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© 2012 Medical Travel Today

Medical Travel Today is a publication of CPR Strategic Marketing Communications, a public relations firm based near New York City that specializes in healthcare and life sciences, with an international clientele. CPR, its Partners, and clients are at the nexus of where medical travel is today, and where it will be tomorrow.

Publisher, Laura Carabello

Table of Contents

From the Editor

From the Editor: This week in Medical Travel Today, Amanda Haar

News in Review

Medical Tourism: 1 In 3 Open To Traveling For Treatments, Poll Finds

Medical Tourism Continues to Grow in Costa Rica

Report Now Available: "Middle East Medical Tourism Industry Outlook to 2016 - Advanced Medical Infrastructure Paving the Way for Future Growth"

Artist Takes Open Source Approach to Addressing Cancer Diagnosis

Dubai Introduces Visa Quota System in Medical Tourism


David Miller, Nueterra Global Alliance

Industry News

US Workers Travel for Cheap Surgery

Nueterra Hosts International Symposium

Maldivian Inks Pact with Apollo Hospitals for Medical Tourism

Upcoming Events

International Medical Travel Exhibition & Conference Slated for March 2013

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Global Health Voyager

Volume 6, Issue 24

by Amanda Haar, Editor


Controlling the complete patient experience has always been one of the biggest challenges to medical travel. One organization that's seizing control in a big way is Nueterra. From ownership partnerships with physicians to building its own facilities, Nueterra has successfully brought a new level of control to the healthcare experience for patients in the US for the past 15 years. However, with the launch of their Global Alliance they are now finding new ways to apply the experience to medical travel both abroad and domestic. We're grateful to David Miller, president of Nueterra Global Alliance, for offering some insight into the venture in this week's SPOTLIGHT.

And just an FYI, for those of you getting a jump on your holiday shopping, please consider clicking on the RetailBenefits banner below this letter. Free to readers of Medical Travel Today, this innovative program allows you to earn cash back when you shop for everything from gifts to pet supplies.

As always, we welcome your comments, story ideas and press releases.


Amanda Haar, Editor

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David Miller, President, Nueterra Global Alliance

David Miller, Nueterra Global Alliance

Medical Travel Today (MTT): I really want to focus on Global Alliance, but begin first by telling me a little bit about it Nueterra.

David Miller (DM): For more than 15 years Nueterra has been helping physicians and health systems succeed. Our company is built on the philosophy of physician empowerment, with a unique model ensuring that physicians maintain control through majority ownership in facilities. By partnering with physicians in a mutually beneficial ownership partnering model, Nueterra builds, equips and manages healthcare facilities, which includes hospitals, ambulatory surgical centers, endoscopy centers and physical therapy centers. We partner with local physicians in their location to build facilities relevant to their market and talents.

MTT: How exactly do physicians benefit from owning the facility in which they operate or practice?

DM: As co-investors in the facility, Nueterra and physician partners have vested interest in the success of the healthcare facility and its longevity in the community. Our proven operating efficiencies use economies of scale to create owner equity and increase market share. Also, physicians benefit from the flexibility of creating their own surgery schedules and increased gains from having vested equity in the business. Essentially, they are in control of their healthcare facility in partnership with Nueterra. Our partner facilities create wealth for the physicians and superior outcomes for patients.

MTT: I'm curious, what's the initial investment on their part and how does that equity pay out?

DM: The investment depends on the size of the facility, the number of investors, type of healthcare offerings, and other variables.

The payout is often in the form of quarterly dividends. Ownership of the facility is shared, and normally Nueterra is a minority owner with the physicians being the majority owner. If there's a health system involved they'll hold the largest share. On average, the timeframe for actually seeing dividends paid out is approximately 12 to 18 months after opening. That's our goal. Of course sometimes the timeframe is longer or shorter depending on the size and scope of the facility.

MTT: And what exactly does Global Alliance do under the Nueterra umbrella?

DM: Global Alliance is a new offering for Nueterra. We're in the process of adapting our model to work with an international patient base. We have partnered with health systems and physicians- 2,500 physicians in 28 states and about 100 facilities - that we're working with to actively bring both domestic and international patients to for care.

Years ago we began researching medical travel to determine its viability within our operating structure. When we began looking into where patients were going to access care, the initial assumption was it was going to be high net worth individuals traveling for elective procedures. We couldn't have been more wrong.

What we found was that there was a $4-5 billion market for international patients coming for care in the US. And it wasn't just elective procedures. It was large complicated cases, i.e. cardio, bypass, total knees and hip.

As we continued to explore the medical travel market, we interacted with more industry leaders. During this process, I met Rolando Rodriguez, who ran the international division of a large hospital in South Florida with approximately $100 million in revenues from the Latin America and Caribbean markets alone. After recognizing that his qualifications and relationships could support our desire to bring quality care options to international patients, we began our partnership and he joined the Nueterra team.

In our research of the market, procedures and the industry, trends began to emerge, and we began building our model in response to these trends. We realized at Nueterra that we wanted to establish a best-in-class network across the US to provide patient access to quality care.

Technology was a significant trend we noticed in medical travel. We found that when people were traveling for care there's little technology to capture and allow their diagnostic information to travel with them. This presents some significant challenges for the treating and referring physicians to communicate, as well as for the care or concierge manager. What we needed was a good technological component that would create a smoother, all-encompassing experience. In time we found a technology partner who had created software for patient exchange, and we acquired an ownership stake in the company so we can utilize the software.

Let's say you were in Panama and want to go to Kansas City for a procedure. You simply call Nueterra Global Alliance at (415) 651-4400 and then you are connected to a case manager who captures all your pertinent information. We then direct you to a physician in our network in the specialty area you need and within the parameters of your geographic goal. We can connect your referring physician to that physician and ensure everyone's communicated with thoroughly about the case. We also have a travel component built into the software so that we can literally pick you up at your home and deliver you to the airport and subsequently the hotel or hospital and back. It's a comprehensive, turnkey approach.

The other missing piece that we wanted to address was post-care. We found that there was very little communication following surgery between the treating and referring physicians so we added a robust post-care component to our software that allows for very easy transfer of data, images and outcomes.

We have built our system to facilitate interaction and patient exchanges across borders to provide comprehensive care.

MTT: It's very interesting. You're really controlling the entire patient experience - from cab rides and physician to the facility and post-care. Short of buying an airline and hotel, you're really managing the complete experience.

DM: Exactly. And we believe this translates into a better experience for everyone involved.

The other key to our success is our relationships. Our team has strong relationships in and across various regions that allow us to build a really strong network across countries and continents.

That physician-to-physician relationship is absolutely critical. We're doing a great deal to build and facilitate the connections. We're doing educational seminars and hosting a series of Borderless Healthcare Symposiums... to develop an understanding between providers. The idea being that if you're a physician in Peru and you have a patient who has a need you can't fulfill, you'll have a trusted partner somewhere in the US.

MTT: Can you explain the symposiums a bit more?

DM: Certainly. The first symposium was in the Bahamas in September of 2012. The symposiums are educational and networking events. At the symposium a physician from the US who is a Nueterra partner provides content relevant to the local physicians and the market. These seminars could be best practices, emerging technology usage or surgical procedure adaptations ... the physician creates pertinent content for physicians. For the remainder of 2012 we have symposiums scheduled throughout the Latin American and Caribbean regions and plan for more in 2013. We want to be perceived as a trusted partner in the various regions, and our goal is to provide educational support for physicians and international patient access when needed. At the first symposium we were able to connect a few transplant patients and begin discussions about how to assist in their needs. This is what the symposiums are about: building relationships so that together we can improve healthcare. More information and registration can be accessed through our Healthcare Symposium website www.nueterraborderlesshealthcare.com

MTT: Is the goal just to build a US network?

DM: Actually after we're done building the US out we're going to move on to the UK, then India followed by China. We want to create not just an inbound US business, but also an outbound one that features our own facilities. Ultimately, we want a global network in which providers can refer patients back and forth between countries and facilities. That applies to the domestic market, too...a doctor in Minnesota may send a patient to St. Louis. All the while the patient stays in-network and in-system, so to speak.

MTT: What exactly is your timeframe for your growth?

DM: We actually have patients ready and in queue right now. The first one is slated to travel for care in two weeks.

Our goal is to move 360 patients by end of year. By the end of next year we're looking at 2,000 to 3,000, and by the end of year five we're aiming for 10,000 globally. Of course that number could go a lot higher depending on how quickly we can build out.

MTT: How has the experience of recruiting physicians been for you?

DM: At Nueterra, our entire model is structured around empowering physicians. We believe the Nueterra Global Alliance is a benefit to physicians all across the globe. It provides access to patients who need tertiary care within a trusted dynamic network of physicians. These are people who have developed relationships at the symposiums, shared conversations, ideas and articles online.

There are a lot of benefits for physicians, and we have intentionally built the Nueterra Global Alliance to benefit physicians and, ultimately, patients. Once physicians understand what we are doing and the benefits, including prestige, educational offerings, networking and patient exchanges, I think many more will join.

It's a particularly easy conversation for physicians who have dealt with international patients before. Once the physician joins the network and becomes familiar with the technological interface, they can experience the benefits of the alliance. After they are in the network we can begin connecting international patients and providers to their practice based on specialty and geographic location.

About David Miller

David Miller provides strategic guidance to the Nueterra Global Alliance and develops strategies for international patient exchanges. Before joining Nueterra, Miller was president of a major national health insurance company for the states of Kansas and Missouri. He has more than 20 years of experience in healthcare, including extensive experience in sales and operations.

Industry News

US Workers Travel for Cheap Surgery

businessweek.com - There is a growing movement among US employers to send insured workers on paid trips to get operations at bargain prices, those involved in the trend say.

Chip Burgett, an executive vice president at BridgeHealth Medical Inc. in Denver - which helps companies, insurers and patients deal with the logistics of shopping for the best prices for surgery and other healthcare - says employers save money even while paying thousands in travel expenses to other states, the Los Angeles Times reported Saturday.

BridgeHealth has deals worked out with about 45 US hospitals, the newspaper said.
"There is a lot of excess margin in healthcare and plenty of room in the pricing of these hospitals," Burgett said. "Hopefully this drives true competition in healthcare and is not just based on how many helicopters a hospital has."

To continue reading click here.


Industry News

Nueterra Hosts International Symposium

Nueterra recently hosted its Borderless Healthcare Symposium in Lima, Peru, on November 6 and 7.

The two days of meetings included a panel discussion with the Peruvian Medical Association, Rimac International, local physicians and the Lima Chamber of Commerce. Physicians from top-ranked facilities in the US also presented as experts in various specialties. "At Nueterra, we are bettering healthcare," said Dan Tasset, chairman of Nueterra. "In Peru, just as in America or anywhere else, we are working to improve the delivery of local healthcare by partnering with area physicians."

Nueterra's vision is to be the preferred and most trusted global partner in the healthcare industry. In supporting this vision, Nueterra is helping physicians and health systems internationally. By contributing intellectual resources in country through the Borderless Healthcare Symposiums, Nueterra is building relationships with physicians from across the globe. Once the healthcare leaders are familiar with Nueterra and its partnership model for creating sustainable healthcare entities, Nueterra then collaborates with governments, health systems and physician partners to build top-quality facilities in-country which are regionalized for patient needs and sustainability.

"We want physicians to be knowledgeable about the latest trends and best practices in healthcare - we want them to be equipped to treat their patients. I want lives to be enriched across the globe because of Nueterra," Tasset shared. For the sickest patients, Nueterra is providing access to exceptional healthcare through the Nueterra Global Alliance, a partnership of best-in-class facilities and health systems in the US. The Nueterra Global Alliance will also provide healthcare options and patient transport through Nueterra's partner facilities in the UK, the Middle East and North Africa.

The Borderless Healthcare Symposium in Peru was just one of the many international events Nueterra is hosting. "We have already hosted an event in the Bahamas. After Peru we are in Barbados," said Steve Harmon, CEO, LAC, MENA and Europe Operations for Nueterra.

Industry News

Maldivian Inks Pact with Apollo Hospitals for Medical Tourism

travelbizmonitor.com - Maldivian, the national carrier of Maldives, has signed a pact with the Chennai-headquartered Apollo Hospitals to give discounts to each others' clients, thus promoting medical tourism in India, as per The Hindu Business Line report. For example, Apollo Hospitals will give a discount on its service charges for those who fly on the airline, and the airline will give similar discounts to the hospital's patients on the airfare.

Abdul Harris, managing director, Maldivian, said it is keen on signing similar pacts with other healthcare service providers in India. He said the Indian healthcare industry attracts a bulk of Maldivian tourists every year. Every day, at least 200 Maldivians visit India, and a big chunk of Indians visit Maldives for medical care. On an average, every Maldivian spends USD 600 in India, he said.

Harris also pointed out that the number can be much more provided, the Indian government scraps the mandatory 60-day waiting period between every two visits. Though there is no need for a visa for Maldivians, the government has imposed the 60-day waiting period. "To that extent you lose forex revenue," he said.

Besides bringing in Maldivians, by connecting Chennai and Dhaka, the airline hopes to bring a lot of health tourists to India. So far, there was no direct flight from Dhaka to Chennai, Harris said.

The airline recently introduced new destinations in India, such as Chennai and Mumbai, both three times a week, from Male. It also proposes to connect New Delhi with Male very soon. With the expanded network, the airline hopes to increase its passenger load factor. Earlier, the airline was operating between Male and Thiruvananthapuram twice a day, flying more than 150 passengers both ways.

Upcoming Events

China's first professional exchange event, The 2013 Shanghai Medical & Healthcare Tourism Show (SMTS) will provide a first-of-its-kind platform for communication and cooperation among suppliers, destinations, hospitals, insurance companies, hotels and other professionals of global medical and healthcare tourism products.

To learn more or to register click here.

International Medical Travel Exhibition & Conference Slated for March 2013

The first truly global exhibition and conference dedicated to medical travel is slated for March 22-23, 2013, at the Grimaldi Forum, Monaco.

Designed to provide a unique opportunity to discuss the latest trends and developments in the medical travel world, IMTEC 2013 offers a combination of exclusive presentations, case studies and panel discussions. Delegates will be able to gain adoptable and sustainable models that can be implemented into an organization directly after the conference.

To learn more about exhibiting or attending visit IMTEC 2013.

To download the show brochure, please click here.

Medical Travel Today: Opinions and Perspectives on an Industry in the Making

Medical Travel Today - the authoritative newsletter for the worldwide medical travel industry - is pleased to announce publication of a new book, "Medical Travel Today: Opinions and Perspectives on an Industry in the Making.

Featuring 40 of the newsletter's most compelling interviews from the first five years of publication, the volume chronicles the explosive growth of international medical tourism as witnessed and experienced by some of the key stakeholders and players. A must-read for anyone interested or involved in the industry.

News in Review

Medical Tourism: 1 In 3 Open To Traveling For Treatments, Poll Finds
huffingtonpost.com - ...Nearly a third of people surveyed around the world say they are open to the idea of medical tourism - traveling abroad to enjoy cheaper medical or dental treatment - according to a new Ipsos poll of 18,731 adults in 24 countries.
Medical Tourism Continues to Grow in Costa Rica
InsideCostaRica.com - Seven out of 10 private clinics in San Jose provided services to medical tourists last year, and in Guanacaste, 4 out of 10 clinics attended such clients.
San Jose registered 1,223 businesses connected with the medical tourism industry, with an average of 38 procedures annually per center.
Report Now Available: "Middle East Medical Tourism Industry Outlook to 2016 - Advanced Medical Infrastructure Paving the Way for Future Growth"

ttrweekly.com - Leading research firm, Research and Markets, released its latest report on medical tourism, Thursday, covering the Middle East and the outlook for this business segment up to 2016.

"Middle East Medical Tourism Industry Outlook to 2016 - Advanced Medical Infrastructure Paving the Way for Future Growth" provides an analysis of the medical tourism industry in Middle East countries in terms of medical tourist arrivals and revenue generated by medical tourism.

Artist Takes Open Source Approach to Addressing Cancer Diagnosis

cnn.com - I was recently diagnosed with brain cancer...My first idea was to seek other opinions. Maybe this hospital is wrong. Maybe there are other places that wouldn't need to do surgery. Maybe there is a laser, a chemical, an ancient tradition, a shaman, a scientist, a nanorobot...I immediately asked for my clinical records in digital format, and left the hospital...I opened up my medical records and converted the data into multiple formats: spreadsheets, databases, metadata files in XML and video, image and sound files. And I published them on The Cure.

The responses have been incredible. More than 200,000 people have visited the site and many have provided videos, poems, medical opinions, suggestions of alternative cures or lifestyles, personal stories of success or, sadly, failures - and simply the statement, "I am here." Among them were more than 90 doctors and researchers who offered information and support.

Dubai Introduces Visa Quota System in Medical Tourism

khaleejtimes.com - Dubai hospitals are set to be more stringently monitored in a bid to protect medical tourists, as announced by the Emirate's health body on Sunday.

Under a new medical tourism visa quota system, hospitals will now have to request a ‘treatment visa service quota' from the Dubai Health Authority (DHA) if they intend to cater to medical tourists.

Such measures have been implemented to ensure hospitals are not over- or underutilizing their services, it said.

The medical tourism visa policy allows a patient to stay in the country for three months - but it can be renewed two times - meaning a nine month stretch in all.

Editor's Note: The information in Medical Travel Today is believed to be accurate, but in some instances, may represent opinion or judgment. The newsletter's providers do not guarantee the accuracy or completeness of any of the information and shall not be liable for any loss or damage caused - directly or indirectly - by or from the information. All information should be considered a supplement to - and not a substitute for - the care provided by a licensed healthcare provider or other appropriate expert. The appearance of advertising in this newsletter should in no way be interpreted as a product or service endorsement by the newsletter's providers.