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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

Prince Court Eyes Higher Medical Tourists

Germany 'Exporting' Old and Sick to Foreign Care Homes

"Birth Tourism" Brings Pregnant Chinese Women to US, Secures Citizenship for Babies

Sri Lanka has begun to Attract Medical Tourists

The Outlook for Medical Tourism in Asia

Heart Procedure is 'a World-First'

Agreement to Facilitate Medical Tourism

Apollo Launches Telemedicine Service in Myanmar


Mary Wong Lai Lin, Ph.D., Malaysia Healthcare Travel Council


International Medical Travel: 2013 Update and Prospects for the Future

Industry News

Wellness Tourism Worldwide Announces Top 10 Wellness Travel Trends for 2013

Can Medical Tourism Save Us From Obamacare?

Another US Domestic Medical Tourism Program: Boeing Offers Cardiac Care Specialty Program at Cleveland Clinic

Timely Tips for Medical Tourism Suppliers & Facilitators for Keeping Your Name off the Wall of Shame

Indo-Pak tension expected to impact Indian Medical Tourism

Reuters Explores Domestic Medical Travel Facilitation: Traveling for Healthcare, but Not That Far


Upcoming Events

ITB Health Tourism Battle - ITB Destination Day at the ITB Berlin Convention 2013

Kuwait Medical Tourism Congress and Exhibition Scheduled for March 2013

2013 CMTR European Medical Tourism Research Symposium

International Board of Medicine and Surgery (IBMS) Mini Medical Conference

Global Connected Care Conference & 4th Meditour Expo

6th Annual World Medical Tourism & Global Healthcare Congress


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Global Health Voyager


Volume 7, Issue 3

By Amanda Haar, Editor


Obstacles and opportunities seem to pervade this issue's news.

From India, where new government visa restrictions are having a devastating effect on patient flow from Pakistan, to Malaysia, where a hands-on government approach is facilitating the creation of visa and extensions to increase patient flow and improve patient experience, the contrasts are dramatic.

We're also pleased to present the top ten wellness travel trends for 2013 as projected by Wellness Tourism Worldwide. From digital detox and spiritual seeking to intergenerational family holidays and sleep, the world of wellness is expanding with new and intriguing opportunities.

Finally, we're grateful to John Maa, M.D., of the University of California, San Francisco for offering his perspective on the future of medical travel and how to achieve a better return on investment of our healthcare dollars.

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


Amanda Haar, Editor

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Dr. Mary Wong Lai Lin, Malaysia Healthcare Travel Council

SPOTLIGHT: Mary Wong Lai Lin, Ph.D., Malaysia Healthcare Travel Council

Editor's Note: In our last issue we featured a write-up from Josef Woodman on the first Malaysia International Healthcare Travel Expo 2012 held late last year. His enthusiasm for the event and Malaysia as a medical travel destination inspired me to reach out to Dr. Mary Wong at the Malaysia Healthcare Travel Council (MHTC) and learn more about the organization and its approach to growing the industry in that country.

Medical Travel Today (MTT): Let's start with the basics. What differentiates Malaysia from other medical travel destinations in terms of clinical quality? 

Dr. Mary Wong (MW): The main point of differentiation is the fact that Malaysian medical travel is initiated and supervised by the Ministry of Health. In most countries, medical travel is simply driven by a tourism board that promotes the availability of services and a country's assets. That's not the case in Malaysia. For us, it's highly regulated. The Ministry of Health really oversees our efforts in the areas of quality concerns starting with licensing.

In order to be considered as a MHTC medical travel provider, a facility has to be licensed under the government's Private Healthcare Facilities and Services Act. If you don't comply in specific areas related to quality and safety, you don't get a license. In addition, a facility must be accredited by either the Joint Commission International (JCI) or the Malaysian Society for Quality in Health (MSQH). A facility is also required to submit foreign patients' data to MHTC. Finally, a facility must have a dedicated medical tourism department with an international patient center and a robust website that promotes their offerings and qualifications.

That's extremely important and it's not just hype.

The MHTC is accountable to essentially a two-person board. That Board includes the Minister of Health himself and the Minister in the Prime Minister's Department in charge of the Economic Planning Unit. These are two very high-level ministers who take our work, and the country's reputation, quite seriously.

They are apprised of all issues and challenges related to medical travel and, believe me, every aspect of the care delivered is monitored and reported on. The result is truly excellent clinical quality and exceptional patient experiences and outcomes.

MTT: What initiatives are underway amongst Malaysian stakeholders, such as Ministry of Health, Ministry of Tourism, Malaysia External Trade Development Corporation (MATRADE), to promote medical tourism?

MW: Because we are a government agency, we work closely with MATRADE and the tourism and immigration departments. If someone needs assistance getting a visa or a visa extension, for example, we can do that very easily. The experience from the prospective patient perspective is quite seamless. There's no ping-ponging between different agencies that one might have elsewhere.

In terms of initiatives, we are looking at customer satisfaction standards and working closely with government agencies and private sector... And when I say closely, I really mean it. This is not an initiative just handed down from the government. We have private hospital representatives who attend our operation meetings. Our advisory council members, all appointed by the Prime Minister, represent both the public and private sector. Representatives of the Malaysian Medical Council, hotels, dental associations, and others all attend our regular meetings. Our vision is one we truly plan together. I don't think you will see this approach in any other country. It's a combined initiative that allows us to work based on each other's strength.

MTT: How high of a priority is medical travel for the Ministry of Tourism?

MW: The Ministry of Health takes it quite seriously. In fact, up until a few years ago medical travel fell under the auspices of the Ministry of Tourism. However, the government, realizing how important quality was to the delivery of care and success of the industry, assigned it under a unit of the Ministry of Health. In 2009 Ministry of Health set up the Malaysia Healthcare Travel Council, and in October 2011, MHTC was corporatized to speed up its operations. I think that move and their continued regulation of the industry speaks of their keen interest in it.

MTT: Are there particular specialty areas you'll be looking to grow and promote in the year ahead? 

MW: The two most sought after areas of care are open-heart surgery and percutaneous coronary intervention (PCI). For that reason they'll remain at the top of our list.

We're also looking to promote orthopedics.

We currently have patients coming from all over the world for hip and knee replacements.

MTT: I was under the impression that the majority of your patients were somewhat regional.

MW: It's true we draw a lot of "local" patients, especially from Singapore, but our largest patient populations come from Indonesia, Japan, India, the United Kingdom, the United States, Australia and China.

In fact, from the US alone Malaysia receives about 12,000 patients per year. That's certainly up from years past.

I think a big part of that growth stems from the fact that we're basically an English-speaking country. Everyone in Malaysia speaks English - from cab drivers and waiters to nurses and doctors - there simply is no communication barrier. I think people are catching on to that and it's helping to drive our numbers.

MTT: Are you aware of any growing interest by employers versus individuals to develop relationships with Malaysian healthcare facilities?

MW: Not yet, but it is a sector we're very interested in growing. I think once employers look at Malaysia as a destination it will be hard to not consider the option. As it is, we're already one of the top ten tourist destinations in the world. Our healthcare costs are excellent - from hospital fees to hotels.

For example, open-heart surgery here versus Singapore is 2.5 times less. Plus, you can stay in at the Ritz-Carlton or Mandarin Oriental for about $180 per night. That kind of pricing extends to everything here. It's extremely reasonable by comparison certainly to the US and to many other destinations. Plus, as I mentioned, the language barrier is non-existent. Employers can feel comfortable that their employee will be understood and will understand completely how they will be cared for, by whom, etc.

MTT: You mentioned Singapore. How would you say Malaysia compares to Singapore in terms of quality, cost, and patient experience?

MW: I can only speak to that in terms of cost savings in that care here is much more affordable.

I can say that we've seen a tremendous increase in the number of Singaporeans coming here for care. In 2011 we had 5,800 patients from Singapore. By October of 2012 the number had already reached 6,500.

MTT: To what do you attribute the increase?

MW: Cost is certainly one factor, as is wait time. Wait time in Malaysia is essentially non-existent. You see your doctor the day you register and not just for a handshake. They sit with patients and consult with them about their options. They're interested in making sure they understand the patient's goals and medical needs and work to direct them to the best course of care. I'm not certain that happens to the same extent in Singapore as it does here.

In addition, we have ten hospitals that operate under the Singaporean MediSave plan. That's certainly an option for those paying out-of-pocket.

And then there's just the appeal of Malaysia that works for people from all over the world: It's very safe and very multicultural. Different races and religions all exist in harmony. There's hardly any stress. It's really ideal for vacations and recovery. Everyone can feel at home.

About Mary Wong Lai Lin, Ph.D.
Dr. Mary Wong Lai Lin is the CEO of Malaysia Healthcare Travel Council (MHTC), a corporatized agency set up under the Ministry of Health Malaysia to develop and promote the healthcare travel industry and to position Malaysia as the healthcare destination of choice.

Dr. Mary Wong has 20 years of experience working in the Ministry of Health Malaysia, serving in various capacities at the federal level, in a state hospital, and in two state health departments. Her experiences are in the areas of health policies, planning and management. She holds a Ph.D. in Health Policy, Economics and Financing from the National University of Singapore.


International Medical Travel: 2013 Update and Prospects for the Future

Description: maa

John Maa, M.D.

By John Maa, M.D., Assistant Adjunct Professor of Surgery, Division of General Surgery, and director, Surgical Hospitalist Program, The University of California, San Francisco (UCSF)

Traveling overseas for low-cost medical procedures was touted on Capitol Hill as an alternative to the high prices of medical care for uninsured Americans as early as 2006. By 2012, Deloitte LLP reported that as many as 1.6 million Americans might travel abroad for medical care. Consistent with the premise of Thomas Friedman's The World is Flat, it was speculated that globalization and competition, achieved through the ability to compare prices for surgical procedures internationally, would create a special opportunity to drive down skyrocketing prices for medical care in the US.

Fast-forward to early 2013: preliminary observations from Thailand and India suggest that a mass influx of Americans for healthcare has not yet materialized. A key intent of the Affordable Care Act (ACA) was to significantly reduce the ranks of uninsured and underinsured Americans, but it is unclear whether the legislation has sidelined medical travel.  The death of an American who received care in Bangkok in 2006 triggered lingering concerns about the safety and quality of care abroad, and highlighted the difficulties of legal recourse against an international hospital in the case of adverse outcomes.  

But large numbers of medical travelers continue to travel from Europe, Asia and the Middle East to Thailand for medical care.  Furthermore, boutique services offering procedures, such as 24/7 colonoscopy and endoscopy, for medical tourists have proliferated and been successful.  

The re-election of President Barack Obama ensures the preservation of his signature healthcare and insurance reform legislation.  Some suggest that the focus on medical travel expansion will therefore shift away from the care of uninsured Americans towards insurance companies seeking to offer low-cost alternatives to employers and employees.  
The special opportunity to utilize financial forces to drive healthcare costs down in the US remains untapped. What's more, there is much that the nation can learn from the healthcare delivery systems in other countries.  Consider the following from The Nation: Thailand spends just over four percent of its gross domestic product (GDP) on healthcare, and achieved universal access to healthcare in 2002, along with remarkable reductions in infant mortality and HIV infection rates.

In the World Health Organization ranking of healthcare systems of 2000, the US was 37th, while Thailand was 47th. As US healthcare expenditures approach 20 percent, with the Congressional Budget Office projecting that 30 million Americans will still remain uninsured despite the ACA, one might reasonably conclude that the Thailand system represents a better return on investment for their healthcare dollars. Perhaps the greatest benefit would result from sending elected US officials, health policy experts and policymakers abroad to observe real-world solutions that are succeeding in other nations, and integrating these valuable lessons into the US healthcare system.

About John Maa, M.D.
John Maa, M.D., assistant adjunct professor of Surgery, Division of General Surgery, and director, Surgical Hospitalist Program, at the University of California, San Francisco (UCSF), is dedicated to improving the quality and access of emergency surgical care. He earned his medical degree at Harvard Medical School, and served as a captain in the medical corps of the US Army for nine years. In 2009, Dr. Maa was named one of the country's leading advocates for healthcare reform by HealthLeaders.

Industry News

Josef Woodman Blogs About Medical Travel on huffingtonpost.com

Editor's Note: Fresh from a healthcare conference in Malaysia, Josef Woodman, author of the highly successful "Patients Beyond Borders" series, was quick to pen/type a blog for the Huffington Post on how the US may find some inspiration for improving healthcare by studying some of the most successful medical travel destinations.

To read the blog, Toward Opening a Practical Dialogue on Improving US Health Care, in its entirety, click here.

Industry News

Can Medical Tourism Save Us From Obamacare?

The rise of first-rate hospitals abroad may provide a vital lifeline for Americans.

Description: maa

Written by Jim Epstein of Reason.com. Reprinted with permission.

Outside of the United States, going to another country for medical care can lead to survival and recovery for patients otherwise facing certain death or long waits for treatment at home. Nigeria has no oncological care to speak of, so cancer-stricken citizens are increasingly going abroad for modern care. Battle-wounded Syrians are getting life-saving surgeries in Turkish hospitals. Canadians come to the U.S. to avoid average wait times of four months for non-emergency procedures.

If the double whammy of Obamacare, which will be fully up and running in 2014, and a rapidly aging population creates pronounced health-care shortages, more and more Americans may soon start looking abroad for fast, affordable, and effective treatments for all sorts of medical problems.

The global health-care industry is booming, which is creating new opportunities for medical travelers to purchase everything from discount dental work to state-of-the-art heart surgery. The international accreditation agency known as Joint Commission International evaluates the quality of hospitals around the world. It has given its stamp of approval to 546 hospitals worldwide and the list is growing faster than ever.

Description: maa

Foreign governments and hospitals are staking big dollars on promotion and infrastructure in an effort to burnish their reputations as medical destinations. That enthusiasm was on display last October at a medical tourism industry conference in Miami, which drew participants from 90 countries. Turkey, which paid close to $100,000 in exchange for prominent branding at the conference, drew 500,000 foreign patients in 2011. Medical tourists brought the country $3.5 billion in revenue in 2011, according to the head of the Turkish Healthcare Travel Council, Emin Çakmak.

Josef Woodman is the founder of Patients Beyond Borders and the author of several guidebooks to the medical tourism industry. He says foreign hospitals face more pressure to keep their costs down than their U.S. counterparts because their patients generally pay their bills out of pocket. And even highly skilled doctors in most countries earn significantly less than in the U.S. In India, heart-valve replacement surgery costs one-tenth of what U.S. hospitals charge. A knee replacement in Thailand runs about one-third of the U.S. price. In South Korea, gastric bypass surgery can be had for half the U.S. price.

The globalization of health care means countries are specializing in certain kinds of care. Turkey excels in pediatric cardiology. Singapore is a destination for oncological care. Chinese heart patients needing top-notch angioplasty go to Japan. Israel and Barbados excel in fertility treatment. Costa Rica and Hungary have become dentistry destinations. Thailand excels in a wide range of specialties thanks in part to its renowned Bumrungrad International Hospital, which serves 400,000 foreign patients a year.

Port Charlotte, Florida-based orthopedist Sam Hess is part of a group that's working to open a full-service hospital on the Caribbean island of St. Maarten. Hess says he's grown tired of the legal and bureaucratic headaches of practicing medicine in the U.S. "I still love what I do, but the issues I have to deal with that have nothing to do with patient care take a lot of wind out of my sails," explains Hess. "We have to assign more and more of our staff to address insurance concerns and approvals. We order tests we don't need to cover ourselves legally."

Hess would also like the freedom to offer treatments that aren't legal yet in the U.S. Medical tourism offers doctors and patients a way around the FDA's often slow-moving approval process. Consider an orthopedic procedure called Birmingham Hip Resurfacing that gives younger patients an alternative to a total hip replacement. It was invented by a British Surgeon in 1991, but the FDA didn't approve the technique until 2006. In the interim, patients flocked to Chennai, India, to be treated by star surgeon Vijay Bose.
Medical travelers don't always make wise choices. Many seek out bogus stem-cell treatments for disorders like autism, multiple sclerosis, Down syndrome, and depression. Researchers anticipate that one day stem cells will be used to treat a broad range of diseases and conditions, but so far they've have been clinically proven effective only for certain blood disorders.

Harvard Law professor I. Glenn Cohen, the author ofa new book about the globalization of health care, says the stem-cell industry could be largely self-regulating if patients had access to better information online. The scarcity of reliable performance data is a major problem in the medical tourism industry, according to Harvard Medical School Professor Sharon Kleefield, who is working on developing better methods for gathering information from foreign hospitals. There's no ranking of the best global hospitals by specialty, which Kleefield thinks would go a long way towards convincing skittish U.S. employers and insurance companies to partner with foreign health-care providers.

Most medical tourists traveling out of the U.S. are seeking procedures that traditional health insurance companies don't cover - such as dental work, plastic surgery, and in vitro fertilization (IVF). But that's likely to change as health care becomes scarcer. Obamacare, which will be fully enacted in 2014, increases the demand for health care without doing much to grow the number of doctors, nurses, and hospital beds necessary to meet that demand. The aging of the baby boom generation (those born between 1946 and 1964) is already putting a strain on resources. By 2025, there will be 64 million Americans over the age of 65. That's almost double the number at the start of the century.

Some U.S. patients will follow in the footsteps of the nearly 50,000 Canadians a year who forego their insurance coverage and pay out of pocket for better and immediate treatment abroad. Medical tourism may also flourish within the regulatory confines of Obamacare.

Southern Methodist University's Nathan Cortez argues in an soon-to-be published essay that there's nothing in the Affordable Care Act that specifically prohibits insurance companies from encouraging their clients to use foreign providers. It's also possible that insurance plans that utilize medical tourism could be offered on the state-based insurance exchanges, although the U.S. Department of Health and Human Services may choose to interpret the law in ways that makes that difficult.

Whatever the hurdles, the often-impeccable quality and low prices available abroad will lead more patients to travel for treatment in the coming years. "You're going to see huge competitive forces coming to bear on the U.S. health care system," says Josef Woodman of Patients Beyond Borders. "And god knows, we need it."

For a related video by the author, click here.

Industry News

Wellness Tourism Worldwide Announces Top 10 Wellness Travel Trends for 2013

Description: maa

Wellness Tourism Worldwide announces its 2013 forecast of each trend and its relevance to today's consumer, focusing upon new wellness design, programs and service levels in air transit, hotel accommodations and destinations.

Camille Hoheb, wellness travel industry expert and founder, Wellness Tourism Worldwide, noted, "Health opens the door to a whole new world. We're looking at wellness domains that contribute to better traveler experiences. We think this forecast will encourage individuals and industries to expand their perceptions on wellness and improve quality of life."

The forecast is based on an analysis of factors including consumer and B2B surveys, site visits, feedback from travel suppliers, destinations and sellers, as well as extensive research -- all of which have been consolidated to bring practical knowledge to both individuals and businesses.

Snapshot: Top 10 Wellness Travel Trends for 2013 (full descriptions below)

  • Wellness Takes Flight
  • Health-Focused Hotels
  • Digital Detox
  • Reconnecting through Nature
  • Sleep at the Forefront
  • Spiritual Seekers
  • Indigenous Healing Experiences
  • Rewarding with Wellness Travel
  • Celebrity Instructor Retreats
  • Intergenerational Family Holiday

Health Focused Hotels
Hotels have realized there's an unmet need for guests to maintain health during travel that goes beyond gyms, pools and spas. Now hotel rooms are designed to alleviate altitude sickness, reduce jet lag, induce better sleep, eliminate bacteria, waterborne chemicals and allergens and purify and humidify the air. Vitamin C-infused showers, dawn simulating alarm clocks and melatonin-producing lighting are other notable features. Guests can access in-room fitness equipment and healthy lifestyle education, as well as take-home tips, programs and wellness apps.

Digital Detox
The World Travel Market Global Trends Report listed digital detox as one of the next big trends to hit the hospitality industry in 2013. A survey showed that 80 percent of smartphone users in the US almost never leave their home without their device, while another found almost 50 percent of mobile owners use their phone during vacations to snap photos and trip planning. Surrendering laptops, tablets and smartphones at check-in are a part of several hotel "Un-plug" programs. Some destinations are also creating technology-free vacation campaigns as a way to market their rustic settings.

Wellness Takes Flight
To draw more passengers and increase revenue, airport renovations are featuring sleek ultramodern designs incorporating natural light, art installations, high-end dining and shopping venues, as well as a plethora of health and fitness offerings. A wide range of offerings from the ubiquitous spa to swimming pools, gardens, walking paths, private napping cabins and cultural centers are all designed to create an atmosphere of "terminal bliss."

Reconnecting Through Nature
Natural assets are the most critical component to wellness tourism product development.
Destinations are beginning to fully leverage their landscape in response to the human need to explore and relax outdoors. "Deprivation holidays" - coined by Euromonitor - is a growing trend in which stressed-out folks choose outdoor boot camp to improve fitness and induce weight loss by pushing to the extreme.

Sleep at the Forefront
Too tired to function? Can't sleep? Lack of proper rest impacts the immune, brain and metabolic systems. With spas, hotels, airplanes and airports, sleep has risen from the ignored to the significant. Micro naps in urban spas create a respite from the frantic pace of cities. Private napping cabins offer respite for weary inter-continental travelers. Hotel designs have evolved to combat jet lag and to help both business and leisure travelers sleep well and prepare for the day ahead. Airlines are catching on, with redesigned planes for peaceful sleep, well-appointed linens on a full-size bed and turn-down service in first class private cabins.

Spiritual Seekers
The interest in non-religious spiritual practices is growing around the world. An increasingly secular global society seeking meaning and purpose opens the doors to spiritual pilgrimages, retreats, temple stays and workshops. Asia, as the place of origin for mind/body lifestyles, practices and treatments is the home of Traditional Chinese Medicine, Ayurveda, various forms of meditation, yoga and other approaches to healing and wellness. An economic powerhouse, Asia has the resources to continue building its tourism platform and exceed traveler expectations.

Intergenerational Family Travel
It seems everyone agrees that multi-generational family travel is a hot trend that has been growing the last few years including Virtuoso, VacationWired, TravelMole, American Express, U.S. Travel Association, ASTA and a variety of others. Grandparents are connecting with grandchildren in a distinct way - by traveling. Grandparents are more active and fit, and have sympathy for their own grown children, who often are required to have two working adults to pay the bills. Vacations create memories and are taking their family relations from cyberspace to real space. The travel industry has designed programs to bring families together to learn, love and play. What could be more "well"?

Indigenous Healing Traditions
As the world has become more globalized, many spa brands have gone the way of Starbucks -- predictable. Placing a spot light on authentic healing traditions is important on several levels. Exporting a region's traditional healing practices gives consumers the opportunity to experience them first-hand at their place of origin. Travelers seeking health and healing traditions at their place of origin contributes to cultural conservation and sustainability, in some cases stimulating economic growth and breathing new life into long forgotten, ancient or undervalued rituals.

Rewarding Wellness Travel
In light of the economic downturn, companies seek peak performance and maximized efficiency. Meeting planners are seeking destinations that align with corporate initiatives for maximum return-on-investment. What better way than to coordinate transformative experiences for both the individual and business organization sponsoring the meeting? Most US companies plan to increase the dollar value of the incentives they offer employees to participate in health improvement programs in 2012, according to a recent employer survey.

Celebrity Instructor Retreats
Wellness travel has taken off as a way to jumpstart a new health regimen or to deepen one's practice of a healthy lifestyle. Studies show that sometimes the most transformative experiences occur far away from home. Yoga, Pilates, meditation and fitness gurus have been elevated to rock stars with their own following and are taking their expertise on the road at exotic locations and regional weekend workshops. Spa destinations and resorts have been offering specialized, themed getaways for a while, but now instructors have realized their own cache and are cashing in.

For a free download of the "Top 10 Wellness Travel Trends for 2013," please go to www.wellnesstourismworldwide.com


Industry News

Another US Domestic Medical Tourism Program: Boeing Offers Cardiac Care Specialty Program at Cleveland Clinic

By Laura Carabello

Boeing, the world's largest aerospace company and leading manufacturer of commercial jetliners and defense, space and security systems, has announced that it now offers approximately 83,000 of its non-union employees and retirees, and their eligible dependents, the opportunity to travel to the Cleveland Clinic for its cardiac care specialty program. The program covers comprehensive treatment for certain cardiac conditions, such as heart-valve replacements, coronary bypass procedures and other non-emergency cardiac procedures.   

"The program is available for our US-based non-union employees and non-Medicare-eligible retirees and their covered dependents enrolled in Boeing medical plans administered by Blue Cross and Blue Shield of Illinois, United Healthcare, Aetna and Cigna," says Joe Tedino, Corporate HR Communications, Boeing. "While the program is initially open to non-union, we would eventually like all employees to have access to this specialized care."

The aim of this specialty care benefit is to ensure that employees and their dependents have access to high-quality cardiac care from a leading medical facility with a proven track record of specialized cardiac care. Known for its sophisticated care and exceptional outcomes for heart surgery, the Cleveland Clinic has served as a pioneer in domestic medical travel partnerships with large employers. Lowe's, the nation's second largest home-improvement retailer, offers its full-time employees and covered dependents heart surgery at the Cleveland Clinic for no out-of-pocket costs. Recently, Wal-Mart Stores Inc. announced that the Cleveland Clinic will serve as one of four Centers of Excellence for its COE Program for insured workers who need heart surgery.

Boeing and the Cleveland Clinic have a decades-long relationship, with the two working jointly to find innovative ways to deliver high-value healthcare for Boeing's employees, retirees and families, including a program to manage healthcare for workers with chronic conditions. This program has significantly reduced hospital admissions, days of hospitalization and absenteeism, while also cutting direct costs of care by more than 20 percent, according to the Seattle Times.

Cost Advantages
The primary motivation for large employers to adopt a domestic medical travel option is to meet goals for keeping costs under control while moving toward paying for quality care - rather than simply paying per service. Such programs give employees a significant cost advantage on heart procedures, as well as free travel and lodging. Employers benefit from a fixed-price menu for complex, often unpredictably expensive surgeries.

Terry White, president, BridgeHealth Medical, Inc., provider of SurgeryPathSM , a proactive program designed to help self-insured companies manage and control their surgery costs, says, "Contracting with hospitals known for high quality has shown promising results in avoiding unnecessary surgeries, which is meaningful, given that large and small employers alike face the same burdensome costs of surgery. In addition to partnering with COEs, a growing number of employer organizations are beginning to focus on educating members about surgery implications and alternatives to achieve quality, cost-effective care."

In the Boeing program, patients who need certain cardiac procedures, such as valve replacements and bypass surgery, have access to care for little or no out-of-pocket expense, according to the Seattle Times. The fixed-price, bundled-payment arrangement gives the self-insured company additional predictability because all expenses for a given procedure are wrapped into one payment. Patients can choose other medical centers but would likely pay more, in keeping with the provisions of their individual insurance plan.

Industry News

Timely Tips for Medical Tourism Suppliers & Facilitators for Keeping Your Name off the Wall of Shame

Editor's Note: Thanks to our friends at Mercury Health for their permission to reprint the following item from their website.

Mercury's Health Insurance Portability and Accountability Act (HIPAA) compliance team offers timely advice about how the new Health Information Technology for Economic and Clinical Health Act (HITECH) raises the ante for compliance by medical tourism facilitators and suppliers that hope to do business with US insurers, employers and consumers.

What You Need to Know
As required by section 13402(e)(4) of the HITECH Act, the Secretary must post a list of breaches of unsecured protected health information affecting 500 or more individuals. These breaches are now posted in a new, more accessible format that allows users to search and sort the posted breaches. Additionally, this new format includes brief summaries of the breach cases that the Office for Civil Rights (OCR) has investigated and closed, as well as the names of private practice providers who have reported breaches of unsecured protected health information to the Secretary.  

**View the Wall of Shame Here**
"Subcontractors" Now Statutorily Obligated to Comply
The burden is on the covered entity to show that there's a low probability that the information has been compromised. Two changes: First, the focus of the assessment is no longer on the harm to the patient but whether the information has been compromised. Second, the burden of proof is clearly on the covered entity. So if it can't be determined pretty clearly that there is a low probability the information has been compromised, the covered entity has to treat it as a breach and self report.

"The final rule adopts the proposal to apply the business associate provisions of the HIPAA Rules to subcontractors and thus, provides in the definition of 'business associate' that a business associate includes a "subcontractor that creates, receives, maintains, or transmits protected health information on behalf of the business associate."

A medical tourism facilitator that transmits or receives personal health information, or a supplier in another country that executes a business associate addendum with a US insurer, employer or facilitator will now be jointly and severally liable by contract for infractions. They must comply with the rules and cannot claim ignorance as a defense.

Federal civil rights laws and the HIPAA Privacy Rule, together protect US citizens' fundamental rights of nondiscrimination and health information privacy. Civil Rights help to protect them from unfair treatment or discrimination, because of their race, color, national origin, disability, age, sex (gender), or religion. Federal laws also provide conscience protections for healthcare providers who refuse to perform certain procedures or dispense certain medications on personal moral convictions.

The Privacy Rule protects the privacy of an individual's health information; it says who can look at and receives one's health information, and also gives one specific rights over that information. In addition, the Patient Safety Act and Rule establish a voluntary reporting system to enhance the data available to assess and resolve patient safety and healthcare quality issues, and provides confidentiality protections for patient safety concerns.

By enforcing the Privacy and Security Rules, OCR helps to protect the privacy of one's health information held by health insurers and certain healthcare providers and health insurers. Some of these providers and insurers may include:

  • Doctors and nurses
  • Pharmacies
  • Hospitals, clinics, and nursing homes
  • Health insurance companies
  • Health maintenance organizations (HMOs)
  • Employer group health plans
  • Medical tourism facilitators that arrange healthcare services
  • Certain government programs that pay for healthcare, such as Medicare and Medicaid

OCR also enforces the confidentiality provisions of the Patient Safety Act and Rule.

Industry News

Indo-Pak tension expected to impact Indian Medical Tourism

TravelBusinessmonitor.com - India's medical tourism industry is set to take a significant hit if tension with Pakistan persists. Hospitals and industry experts fear the visa hurdles may restrict the movement of patients from Pakistan, who constitute 15-20 percent of the total international travelers coming to India for medical treatment, causing a chunk of revenue loss for the country, according to a report by Sushmi Dey in the Business Standard.

While the number of patients from the neighboring country has already started reducing in some hospitals starting this week, the impact on India's medical tourism is expected to slow more after around a month if the situation continues.

Industry News

Reuters Explores Domestic Medical Travel Facilitation: Traveling for Healthcare, but Not That Far

Editor's Note: A recent Reuters' story entitled Traveling for Healthcare, but Not That Far caught my eye. The story briefly chronicles one man's quest for an affordable hip replacement, and introduces North American Surgery, a company specializing exclusively in domestic-based medical travel facilitation. (FYI: Medical Travel Today actually featured North American Surgery's founder in an interview in 2004. Click here to read.) What I found interesting is the fact that the company is now contracted by hospitals to maximize empty operating rooms. Click here to read the piece.

Upcoming Events

ITB Health Tourism Battle - ITB Destination Day at the ITB Berlin Convention 2013

March 7, 2013 - Messedamm 22 D-14055, Berlin

Following up on 2012's great success, the ITB Berlin Convention and visitBerlin will present the second round of the ITB Health Tourism Battle on ITB Destination Day, March 7, 2013. The event is designed to provide insight into international best practices, challenges and trends in health tourism -- a long-term tourism growth market. Worldwide, there has been an increase in the number of destinations and travel companies focused on health tourism and developing new products in this sector. The Health Tourism Battle will feature nine short and dynamic presentations in English on excellent, creative, unique or innovative products and destinations related to health tourism. Each four-minute presentation will be voted on by the audience, with the winner receiving an award and prize.

To learn more or to register click here.


PANASALUD International Medical Tourism Conference 2013

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March 14, 2013 - Horacio Alfaro Hall of the Panama Chamber of Commerce, Industries and Agriculture, Panama

Panama's first major international conference on medical tourism and global health will bring together more than 150 professional groups and five international speakers to share historical market data, current statistics, knowledge on the formation of multi- disciplinary business structures and commercial and risk preparation for small, medium and large companies. As medical and health tourism becomes a budding industry in the Republic of Panama, this conference seeks to bring together doctors, dentists, clinics and hospitals to acquire knowledge and experience directly from medical tourism experts.

To learn more or to register click here.

Kuwait Medical Tourism Congress and Exhibition Scheduled for March 2013

Kuwait Medical Tourism Congress and Exhibition invites local, regional and international best hospitals and medical tourism facilitators for a three-day convergence focusing on networking among the stakeholders, high quality of medical services, and the investment opportunities in healthcare throughout the world.

Slated for March 19 - 21, 2013, at the Crowne Plaza Hotel in Kuwait, the event will see the participation of some of the leading names in the medical tourism and healthcare industry. The conference will comprise workshops conducted by renowned international speakers. The workshops will cover topics that range from medical tourism, current medical research initiatives, the latest innovations in the health sector, future business opportunities in healthcare, insurance, and healthcare quality to the globalization in healthcare.

To learn more or to register click here.

2013 CMTR European Medical Tourism Research Symposium

April 26-27, 2013 - Heidelberg, Germany

The Center for Medical Tourism Research (CMTR) examines the business, clinical, economic, ethical, legal, marketing, operational, policy, social justice and societal impacts of the medical tourism, medical travel, dental tourism, health tourism, wellness tourism, fertility tourism, transplant tourism and retirement tourism industries worldwide.

The 2013 CMTR European Medical Tourism Research Symposium is open to all interested stakeholders in this emerging global industry.

Keynote speakers include:

  • Dr. Melanie Smith, Budapest Business School, associate professor and researcher in Tourism at the Budapest Business School in Hungary
  • Dr. Laszlo Puczko, managing director, Xellum Consulting, LTD, and teacher at the Budapest College of Communication and Business in Hungary

A conference fee of 50 Euros is due onsite. Government and student fees are 25 Euros with valid verification of government or student status.

To learn more or register click here.

International Board of Medicine and Surgery (IBMS) Mini Medical Conference

April 29-May 1, 2013 - Tampa Bay, FL

The International Board of Medicine and Surgery's (IBMS) Mini Medical Conference in Tampa Bay, Fla., will feature key speakers Dr. Sharma, executive director of IBMS India in Mumbai, and Dr. Rai of the India Medical Association.

During the conference, IBMS will meet with various institutions in the Tampa Bay area to share information about medical tourism.

To learn more or to register click here.

Global Connected Care Conference & 4th Meditour Expo

June 5 and 6, 2013 Hyatt Regency - Orange County, CA

This two-day international conference will bring together professionals from all over the world to discuss the latest trends and opportunities in global healthcare. The conference will include presentations by some of global healthcare's biggest decision makers and thought leaders. Conference themes include:

  • Global Physician Referral Networks and Patient Care-The Next Generation of Care
  • Self-Funded Insurance Groups-Providing Healthcare Travel Alternatives
  • Business Processes and Advanced Global Healthcare Marketing Strategies
  • Integrating Global Healthcare Technologies with Medical Travel
  • Legal Issues in Global Care
  • Accessing the US healthcare market: both inbound and outbound
  • Dental Tourism
  • M-health, Telemedicine and Electronic Healthcare Information Platform

To learn more or register 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

Prince Court Eyes Higher Medical Tourists

FreeMalaysiaToday.com - Private healthcare provider Prince Court Medical Centre (PCMC) aims to attract more foreign patients and establish a stronger footprint in its medical tourism business. As PCMC aims to be the leading healthcare provider in Asia, the centre has attracted more foreign patients coming from Asia Pacific, the Middle East and Europe.

Germany 'Exporting' Old and Sick to Foreign Care Homes

Amar.org - Growing numbers of elderly and sick Germans are being sent overseas for long-term care in retirement and rehabilitation centers because of rising costs and falling standards in Germany. The move, which has seen thousands of retired Germans re-housed in homes in Eastern Europe and Asia, has been severely criticized by social welfare organizations.

"Birth Tourism" Brings Pregnant Chinese Women to US, Secures Citizenship for Babies

CNN.com - A growing number of Chinese businesses have begun to facilitate Chinese pregnant women to come to the US to deliver their babies in order to obtain US citizenship for their child. "Birth tourism" is a booming business orchestrated by Chinese companies that charge women from mainland China high prices to give birth in the US. Chinese language websites advertise the American birthing experience to prospective mothers, with packages ranging from $5,000 to $15,000, according to ABC News.
Dozens of houses -- called "maternity hotels" -- operate covertly in the US, serving as temporary homes for the pregnant women. Under current federal law, birth tourism is not illegal, according to CNN.

Sri Lanka has begun to Attract Medical Tourists

News360.lk - Sri Lanka has begun to attract patients from all over the world with enticing offers of cheaper prices, shorter flights and cutting-edge technology, says a newly formed medical tourism firm. According to Sanjaya Padmaperuma, director of Healing Journey, Sri Lanka has gained this advantage, as health travel has gained acceptance as a real solution to the high cost of healthcare in the US and other parts of the developed world.

The Outlook for Medical Tourism in Asia

BangkokPost.com - India and Thailand have traditionally dominated the medical tourism industry in Asia. However, other regional competitors, including Singapore, Malaysia and the Philippines, are recognizing the industry's potential and implementing government-sponsored initiatives to promote development of the industry within their borders. The results of these initiatives have been impressive. For example, in the past few years Malaysia and Singapore have been averaging annual compound growth rates of 29.2 percent and 11.9 percent respectively.

Heart Procedure is 'a World-First'

Iol.co.za - Doctors at the Panorama MediClinic performed a groundbreaking operation during the world's first non-surgical closure of a leaking heart valve on a 59-year-old Cape Town patient. The patient suffered from dextrocardia with situs inversus, a medical condition where a person is born with his or her heart transposed in a mirror image of what is considered to be anatomically normal - on the right side of his or her chest.

Agreement to Facilitate Medical Tourism

GulfToday.ae - In a move to streamline the medical tourism initiative for the Emirate of Dubai, the Dubai Health Authority (DHA) and the General Directorate of Residence and Foreigners Affairs (GDRFA) have signed an agreement on Wednesday to facilitate and support medical tourism in the Emirate.

Apollo Launches Telemedicine Service in Myanmar

Ehealth.ELetsOnline.com - The Apollo Group of Hospitals, one of Asia's largest healthcare providers, formally announced the launch of its telemedicine service in Yangon recently. With this facility, people of Myanmar can now consult world-renowned Indian doctors and get access to quality treatment and latest medical technology without physically going to Apollo Hospitals, India.

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.