended appearances on television dealing with investment and economic issues. He has been an organizer of numerous conferences on international banking and finance for academics and professionals. He has spoken on many political issues in the U.S. and abroad and taught or given presentations in over 30 universities all over the world. He has done extensive research on the economics of medicine and medical tourism as it relates to the Obama Health Care Bill. For further information. Please email him at: sjkhoury@earthlink.net
Timmons leaving CEO post at JCR, JCI
National Health Options Creates First Private National Health Care Assistance Program for Employers, Individuals Who Are Underinsured or Uninsured Mt. Kisco, N.Y. – June 2010 -- National Health Options (NHO) announces the first health care assistance program of its kind designed to offer an affordable, accessible, and comprehensive solution for Americans, employers, groups, and associations -- including an estimated 47 million people who are underinsured or unemployed. NHO provides access to high quality health care products and services that can improve individual health and welfare. “The Congressional Budget Office estimates that reform legislation will eventually cover 32 million more Americans, leaving 23 million uninsured by 2019,” says Richard Lungen, president of NHO. “Similar to ‘big box’ retail shopping clubs for purchasing merchandise at a lower cost, NHO offers convenient, cost-effective options to access prescription drugs and health care services through a private network of nearly one million dentists, physicians, and other health care professionals. Nobody is excluded, including non-citizens or those with pre-existing conditions.” Marketed directly to consumers and through insurance brokers, third-party administrators, and channel partners, NHO’s private label, custom health care programs can mirror or supplement traditional employer benefit plans. NHO has assembled best practice companies into a single platform:
“We took more than 60 years of health insurance and human resources experience to create the single best solution available anywhere in the country,” says Lungen. “Market receptivity is already palpable.” About National Health Options
MediConnect Global Renames PassportMD Personal Health Record Portal to myMediConnect
Asian Medical Tourism Analysis Provides Detailed Analysis of the Health Care and Medical Market The recently released Asian Medical Tourism Analysis (2008-2012) provides comprehensive research and unbiased analysis of current market performance and future outlook of key Asian medical tourism markets—Thailand, Singapore, India, Malaysia, Philippines, and South Korea. It acknowledges the fact that the six Asian markets covered in the report have vast differences in terms of cost, infrastructure, human resources, patient perceptions, competencies, and level of government support. Each factor has been thoroughly studied in the report. The report provides valuable information to clients looking to venture into these markets and helps them to devise strategies. Asian Medical Tourism Analysis (2008-2012)
Mexico Real Estate – Retirees Benefit from Strong Medical Tourism One example of the significant price differences can be seen in major surgery: the average price for open heart surgery in the U.S. is about $64,000; in Mexico it is only $24,000, which is $40,000 or 66 percent less. While most people aren't planning on major surgery of this sort (or at least not hoping for it) it is a reflection of the fact that medical procedures are generally much cheaper in Mexico, which can be significant for a retirement budget. Another concern that has grown recently is the cost of medical insurance: U.S. insurance (in California) designed specifically for Mexican health care is available for about one-third the price of insurance for U.S. health care, presenting another means of saving. Insurance within Mexico itself is also considerably more affordable. The World Health Organization has found that on average private Mexican hospitals are of similar quality to private U.S. hospitals. While many of Mexico's favorite retirement destinations include very new and modern facilities, retirees who buy Lake Chapala real estate will enjoy being close to one of Mexico's main centers for world-class health care, Guadalajara. Guadalajara is only 45 minutes away from the villages of Chapala and Ajijic. (The city is the second largest in Mexico, so travel time to health care facilities can vary, depending on where in the city they are located.) Basic, but up-to-date, health care services are available in the Lake Chapala communities themselves, but for any more extensive service or for the sake of more options, this proximity to Guadalajara is a large benefit for both retirees and families moving to the area. Top Medical Tourism Destination Hospital Angeles Tijuana Announces JCI Accreditation Program
Online PR News – 27-May-2010 – Angeles Health International, the medical travel division for the largest private hospital network in Mexico featuring state-of-the-art facilities, has announced the kick-off of its Joint Commission International (JCI) accreditation program, working with the Phoenix Consulting Group. JCI is the international division of Joint Commission Resources, a not-for-profit organization that establishes standards and resources for hospital’s to improve quality of care and patient safety. It is part of the World Health Organization (WHO) Collaborating Centre, a collaborative effort with WHO dedicated to patient safety solutions. “JCI accreditation of Hospital Angeles network of hospitals is an important step for our Angeles Health International Medical Travel program,” says Paulo Yberri, the director of Hospital Angeles Tijuana. “In the past three and a half years, Angeles Hospitals have worked with more than 6,000 medial travelers from the U.S., Canada, and Europe. JCI Accreditation will add to the reassurance factor so important to the medical travel process.” Yberri notes that Hospital Angeles Tijuana is the first hospital in the Angeles network scheduled to receive its JCI Accreditation. “The JCI Accreditation program will prioritize the Angeles hospitals most often selected by medical travel patients because of their convenient locations,” says Yberri. “Hospital Angeles Guadalajara already serves an ex-pat community of more than 30,000 Americans,” notes Yberri. “In addition to relying on Hospital Angeles for their primary medical and surgical care needs, this community of American retirees consistently refers friends and family to Hospital Angeles for the high quality medical care, particularly in the areas of cardiovascular and orthopedic surgery.” Yberri indicates Hospital Angeles Lomas and Hospital Angeles Perdregal (both in Mexico City) and Hospital Angeles Puebla round out the top priority facilities for the Hospital Angeles JCI accreditation. Not all international hospitals seek JCI accreditation, and the lack of JCI accreditation is not an indicator of a lack of quality for a medical care facility. However, JCI accreditation demonstrates to patients a hospital’s acceptable compliance with specific standards in ambulatory care, care continuum, clinical laboratory, disease- or condition-specific care certification, and medical transport, as well as an overall compliance with International Patient Safety Goal requirements. For patients seeking medical care abroad, the JCI accreditation provides a third-party quantifiable measure of the standard of care at an otherwise unfamiliar hospital. According to executives quoted on the JCI website, accreditation is now being looked upon by insurers, government and nongovernment agencies, and global employers as a way to gauge whether a health care organization is a safe one for their constituents such as Medical Tourism patients. Medical tourism continues to garner considerable attention as a growing number of U.S. employers, consumers, insurers, and TPAs explore cost effective health care options for their organizations. Experts currently estimate the size of the medical tourism market to reach $100 Billion by 2012. “We’re pleased to see the Angeles hospital network taking this step,” says Herb Stephens, CEO of Health Travel Technologies, which licenses its medical travel platform to the Angeles Hospital system’s medical travel division, Angeles Health International. “The JCI accreditation is relevant to the decision-making process of medical travelers. Researching an international hospital can be a difficult and confusing process. JCI standards are held by many to be objective evidence of a hospital’s quality of medical care and general professional competence. JCI accreditation of Angeles hospitals is a big win for patients who might otherwise not have learned of the quality of Angeles medical care.” JCI has accredited more than 300 public and private health organizations in 39 countries. About Angeles Health International the Grupo Angeles network of hospitals is the largest private hospital network in Mexico, with 22 hospitals throughout Mexico, and $700 million currently invested to build an additional 12 facilities over the next five years. Grupo Angeles hospitals are full-service, offering a range of specialties such as bariatric surgery, hip replacement and resurfacing, noninvasive lumbar stabilization, kidney transplant and adult autologous stem cell therapies. Facilities feature state-of-the art operating rooms, ICU care, and diagnostic services, including globally renowned board-certified medical and surgical physicians and surgeons. Hospitals in the Grupo Angeles network are modern, offering upscale accommodations such as master suites that cater to the international patient population. Patients experience a full-service, fluently bi-lingual medical and health care environment, featuring dedicated units for every level of patient services, from neonatal to intermediate to emergency and intensive care.
Quality Health Advice and Trent Health Care Work Together to Create QHA Trent When the organization that used to oversee the U.K.’s Trent Accreditation Scheme, or TAS, made the decision to withdraw from all hospital accreditation-related activities, this was a bitter blow for the many surveyors who had been very happy to donate their own precious free time and duty leave to undertake surveys on behalf of TAS. Surveying of hospitals and clinics was universally considered to be highly worthwhile continuing professional development (CPD) by all those health care professionals from diverse professional backgrounds who were involved. It was obvious that there was a considerable pool of talent, expertise, experience, and enthusiasm in existence just waiting to be drawn upon. Furthermore, it was believed that partnership with U.K.-sourced health care accreditation remained a highly attractive option to hospitals and clinics around the world. Accordingly, a group of former surveyors took the decision to collaborate and to continue with accreditation work. It was out of this decision that “QHA Trent” emerged in 2010.
The QHA Trent team are very much looking towards a future in which they will provide a high-quality professionally-based surveying and accreditation service at attractive prices for an increasing number of hospitals and clinics anywhere in the world. QHA Trent definitely represents an exciting new start for all. Web site www.qha-international.co.uk Destination Health Rescheduled for June 26-27, 2010
Destination Health, a consumer event for the growing numbers of people Visitors can come to the show for free if they pre-register on the Destination Health website www.destinationhealth.co.uk. All the original exhibitors will be attending the event, which will give potential medical tourists the opportunity to meet doctors and personnel from around the world, compare and discuss treatment options and attend seminars on all aspects of medical tourism including fertility treatment, tips and advice on everything the medical traveler needs to know, medical travel insurance and many other subjects. Destination Health has been launched to help the increasing numbers of British medical tourists find out all they need to know about travelling aboard for health and medical treatment. The two-day event will showcase top hospitals, clinics, and spas from around the globe giving visitors the opportunity to meet doctors and medical specialists, get free advice, and explore various treatment options abroad including cosmetic surgery, dental treatments, the growing trend for obesity surgery and fertility treatments -- among others. With a large amount of exhibitors at the event it will be easy for potential patients to easily find the type of medical specialists they are looking for. The event is divided into different areas to include sections for dentistry and cosmetic surgery, fertility and conception, medical spa and wellness and general treatments and procedures and the organizers, Bluewater Events, are expecting a large audience. Nav Mann, event director says: “Interest from exhibitors and consumers in the event indicates that we expect a high turnout and hope that Destination Health will become a popular annual event for the medical tourism businesses and consumers alike.”
The Second Malta Medical Tourism Summit by Europe Business Assembly The second Malta Medical Tourism Summit, June 26, 2010, St. Julians (Malta) at the Corinthia San Gorg Hotel and Business Centre, is set to bring together many senior figures within the industry. The events of the forum will be held under intellectual and organizing support of the Government of the Republic as well as leading medical institutions of Malta - St. James and St. Phillip Hospitals. The official organizer of the summit Europe Business Assembly (United Kingdom) under the auspices of 'Malta Enterprise' Corporation (Malta). The Europe Business Assembly (EBA) is an independent international project-development and management organization. Our international panel of expert speakers will be sharing their thoughts and experiences on topics such as: -The dynamics of the current medical tourism marketplace To view the current agenda and speaker list, visit: www.ebaoxford.co.uk/Malta_Medical_programme_06_10.html.
Asian Countries Unite for Medical Tourism in IMWell Summit “Without question, medical travel has significantly transformed the face of global health care,” says Undersecretary Cynthia Carrion, who heads the Department of Tourism’s Office for Sports and Wellness. “The pool of patients around the world seeking medical treatment abroad has grown, with increasing cost efficiency and adoption of advanced medical technology overseas. This presents a huge opportunity for us, and it is only fitting that the Philippines is hosting the IMWell Summit, as we have already proven our country to be an emerging powerhouse as a health and wellness destination.” According to the Department of Tourism, the number of overseas patients and clients visiting the Philippines has rapidly increased from 60,000 foreign patients in 2007 to about 100,000 foreign patients in 2008 and gross revenues estimated to be at US$350mn since the program was launched in 2006. In light of this booming phenomenon, the Department of Tourism expects the Philippines to corner a total of US$3bn of the global medical tourism industry by 2015, with 200,000 foreign patients arriving annually. “The IMWell Summit demonstrates that the Philippines is at the forefront of this ‘sunrise’ industry, which has been a key driver in our economic growth. As a pioneering initiative in the whole region, it also establishes our pro-active stance in cooperating with our neighboring countries and making them partners in medical tourism,” says Joyce Alumno, Conference director. The four-day event features a full agenda that includes plenary sessions on Industry Perspectives, Opportunities and Risks; Regional Presentation of Best Practices; Global Opportunities in the Retirement Industry; Marketing and Branding for Global Markets; Quality Management and the Continuity of Care; and the Future of Medical Tourism and Healthcare Travel Industry. The IMWell Summit also includes Executive Workshops about Balanced Score Card in Healthcare Organization and Effective Leadership Styles in Healthcare Organization. Four break-out conference tracks will be presented: Quality in Healthcare, Marketing, Investment and Capacity Building, and Retirement, giving an in-depth look at each specific aspect of medical and wellness tourism. “We have ensured that the program of the IMWell Summit is comprehensive and at the same time attuned to the needs and gaps in information of this growing field. By gathering the region’s leading policy makers, decision makers, and solution providers, we aim to redefine, redesign, and refine health care delivery around the world,” stated Sanjiv Malik, M.D., a renowned international guru in medical tourism, who sits as the Conference Honorary chairman. The Advisory Board and Speakers of the IMWell Summit include prominent leaders in their fields of expertise, including David Vequist, M.D., of the Center for Medical Tourism Research (USA), Dato Jacob Thomas of the Association of Private Hospitals in Malaysia, Nipit Piravej, M.D., of Bangkok Chain Hospital (Thailand), Ares Leung, M.D., of Union Hospital (Hong Kong), Sam Bernal, M.D., of Cedar Sinai and The Medical City (USA and Philippines), Samie Lim of Philippine Chamber of Commerce and Industries, Girdhar J. Gyani, M.D., of the National Accreditation Board for Hospitals and Healthcare Providers (India), Jeff Staples, M.D., of Parkwayhealth (China), Tony Gibson of the Australian Human Resource Institute, Henry Schumacher of the European Chamber of Commerce, and others. “Aside from our powerhouse line-up of speakers and advisors, what makes the IMWell Summit truly exceptional is the fact that it’s a pioneering event in regional cooperation. It is the first of its kind to present the global state of health care, explore current and future opportunities in medical tourism, and map out a strategy for the growth of the entire industry,” adds Alumno. The IMWell Summit is produced and organized by HIM Communications, in collaboration with the Department of Tourism as Host, and supported by the Department of Health, Department of Trade and Industry, Retirement and Healthcare Coalition, Philippine Chamber of Commerce and Industry, and Spa Association of the Philippines, with HealthCORE and Asian Academy for Healthcare Executives as Knowledge Partners. For more information about the event, please visit www.IMWellSummit.com, or call (63 2) 910.8030 or 468.9999, or email info@himcommunications.com
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