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© 2017 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.

Laura Carabello

Managing Editor
Nathan Molinari

Assistant Managing Editor
Brittany Tedesco


From the Editor

From the Editor: This week in Medical Travel Today, Laura Carabello

News in Review

ANA to offer Japan medical tourism packages

Medical Tourism to Guatemala Grew Over 12% This Year

More Americans Are Expected to Leave for Medical Treatments

Trading Hospital Rooms for Hotel Suites

Globalisation responsible for world's obesity crisis: Study

Spotlight Interview

Tim Vicknair, co-founder and managing director, European Medical Tourist (EMT)

Industry News

Part Two: ‘Choosing the Good Hospital'

PRESS RELEASE: NASH Launches First-of-a-Kind Travel Surgery Practice: Serves US Patients, US Self-Insured Employers, Plan Sponsors, TPAs, and Healthcare Business Coalitions

Without the Affordable Care Act Will Medical Tourism Increase?

Repeal of Affordable Care Act Impacts International Medical Travel

The First Global Healthcare Travel Forum In Amman, Jordan

New study: Growing demand and trends for medical tourism market across the globe

Upcoming Events

Health in Greece Convention

The 2017 Global Healthcare Travel Council Forum in Jordan

8th International Exhibition of Medical Treatment Abroad

Pan-African Health Tourism Congress

Medical Fair India 2017

Healthcare Travel Expo and International Medical Forum

Indonesia Health, Medical Treatment and Tourism Expo

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Volume 9, Issue 7

Dear Colleagues:

Patients worldwide are traveling to Europe not only for its beautiful scenery and rich cultural history, but also to access medical care that offers higher quality, lower costs and better value.

This month I had the pleasure of speaking with Tim Vicknair, co-founder and managing director, European Medical Tourist (EMT) about the advanced technology utilized by European hospitals, as well as significant cost savings in comparison to the US. 

Read on to learn more about this competitive service platform along with relevant industry news and global conferences. 

We are going to begin featuring emerging partnerships between US Centers of Excellence and hospitals outside the US. We'd love to hear from US domestic and hospitals around the world that are either interested in pursuing relationships or exploring collaborative opportunities for knowledge transfer and patient referrals. Please be in touch! 

Laura Carabello
Editor and Publisher
Medical Travel Today



Global Health Voyager

Follow us on Facebook and Twitter
For more information, visit http://www.medicaltraveltoday.com


Tim Vicknair, co-founder and managing director, European Medical Tourist (EMT)

+1 512 784 5824 bs
+1 919 595 3612 fx

About European Medical Tourist (EMT)
EMT began from the personal experiences of its founders, who worked in international business and had medical procedures performed overseas in Western countries. Both were impressed by the quality of care, the 75 percent in savings they realized and the medical skill of their physicians. They were also pleasantly surprised to find that their doctors were trained to establish a kind and gentle rapport with their patients.

EMT, through its wide number of hospitals, now finds high quality, low-cost medical care for people all around the world. Whether you are uninsured or underinsured, EMT can often find the procedure for you at a fraction of the cost of what you would pay in the US. If you have a major medical policy with high deductibles, our prices often beat the deductible. If you are on an NHS waiting list or just want your procedure done quickly, we can usually have your procedure done in the hospital in a month.

Medical Travel Today (MTT): Give our readers some background on European Medical Tourist.

Tim Vicknair (TV): Established in 2005, European Medical Tourist (EMT) came to life in response to the health insurance crisis in the United States, along with the long wait lists for treatment in Canada.

MTT: Does EMT serve all of Europe, or just specific locations?

TV: At this point, EMT places heavy focus on health care in Germany.

Germany is the most technically advanced country in Europe and is positioned as the fourth largest economy in the world, supporting a wide variety of medical care and advanced medical technology.

Often U.S. companies bring their innovations to Germany before the U.S. And, in my opinion, physicians in Germany receive superior education.

MTT: How does EMT choose the network of providers it recommends to patients?

TV: Our decision to work with certain providers is based on extensive research.

EMT fully investigates the quality of care provided by physicians, and even goes as far as speaking with their past patients, nurses and colleagues. We always ask the potential providers how many doctors they have as personal patients, as well as how many scientific-based publications they have authored in the past.

The majority of the MD's within EMT's network hold a Ph.D. and are employed as professors at a University.

Of course, the medical facility and the staff must also be investigated as are part of the team that treats the patients.

We only recommend the best of the best.

MTT: What makes Europe an attractive destination for medical travelers?

TV: Europe utilizes the most advanced, proven technology, with Germany often leading the U.S. by nearly ten years in their respective space.

Additionally, the country offers health care services at an affordable price, in a safe and heavily regulated environment. 

In comparison to the U.S., cost savings in Europe can range anywhere from 25 to 75 percent, depending on the case.

MTT: Where do most of EMT's medical travelers come from?

TV: Most of our patients travel from the U.S. and Canada.

However, we do attend to patients from all over the world, including Australia, South Africa, the UK, Indonesia, Russia, Italy, Spain, Japan, and the Middle East.

MTT: How do you track quality data?

TV: Following treatment in Germany, our network of providers recommend patients receive follow-up questionnaires and X-rays in their home country, which are then sent back to their original physician.

This also provides EMT with quality control information.

Patient follow-up tracking can range anywhere between one to 10 years.

MTT: At this point, is there anything else you would like to share?

TV: I think it is important to emphasize that while Europe offers beautiful scenery, EMT offers true health care value to its patients - we are not a ‘discount medical option' or a vacation.

For additional information about EMT, please visit: http://www.europeanmedicaltourist.com/.

Industry News

Part Two: ‘Choosing the Good Hospital'
Helping medical tourists make informed decisions
by Sharon Kleefield

Part One was featured in January's issue of MTT.

The business case
Medical tourism offers business opportunities for entrepreneurs and governments to increase revenues from tourism. For example, Thailand made an early entry into medical tourism when the government launched a campaign to promote it as the ‘medical hub of Asia', advertising high-tech, high-quality and lower-cost medical care. Bumrungrad International Hospital has generated an estimated US$2 billion in medical tourism, or 0.4per cent of their GDP, showing that these efforts have paid off for the Thai government (Lunt and Mannion, 2014). Limited by its own population to finance what is needed for high-tech medical care, Malaysia established the government-industry partnership under the Ministry of Health, increasing the number of international patients with a target of 1 million medical tourists. The Indian government adopted a policy in 2002 to support medical tourism by subsidising the effort through tax and land concessions, duty and tax concessions on various imports and special M visas for medical tourists. With the growing medical tourism industry, the global patient and the physician are no longer restricted by geographical boundaries or local restrictions (Labonte, 2013). There are approximately 11,000 medical tourism brokers and facilitator companies who advertise their services on the internet and social media (Lunt et al., 2010; Turner, 2007).

Facilitator companies are ‘mediators' between hospitals or clinics and medical tourists, but the service and advice they provide remain unregulated, so it is difficult to verify what they advertise and how they manage referrals. Facilitators provide information on locations and costs and many actually arrange the ‘package' for care, including flights, visas, hotels and physician/ hospital referrals. They are likely to receive a monetary return from specific referrals. The consumer may not have this knowledge and its potential conflict of interest for facilitators. Facilitators often have built-in clauses for contracting services that do not take responsibility for patient outcomes and protect them from malpractice (Snyder et al., 2011).

Choosing an international hospital
Little is known about how patients actually utilise these resources to decide on where to travel, but two recent studies conducted via telephone interviews provide some insight. Telephone interviews were conducted with 32 Canadians who travelled abroad for care. The goal of the study was to understand better why they travelled, how they understood the risks and how they gathered information from other patients who travelled abroad. Crooks et al. (2010) conclude that we have much to learn about patients' experiences as medical tourists, specifically how they access and evaluate information from sources before deciding where to travel (Crooks and Snyder, 2010; Lunt et al., 2011). Lunt et al. suggest this gap in understanding and identifies patient decision making as a priority for medical tourism research, especially related to continuity of care, patient health and safety and the commodification of care. ‘We have very limited knowledge about the process of patients' medical travel from start to completion' (Lunt et al., 2010).

Canadians, for example, use facilitators for arranging travel, visas, hotels and referrals to inter- national hospitals. While the number of Canadian medical tourists is small compared to other countries, they do travel for dental and cosmetic surgery that is typically not covered by their healthcare system; they also travel for orthopaedic procedures because of long waiting times and ineligibility due to age.

In choosing a destination, several patients said that the major deciding factor was the reputa- tion of the surgeon whom they had found online and/or through social networks (Hohm and Snyder, 2015). Length of stay and time to recuperate were also factors influencing their choice. As affordability was a factor, neither the USA nor the UK were viable options. Anecdotal reports from other medical tourists, such as testimonials and support from family members, were also factors in choosing the destination. Their local family physician did not typically provide advice and often was not asked for an opinion, as many patients anticipated that the general practitioner would not be supportive about them leaving their own communities. There were a few physicians who offered to speak directly with the surgeon abroad and who said they would provide follow-up care if needed. Participants stated that medical tourism facilitators and clinics abroad provided most of the support in their decision making. Some had direct communication with the surgeon via phone or email, where they could ask questions about the potential risks of the surgery, likely outcomes and if they were appropriate candidates for the procedure.

While waiting time was part of their decision to go abroad, the availability of certain procedures was more important for those who sought alternative procedures, such as hip resurfacing, an alternative to a total hip replacement or a vertical sleeve gastrectomy, a form of gastric bypass surgery. All participants expected that the surgery would improve their qual- ity of life. The specific destination was less important than what they understood to be the expertise of the surgeon and reputation of the facility.

The Canadians who were interviewed (Penney et al., 2011) highlighted issues similar to other medical tourists who are exposed to the same internet sites, advertisements and testimo- nials, regardless of specific regulatory or legal issues within their home country. This study of 32 Canadian medical tourists who sought surgery abroad confirms other accounts of medical tourism that attribute its growth to the influence of the internet (and social media) in connect- ing appropriate expectations and needs. Information from other medical tourists also influenced these decisions, although there is limited reporting regarding effectiveness and outcomes, both short- and long-term (Penney et al., 2011; Turner, 2013a).

A similar study of medical tourists (Ozan-Rafferty et al., 2014) who travelled to Turkey is another example of how the internet is used to access information. Turkey has invested sig- nificant resources to become a ‘hub' for international patients. The study included 36 medical tourists from 13 different countries who had 47 procedures in Turkey between 2007 and 2012. They were predominantly from the USA and Europe and decided on treatment in Turkey because of lower costs and availability of treatment options.

Like the Canadian study, patient reports via the internet, blogs and other discussion posts provided limited information on patients' experiences when travelling abroad for care. Turkey was reported as a top destination between 2008 and 2011. These patient narratives reported sat- isfaction with their outcomes of care in Turkey (75 per cent). The few negative reports included postoperative infections, negative outcomes after IVF and unsuccessful hair transplants. Most of the feedback about the physicians was positive and noted that follow-up was available via email, Skype or telephone. Facilitators provided the necessary logistics of travel. Hospital accreditation was mentioned, but did not appear to be a significant factor in their decision making. It was not clear that they understood that some facilitator companies may have had a financial incentive for these referrals (Erdogan et al., 2012; Ozan-Rafferty et al., 2014).

Both studies of patient narratives, albeit limited, identify the main pathways for learning about medical tourism as ‘word-of-mouth', internet searches, media stories and direct hospital- to-patient advertising (Hohm and Snyder, 2015). Medical tourism facilitators often emphasise the benefits of such travel while there is little to no information on comparative quality, safety and risks. There are thousands of websites with very attractive pictures, personal testimonials, credentials of physicians and their experience.

Common to most websites is the lack of discussion regarding safety and risks of procedures, while some minimise potential questions about the quality of care at a particular facility. Clinical outcomes are presented with very general descrip- tions. Due to privacy issues for the specifics of care, there is little public clinical information about postoperative complications, lapses in safety, infection and any questionable professional or business practices.

The importance of informed consent: a first principle of medical treatment
Informed consent is a first principle of the ethics of medicine. The principle of consent was already evident during Greek and Roman civilisations, with evidence that the doctor's inter- vention had to be, in some way, first approved by the patient. Plato had foreseen the problems, the procedures and the modes of information that are at the root of the modern principle of informed consent: the only guarantee for the patient should be derived from a fundamen- tal principle of medicine at all times: ‘In disease, focus on two aims, to improve and not to cause damage' (Plato, law IV). The Hippocratic oath suggests the awareness of precautions and preventive information. From the Hippocratic oath, the relationship between the doctor and patient was based upon two criteria: by the professional duty of the physician to do what is best for the patient and the duty of the patient to completely understand and consent to the physi- cian's decisions and interventions. The obligation and certainty that the physician acted in the interest of the patient's best interests have been passed down for centuries as the ethical standard that bestows professional authority upon physicians.

During the twentieth century, informed consent was defined by more specific criteria: the fundamental autonomy of the patient to decide, as part of one's personal rights and also the essential objective element of having information necessary for consent to a medical interven- tion. A truly informed consent is said to be given based upon a clear articulation and under- standing of the facts, implications and consequences of a medical intervention. To give an informed consent means that the individual has and understands all the relevant facts - possible complications, potential risks and benefits, duration and cost of treatment, as well as expected outcomes and follow-up. In providing informed consent, a patient agrees and gives explicit and written permission to an intervention (Satyanarayana, 2008). Patients have the moral right to an informed decision when choosing their care, whether at home or abroad (Beauchamp and Childress, 2001; Faden et al., 1986). Physicians (and hospitals) have the moral obligation to provide such information as the foundation for their trust and mutual agreement.

In the UK, Malaysia and Singapore, informed consent for medical procedures requires proof of the current standard of care locally. This is referred to as ‘sufficient consent'. Medicine in the USA, Australia and Canada takes a more patient-focused approach, requiring doctors to disclose significant risks and benefits to the individual patient. In some of the Mediterranean and Arab countries, informed consent is approached more on the context of the delivery of information, with the emphasis more on who is saying it and where, when and how it is being said, rather than what is said, which is relatively more important in Western countries. ‘Optimal' establishment of an informed consent requires an understanding of relevant cultural or other individual factors of the patient; however, the moral and technical requirements for informed consent should rest on the Western definition. With no regulatory oversight internationally, the requirements for an informed consent should have the same ethical conviction and requirement as defined by the World Health Organization (www.who.int/).

The medical professionals at the World Bank's Health Services Department developed the following criteria for choosing surgical procedures abroad: (1) only surgery for a non-acute condition; (2) the patient is able to travel without major pain; (3) the surgery is commonly performed with acceptable volumes, with minimal rates of postoperative complications; (4) the surgery requires minimal follow-up treatment on site; (5) the surgery requires minimal laboratory and pathology reports; and (6) the surgery results in minimal post-procedure immo- bility. In applying these criteria, medical tourists could initially understand their general risks and benefits for the most commonly performed procedures (Agency for Health Care Quality, 2012) and communicate to surgeons abroad as to their expectations for quality and outcomes.

Quality and safety risks for medical tourists
The Economist Intelligence Unit published its first study on the medical tourism market, Traveling for Health (EIU, 2011). The report highlights the fact that developing markets are becoming more ‘pronounced' because of the continued rise of medical costs in the USA and Europe and the increasing number of ‘baby boomers' moving toward retirement age, causing additional strain on healthcare systems in the West; however, identifying hospitals and physi- cians who provide the best care remains challenging (Connell, 2013).

What are the risks faced by medical tourists and what information do we have on com- parative quality and safety of facilities and providers abroad (Greenfield and Pawsey, 2014)? In the USA, there are many regulatory mechanisms designed to protect patients in the health- care setting. The USA requires accreditation for all hospitals, certification and professional self- regulation of physicians, nurses and other ancillary staff. Malpractice suits are reported in a National Malpractice Database that is accessible publicly; a government agency, the Department of Health and Human Services, requires hospitals to report a robust list of quality measures that are used for payment. The ‘overabundance' of required reporting has led to improvement across the best hospitals.

As Lunt et al. (2011) reported, evidence of clinical outcomes for medical tourists is sparse and reports are difficult to verify. Turner observes that, without data, there is no viable way to track the movement of patients, clinical outcomes, surgical complications, infections and other hospital-related events. There is no information, for example, on improperly performed procedures, disease transmission and spread of infections from inbound and outbound medi- cal travellers. When medical tourists return home with less than satisfactory outcomes, that knowledge is not available unless through testimonials and social media (Turner, 2007, 2013b).

Many destination countries have infectious diseases of global concern, such as tuberculosis, polio, malaria and other mosquito-borne infections. Medical tourists can be exposed to circu- lating infectious diseases as soon as they come in contact with other patients and staff in the hospital. There are also nosocomial infections - hospital-acquired infections (HAIs) - from contaminated water, food, devices (catheters and ventilators) and contact with healthcare team members who may be delinquent in required hand hygiene practices. In developed countries, including the USA, urinary tract infections are the most common HAIs. In the USA, the annual costs of the major HAIs in hospitals (central line-associated blood stream infections, ventilator- associated pneumonia, surgical site infections and catheter-associated urinary tract infections) totalled $9.8 billion - a significant cost to the healthcare budget (Zimlichman et al., 2013).

On average, 10-15per cent of all hospitalised patients in lower-income countries will acquire HAIs. Blood safety presents additional risks, with 39 of the 164 countries responding to a 2008 World Health Organization (WHO) survey on blood safety (www.who.int/), indicating that they do not follow the WHO guidelines for screening donated blood for HIV, hepatitis B and C and syphilis. Rates of HAIs in developing countries are recognisd to be higher than those in developed countries (Allegranzi et al., 2011).

One identifying marker of a good-quality hospital is a JCI accreditation or an equivalent accreditation identified by the International Society for Quality in Healthcare. Another marker is foreign-trained physicians who have been deemed qualified to practise in the USA or UK. A third is that the hospital engages in collaborations with prestigious US medical centres (Cohen, 2015). While these considerations can identify positive characteristics of a hospital, there is limited available evidence that these are correlated with the best patient outcomes. Quality of care remains the most frequently cited concern for medical travel abroad. The medical tourist typically has this information, if guided properly, but too often these data are under-reported by hospitals and by specific procedures (Cohen, 2015; Lunt et al., 2010: 11; Snyder et al., 2011; Turner, 2011). Patients may not know what questions to ask regarding their exposure to risk and safety in a foreign country, for example infections, especially across many different cultures and local professional variations in comparable standards of care.

Stay tuned for Part Three, which will appear in March's issue of MTT.

Industry News

PRESS RELEASE: NASH Launches First-of-a-Kind Travel Surgery Practice: Serves US Patients, US Self-Insured Employers, Plan Sponsors, TPAs, and Healthcare Business Coalitions
Introducing Program in Cancun

DENVER, CO - January 17, 2017 - The North American Specialty Hospital (NASH) announces the opening of a first-of-a-kind center of excellence in the delivery of healthcare, with pre-and post-surgical care delivered in the U.S. and surgery performed outside the country. This unique model is equipped with U.S. clinical protocols, U.S. performance-based quality metrics, U.S. surgeon continuous engagement, U.S. malpractice insurance coverage, U.S. accreditation, and an attached US hotel.

Jim Polsfut, NASH CEO, says, "We're very pleased to offer what U.S. self-insured employers have told us they are seeking: U.S. standards of quality of care, billing that is both bundled and transparent, pricing that is internationally competitive at roughly half the US rates, and a travel destination that is at once appealing and convenient."

NASH now provides these elements of patient care in one location - Cancun, connected to the U.S. with non-stop, year-round flights. With exclusive use of two operating rooms as well as an entire patient recovery floor, NASH functions within the recently expanded Galenia Hospital, the only facility in North America with triple accreditation - both Canadian and Mexican authorities and the U.S. Joint Commission International. The grand opening of a Sheraton Four Points Hotel, attached directly to the Galenia Hospital, completes the ideal patient experience, with international hospitality delivered within a renowned U.S. hotelier.
"Continuity-of-care is a hallmark of NASH's service model, with U.S. surgeons involved by design in every step of the surgical process," says Polsfut. "Pre- and post-operative care are provided in the U.S. where employees are based, and surgery is performed on a rotational basis in Cancun in collaboration with NASH's local medical personnel."

According to Theodore Schlegel, MD, member of the NASH Board of Directors, founding member of the Steadman Hawkins Clinic in Denver, and former team physician for the Denver Broncos, "The NASH continuity network already includes some of the most respected surgeons in the United States from leading physician practice groups and universities. And in Cancun, each of our rotating surgeons serves as an adjunct professor for Anahuac University, Mexico's leading medical school, thereby contributing to NASH's role as a teaching institution focused on innovation and quality."

NASH launched its medical services in October 2016, with an initial caseload concentrating on orthopedic procedures, including total knee and total hip replacements.

"Over time, NASH will expand into other medical specialties, including spine, cardiology, and oncology," says Dr. Schlegel. "For each specialty, NASH's primary value-added objective remains the same - strict attention to quality with substantial cost savings."

About North American Specialty Hospital
Headquartered in Denver, NASH is a US majority-owned and managed enterprise. Incorporating US physicians in its service delivery, NASH is designed to provide pre-operative and post-operative services throughout the US, while providing clinical care in Cancun. http://northamericanspecialtyhospital.com/

Media Contact:
Nathan Molinari
CPR Communications


Industry News

Without the Affordable Care Act Will Medical Tourism Increase?
by Laura Carabello

mdmag.com- The impending repeal of the Affordable Care Act (ACA) has created uncertainty in the US healthcare marketplace. As the existing system is dismantled, and programs shut down or replaced, many Americans will be scrambling to access truly affordable, quality care.  

This phenomenon has many implications for US physicians as people in every market sector begins to explore their options - from uninsured individuals to Medicare and Medicaid beneficiaries, as well as employees covered by self-funded companies.

If the ranks of the uninsured grow as a result of the demise of the ACA, medical travel options could represent an ideal solution. According to the research published in the Annals of Internal Medicine in January 24, 2017, even after implementation of the ACA, 15% of people with chronic diseases still lacked health insurance coverage and more than a quarter of them didn't get a checkup in 2014. About 23% of people with chronic disease went without care because they found that costs were still too high.

This signals a potential boon for the international medical travel industry, further propelling the steady growth it has experienced in recent years. Medical travel was valued at $439 billion, and is projected to grow 25% a year over the next decade. In 2016, an estimated 1.4 million Americans traveled abroad for a medical procedure.  

US physicians may also find that even Medicaid beneficiaries and Medicare enrollees will be lured to hospitals and providers outside the US.

For Medicaid patients who remained optimistic that their home state would offer expanded coverage, their hopes are fading. Repeal of the ACA will leave millions of the poorest and sickest Americans without insurance. Many states may either abandon Medicaid expansion or be forced to significantly redesign their programs to ensure that individuals below 400% of the federal poverty level can receive affordable healthcare coverage and services.

While these low-income families may not have cash reserves to fund expensive care in the US, they might have the resources - or may be able to gather support from family and friends - to access affordable surgeries overseas. 

As for Medicare enrollees, including 57 million senior citizens and disabled Americans, higher premiums, deductibles and cost-sharing could spark a shift toward medical travel, especially given the country’s aging population and the likelihood that many seniors will require surgery. 

Seniors could face higher deductibles and co-payments for their Part A, which covers hospital stays, and higher premiums and deductibles for Part B, which pays for doctor visits and other services. Under a full repeal, Medicare enrollees may also lose some of their free preventative benefits, such as screenings for breast and colorectal cancer, heart disease and diabetes.

Self-insured employers are actively seeking to lower health-care costs and increase their financial margins, and they may opt to steer workers to more cost-effective Centers of Excellence outside their home state or region.  As a result, and despite long-term relationships with their hometown physicians, patients will be incentivized to leave the country and access care at foreign hospitals that demonstrate quality care at lower cost.  By waiving deductibles or copays - and even paying cash rewards for choosing the medical travel option - employers will prompt patients to make the decision to travel.

Further raising patients' comfort levels regarding medical travel is the increased quality of care now offered at international hospitals. This improvement is due to the success of knowledge transfer programs and training offered by US institutions and providers to hospitals worldwide. These collaborative efforts are bringing American ingenuity, sophisticated technology, administrative simplification and advanced techniques to hospitals in Mexico and throughout the Caribbean, as well as to locations as far away as Malta and the United Arab Emirates.

If the ACA is fully repealed, distinct changes in medical travel patterns are expected.

While Americans traditionally traveled out of the country to access elective procedures -- dental care, esthetic surgeries or wellness care not typically included in their health benefits packages - they are now more likely to seek reliable medical treatment for complex conditions in destinations that are cross-border but only requiring three to four hours of travel time.
Hospitals and providers in the Latin America-Caribbean Region are likely to become destinations of choice for employers, as well as individuals. The lure of less expensive and shorter travel, reduced language barriers, and more cultural familiarity are appealing to all.  The challenge will be to access benchmarks for selecting providers, ascertaining costs, determining legal recourse regarding less-than-optimal outcomes and other issues. Without the guidance of a health plan or administrator, this process may be challenging to many.

With the steady rise of medical travel, a growing number of US physicians will encounter patients seeking consultation prior to getting treatment abroad. This means providing medical records or consulting directly with the international team.

Physicians will also encounter more patients who require follow-up care after undergoing a procedure in another country. In this case, it will be important to access treatment information and discharge papers from the overseas hospital, as well as records for blood work, X-rays or other screenings for use as a roadmap for the patient’s post-care. Physicians may also be reticent to perform additional services that may be required following care performed outside the US and not in their control. 

Beyond the medical details, physicians need to understand every aspect of medical travel to deal with the increased competition and cost pressures. They may want to look into making improvements and upgrading services to justify the expense of treatments here in the United States. The strongest transformation will occur in what is today the most lucrative part of the industry: high-cost surgeries and procedures. Keep in mind that US treatment costs often justify travel elsewhere, despite additional travel and accommodation costs. 

Going forward, physicians can play a role in guiding patients to seek the best possible care - wherever it is available -- while helping them understand the benefits and potential risks of medical travel.

To view the original article, click here.

Industry News

Repeal of Affordable Care Act Impacts International Medical Travel
by Laura Carabello

wphealthcarenews.com- The repeal of the Affordable Care Act (ACA) has been met with considerable market uncertainty. As the transition gets underway, many Americans will be scrambling to access affordable, quality care. 
Fortunately, the international medical travel industry -"Travel for Treatment" - may finally gain the attention it deserves from the American public and U.S. employers. Experts predict that the number of Americans traveling abroad for medical care or episodes of treatment is expected to increase 25 percent annually over the next decade.

Medical travelers are likely to come from every market sector: the growing ranks of uninsured individuals, self-insured employers facing higher healthcare expenditures, disenfranchised Medicaid beneficiaries, as well as Medicare enrollees with high out-of-pocket expenditures and the loss of coverage for preventive care.

Individual Consumers
Once "minimum essential healthcare coverage" is no longer mandated, the burden of payment will transfer onto healthcare providers and systems that will be forced to continue cost shifting onto the backs of paying customers.
Fewer insurance companies will be willing to underwrite coverage in the exchanges. In fact, many will leave the individual marketplaces altogether because of the potential loss of federal subsidies for both beneficiaries and insurance companies themselves.

Burdened by hefty cost-shifting, more Americans will be forced to pay out of their own pockets for surgeries or treatments in the U.S. Those who can afford a plane ticket will find it increasingly attractive to travel outside the country for quality, affordable options, such as joint replacement, cardio-thoracic surgery, oncology, bariatrics, and a host of other medical procedures, including treatment for Hepatitis C. 

Low-Income (Medicaid) and Seniors (Medicare)
For Medicaid beneficiaries who remained optimistic that their home state would offer expanded coverage, their prospects look dim. The unraveling of the ACA will leave millions of the poorest and sickest Americans without insurance. Many states may either abandon Medicaid expansion or be forced to significantly redesign their programs to ensure that individuals below 400 percent of the federal poverty level can receive affordable healthcare coverage and services.
While these low-income families may not have cash reserves to fund expensive care in the U.S., they might be able to gather the resources to access needed surgeries overseas - and pay less than half of the US rates. Those who have emigrated from Latin American countries, in particular, will take advantage of opportunities to travel to their homelands to gain access to care that is substantially less expensive, and in a familiar setting.

The 57 million senior citizens and disabled Americans enrolled in Medicare could also benefit from accessing international medical travel. Under a full repeal of the ACA, seniors face higher deductibles and co-payments for their Part A, which covers hospital stays, and higher premiums and deductibles for Part B, which pays for doctor visits and other services. Medicare enrollees may also lose some of their free preventative benefits, such as screenings for breast and colorectal cancer, heart disease and diabetes. The opportunity to access quality care at lower costs - plus prescription drugs that are sold at far lower price points outside the US - present attractive options.

Healthcare will continue to be driven through employers, and cost pressures will push high-deductible plans, risk-based contracting and consumerism. In the United States today, even a negotiated, discounted rate for a total knee replacement at a local hospital may well exceed $45,000, $60,000, or more. The bottom line for self-insured employers - the coverage model that now dominates the marketplace: even after factoring in the cost of travel and accommodations for the patient and the companion, as well as waiving deductibles and co-pays as incentives to program adoption, the savings on surgical procedures such as joint replacement are significant.

Employers will also be more likely to send workers to emerging COEs outside the country in light of the many partnerships that are underway between US providers and foreign hospitals. These collaborative programs are bringing American ingenuity, sophisticated technology and advanced levels of care to institutions throughout the world. 

Quality and safety standards at many institutions are now equal to or exceed US benchmarks. Many foreign hospitals are accredited by Joint Commission International, an extension of the US-based Joint Commission. Select hospitals outside the country adhere to US clinical protocols. 

In fact, one organization that serves self-insured employers - North American Specialty Hospital in Cancun - even offers U.S. surgeons with US malpractice insurance who perform pre- and post-operative care in the US and then travel to Cancun for surgery. This ensures continuous engagement and continuity of care. 

The ACA has contributed to hospitals experiencing higher volumes of insured patients, but those volumes would drop with the law’s repeal. It could also cause fewer people to keep prescription coverage, which would be modestly negative for the pharmaceutical industry.

Experts believe the majority of primary care physicians are open to changes in the law but overwhelmingly oppose full repeal, according to a survey published in The New England Journal of Medicine.

Insurance coverage for the 20 million people who obtained insurance from the exchanges sparked growth in patient numbers for hospitals, which offset lower payments. Without this, hospitals can expect deepening economic problems. This could lead to higher prices, and greater impetus among individuals to seek medical care outside of the U.S.

Key Destinations for International Medical Travel
With the growing ranks of uninsured, medical travel options are likely to emerge as a critical solution to healthcare cost woes. Hospitals and providers in nearby locations such as Latin America - known as the LAC Region - are likely to become destinations of choice: less expensive travel expenses, reduced language barriers, and cultural familiarity. Individuals and employers will require guidance in terms of choosing the right providers and determining costs to overcome the challenges that lie ahead.

To view the original article, click here.

Industry News

The First Global Healthcare Travel Forum In Amman, Jordan
drprem.com-Global Healthcare Travel Council (GHTC), the well-recognized forum of National Councils in Healthcare Travel industry would be organizing the first Global healthcare travel forum in Amman, the capital city of Jordan. Under the royal patronage of His Majesty King Abdullah II Ibn Al-Hussain and hosted by Private Hospitals Association of Jordan, the event is scheduled at Le Royal Hotel from 25th to 27th February 2017.

This prestigious meet is poised to bring out unique marketing strategies to enhance the growth of global medical tourism with the active participation of renowned marketing and business consultants and other important stakeholders.

Dr. Prem, the award-winning keynote speaker and experienced medical tourism consultant will be delivering a highly informative presentation on latest innovation in medical tourism and wellness tourism marketing in this forum. Through his educative information and knowledge-sharing session, he will enlighten the audience about the latest developments and strategies to be implemented in medical tourism marketing which would be highly beneficial for the healthcare organizations.

Keeping in view the immense potential of global medical tourism sector, GHTC was launched in 2013 as a benchmark setting organization to further the growth of healthcare travel. The organization is represented by the top executives of world's reputed Healthcare Travel councils. Its mission is to raise awareness in global healthcare travel and make it accessible to all global citizens.

In the healthcare domain, Jordan ranks 1st in the Middle East and 5th in the world. Considering the high-quality treatment facilities available at a substantially low cost, the country's potential to be among the top medical tourism destinations is beyond any question. Hosting a prestigious global forum with GHTC, at this juncture, is a great marketing effort that will surely place the country in global limelight.

With medical tourism growing at a faster pace, marketing in medical tourism is also catching up fast as more numbers of leading global healthcare organizations are supporting this niche tourism sector aiming a bigger share in the market. The need for such an organized platform like GHTC is very much relevant today.  With the swelling in number of global medical tourists, the market is bound to experience astronomical growth. But this growth can be realized only through effective marketing strategies and by creating suitable infrastructure support.

Dr Prem has delivered highly valuable speeches on different global platforms on medical and wellness tourism which was greatly appreciated by prominent stakeholders and business partners. Invitees in the upcoming GHTC meet will be pleased to enhance their knowledge and information base from his presentation and innovative ideas which they can implement fruitfully.

Talking of the potential of medical and wellness tourism, every country has its own assets and resources that often remain shadowed due to lack of proper marketing. Unlocking the potential is Dr Prem's forte. Being a highly knowledgeable person on medical and wellness tourism and wide exposure in global tourism, it is Dr Prem's passion to dig out the trapped potential of a country by providing unique marketing ideas.

He has vast travelling experience covering more than 45 countries where interaction with the local people and culture forms an integral part. This has helped him develop a strong knowledge base that imparted a finer sense to unearth the potential of medical and wellness tourism based on natural resources and talents. His contributory speech and presentation in this meet would set another benchmark in medical and wellness tourism marketing to be carried forward in future.

To view the original article, click here.

Industry News

New study: Growing demand and trends for medical tourism market across the globe
by Pawan Kumar WhaTech Max

whatech.com-Global medical tourism market is expected to garner $143.8 billion by 2022, registering a CAGR of 15.7% during the forecast period 2015 - 2022

Research Beam study says Global medical tourism market is expected to garner $143.8 billion by 2022, registering a CAGR of 15.7% during the forecast period 2015 - 2022, Download Sample Copy @ www.researchbeam.com/medical-tourism-market/request-sample

Global medical tourism market is expected to garner $143.8 billion by 2022, registering a CAGR of 15.7% during the forecast period 2015 - 2022. Medical tourism can be broadly defined as travel across international borders with the purpose of availing medical treatment of some form, which may or may not be available in the travelers' home country.
This treatment may include a wide array of medical services; however, the most frequently availed services include dental care, cosmetic surgery, elective surgery, and fertility treatment. The motives for making the travel could be one or more among the following major factors:

  1. High cost or affordability of medical services including the one the customer needs to avail.
  2. Non-availability or low quality of the necessary treatment due to lack of healthcare infrastructure or skilled service providers.
  3. Less waiting time for the available treatment such as organ transplant.

Medical tourism includes people who travel to a different place to receive treatment for a disease, an ailment, a condition, or to undergo a cosmetic procedure, and who are seeking lower cost, higher quality, different or better access to care than what they could receive at home.

The medical tourism market encompasses a large and broad number of categories of travelers. However, for the purpose of this study, we have limited the scope to patients travelling across international borders to avail critical or less critical but necessary treatment.

We have excluded out-patient single day procedures, aesthetic, cosmetic and dental treatment medical tourism within international borders.

The report highlights the global medical tourism market in accordance with the treatment type and geography. Based on treatment type, the market is categorized into cosmetic, dental, cardiovascular, orthopedic, neurological, cancer, fertility, and other general treatments.

The report also provides the revenue generated from medical tourism segmented by geography and the key countries that attract patients to travel to the destinations in order to avail medical services.

To provide a detailed market assessment, this study also considers the government regulations, reimbursement scenario in developed as well as developing regions and the potential impact of medical tourism on the healthcare system.

Major destinations for medical tourism include Thailand, India, South Korea, Barbados, Mexico, Brazil, Japan, Malaysia, Costa Rica, Singapore, Hong Kong, Israel, Iran, South Africa, France, Germany, Turkey, and the UK among others. Most of these destinations offer specialized treatment for specific medical conditions.

For instance, Barbados is known for fertility treatment services while Singapore is famous for stem cell treatment and cancer treatment.

Medical tourism is among the major revenue generators for developing nations such as India, South Africa, Thailand, and Mexico. These destinations offer a variety of good quality medical services at a relatively low price when compared to developed nations.

Medical tourism is being supported by the respective governments of popular medical tourism destinations, such as India, Thailand, Malaysia, and South Korea, through subsidies on infrastructure development, relaxed visa regulations for patients & their travel partners, and supportive legal issues resolution. For instance, in a bid to promote medical tourism in the country, Thailand's Ministry of Interior decided to allow an extended stay of 90 days, without visa, to the medical tourists from the six GCC countries in 2011.


  1. This report provides an extensive analysis of the current and emerging trends and dynamics in the global medical tourism market.
  2. The medical tourism market scenario is comprehensively analyzed in accordance to the key regions.
  3. The market estimations are based on high-end analysis of the key market segments from 2014 to 2022.
  4. Extensive research is done for the market by treatment type, which provides a clear understanding about the current trends and flow of medical tourists.

A detailed SWOT analysis enables to study the internal environment of the leading service providers for strategy formulation.

To view the original article, click here.

Industry News

Help Save a Life and Support MatchingDonors
100 percent of all donations on MatchingDonors.com go to help people get organ transplants on MatchingDonors.com.

MatchingDonors is a 501c3 nonprofit organization and the nation's largest online living organ donor organization finding living organ donors for people needing organ transplants. In conjunction with various health organizations throughout the United States we have created a very successful Public Service Announcement campaign to help people recognize that they can save lives by being a living organ donor, to encourage them to register as an altruistic living organ donor, and to make them realize they can help save the lives of people needing organ transplants by donating other things. This MatchingDonors Living Organ Donor Initiative program has already saved thousands of lives.



Upcoming Events

Health in Greece Convention

February 11-12, 2017 - Athens, Greece
To learn more or to register click here.

The 2017 Global Healthcare Travel Council Forum in Jordan

February 25-27, 2017 - Amman, Jordan
To learn more or to register click here.

8th International Exhibition of Medical Treatment Abroad

March 14-16, 2017 - Expocentre Fairgrounds, Moscow, Russia
To learn more or to register click here.

Pan-African Health Tourism Congress

March 29-31, 2017 - Umfolozi Hotel Casino and Convention Resort, South Africa
To learn more or to register click here.

Medical Fair India 2017

April 6-8, 2017 - Pragati Maidan, New Delhi
To learn more or to register click here.

Healthcare Travel Expo and International Medical Forum

April 25-27, 2017 - Exhibition Center Kyiv Expo Plaza, Kiev City, Ukraine
To learn more or to register click here.

Indonesia Health, Medical Treatment and Tourism Expo

May 11-14th, 2017 - Jakarta Convention Center - Indonesia
To learn more or to register click here.

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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

ANA to offer Japan medical tourism packages
Asia.nikkei.com- Airline group ANA Holdings is getting into the medical tourism trade, looking to make long-term fliers of affluent Chinese and others seeking quality care in Japan.
Travel subsidiary ANA Sales will begin offering packages, including airfare and hotel stays, for Chinese travelers as early as this month as an initial step. The first tours could begin in late March. ANA will partner with Kameda Medical Center in Chiba Prefecture, near Tokyo, which will offer comprehensive health checkups as part of the deal.

Medical Tourism to Guatemala Grew Over 12% This Year
news.co.cr-Tourism to Guatemala for medical, health and wellbeing services brought in over US$66 million last year, and the sector is growing quickly.
More Americans Are Expected to Leave for Medical Treatments
pastemagazine.com-This year, an estimated eleven million people scaled the globe for low-cost medical procedures.

Trading Hospital Rooms for Hotel Suites
nytimes.com-As patients increasingly travel for medical treatment, developers are seizing on the benefits of situating hotels near major medical centers.

Globalisation responsible for world's obesity crisis: Study
hindustantimes.com-An international study by the London School of Economics has highlighted the link between globalisation and rising obesity levels, with authors confirming that our modern lifestyles have had a profound effect on our overall health.


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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.