[email protected] http://www.philadelphiamedicine.com/ About Leonard Karp Leonard Karp is the president and CEO of Philadelphia International Medicine and a two-decade veteran of the U.S. healthcare industry. At Philadelphia International Medicine (PIM), Karp leads an organization dedicated to establishing the Philadelphia region as an international healthcare destination of choice. PIM is seen as an economic development initiative and works closely with city, state and federal commerce departments. It is a successful model of collaboration among academic medical centers in the Philadelphia region, and Karp has been interviewed about international medicine as an economic driver by CNN, the New York Times, Philadelphia Inquirer, and publications around the world. This unique hospital marketing and management company is owned jointly by Fox Chase Cancer Center, Temple University Hospital and Thomas Jefferson University Hospital, and has service agreements with Nemours/Alfred I. duPont Hospital for Children, Jefferson Home Care, Magee Rehabilitation Hospital and Wills Eye Hospital. PIM has three product lines: the care of international patients at Philadelphia area hospitals; training and continuing education of healthcare professionals from around the world; and management and consulting services to international hospitals, governments and health agencies. PIM patients have contributed about $250 million to the Philadelphia economy, while its training and continuing education events utilize faculty from its university medical centers to explain the latest in medical techniques and research. PIM organizes clinical training for physicians, advanced training for nurses, and MBA-like training for international hospital administrators. Karp is also an international trade advisor to the U.S. Department of Commerce and the Office of the U.S. Trade Representative as a member of the Industry Trade Advisory Committee on Services. He is a co-founder of Greater Philadelphia Global Partners, a regional organization to promote global trade in the Philadelphia area. He has spoken on international healthcare to audiences in South Korea, Equatorial Guinea, Abu Dhabi and throughout the United States. Karp is on the board of Global Philadelphia Association, the Life Sciences Congress of the Greater Philadelphia Convention and Visitors Bureau and is chairman of the Upper Dublin Township Zoning Hearing Board. He has been a mentor to the Temple University Fox School of Business entrepreneurship program for four years. Previously, Karp was vice president of the Delaware Valley Hospital Council, director of Public Affairs for the New Jersey Insurance Department, and an award-winning reporter/editor. About Philadelphia International Medicine Philadelphia International Medicine (PIM) is a healthcare organization dedicated to bringing the services of six prestigious Philadelphia area hospitals to the international community. Our owner hospitals include Fox Chase Cancer Center, Temple University Hospital, and Thomas Jefferson University Hospital. We also have service agreements with Alfred I. duPont Hospital for Children, Magee Rehabilitation Hospital and Wills Eye Hospital. Learn more about PIM’s history, organization and development in the following pages. Medical Travel Today (MTT): How did you get involved in the medical travel space? Leonard Karp (LK): Philadelphia was, and still is, a major medical focal point in the United States. When I first got involved in the industry, the city was home to more than 80 hospitals and five or six different medical schools. The healthcare infrastructure was – and still is — a vital asset to the economy. Back in the mid 1990’s, Health Maintenance Organization’s (HMO) were rapidly developing and changing the way medicine was delivered. Simultaneously, we were witnessing a dramatic decrease in the length of patient hospital stay, and as a result, we were seeing an oversupply of medical beds in the Philadelphia region. Around 1998, I was part of a team at the regional hospital association that was looking at different opportunities to preserve healthcare as an economic driver, one of which was medical travel. The hospital council decided to organize a regional medical travel infrastructure, which took approximately a year to finalize in terms of appropriate finances, responsibilities and active roles. In 1999, we launched our organization, now known as Philadelphia International Medicine (PIM), a limited liability corporation owned by hospitals. Originally, we did receive city and state funding to get started, but we’ve been self-sufficient for quite some time now. PIM funds itself through training programs that we provide for physicians overseas, or through the hospitals that pay for the marketing services that we offer. MTT: Are you aware of other groups similar to PIM throughout the United States? LK: There aren’t other groups exactly like PIM, but Partner’s International in Boston, Massachusetts, does have a similar model. MTT: Can you share major milestones that PIM has achieved thus far? LK: Philadelphia International Medicine consists of two groups – owner hospitals and hospitals that participate through service contracts. The owner hospitals include:

• Thomas Jefferson University Hospital
• Temple University Hospital
• Fox Chase Cancer Center

The service agreement hospitals include:

• Nemours/Alfred I. duPont Hospital for Children
• Jefferson Home Care
• Magee Rehabilitation Hospital
• Wills Eye Institute.

We have also developed a relationship with a home healthcare agency. Currently, PIM only works in the international medical travel space. We do not work within the domestic medical travel industry for a host of reasons, the primary reason being competition. We feel that internationally, it is more beneficial to work in a non-competitive, collaborative environment. Last year, PIM had more than 6,000 international patient encounters, and is responsible for contributing $45 million to the regional economy. We are primarily focused on the Caribbean, Canadian and Middle Eastern markets, but we are also attempting to take the initial steps to look at additional markets, such as North Africa. MTT: Does PIM track patient data in terms of follow ups, outcomes, readmissions, etc.? LK: We do not track the data because although we are part of the hospital, we are not inside the hospital. The hospitals do track statistics and then send the information to organizations that can specifically code the data. In Pennsylvania, there is an agency called the Pennsylvania Healthcare Cost Containment Council that provides outcomes and data from a number of different service lines. There is another organization run out of Rush University in Chicago, Illinois, that many hospital-based international departments, including PIM, report data to. Visit National Center for Healthcare Leadership: http://www.nchl.org/. MTT: That is just on the international side? LK: Correct. This information specifically pertains to data regarding the number of patients, revenue, and DRG’s (why people come here). The outcomes are available in other formats. MTT: How do you market to international countries? LK: Our number one and most effective marketing tactic is word-of-mouth. We have quite a bit of referrals that have been generated by past patients and physicians. We also provide training and continuing medical education (CME) events overseas that gain a great deal of exposure for doctors. It is important to mention that this is no longer a primarily self-paid business, it is now increasingly paid by international insurance. MTT: How is your organization staffed? LK: Our board of managers consists of hospital leaders, and we start with a very high level of oversight from these facilities. Our staff is then broken down into patient care and patient accounts. I have people who strictly work on billing and receivables, and then others who schedule appointments and operate as patient advocates. MTT: How do you handle language barriers? LK: We have multilingual interpreters who are available to translate for patients. MTT: Do you notice a lot of competition between PIM and hospitals in Florida that are pushing to gain Caribbean and South American patients? LK: There are a growing number of competitors both domestically and globally. Our main competition is truly global now – and it has been for some time. The hospitals in London, Halifax, Toronto and South Korea are very active in promoting themselves to international patients. Everywhere I go, I run into a South Korean delegation. Of course, organizations need to be aware of what competitors are doing, but it is most important to make sure YOUR organization is providing the highest quality service and best outcomes to the patient. MTT: Taking into consideration the high cost of healthcare in the United States, are your price points competitive with others internationally? LK: We try to provide pricing that matches the level of skill and quality that a patient would receive in the American healthcare system. There are certain locations that we can never compete with on price, such as India or Thailand, and we don’t try to. That is not what American medicine is about. A lot of individuals are willing to spend the extra money, within reason, to match the value in quality. I will say that price is likely the number one reason why prospective patients decline treatment here, which is a common occurrence at any major facility in the United States. MTT: Do you think your model can be replicated in other areas? LK: I think our model is complex, but it can certainly be replicated. We have been successful thus far because we have organizations that are willing to collaborate with us – they see us as an opportunity to provide services at a lower cost through shared expenses. In geographic areas where there is already an established market leader, or perhaps one or two hospitals that are heavily invested in international medical travel, it might be more of a challenge to go into a collaborative organization approach with other institutions. MTT: Final thoughts? LK: I think it is important to reiterate the reason we are in this business, which is to help the patients. The number of patient lives that we are able to touch, and who touch us, is incredibly rewarding. Many patients seek long-term treatment in Philadelphia for life threatening diseases, and they really do become loyal ambassadors for the city.