Travelmarketreport.com – A new study predicts that much of the growth in medical travel will be focused in three niches – dental, cosmetic and fertility services. The 2012 Medical Tourism Facts and Figures study, released recently by the International Medical Travel Journal (IMTJ), also predicts that medical tourism’s growth will be primarily in regional and domestic travel – and paid for by customers themselves, rather than health insurers. Capitalizing on that growth will require “different marketing strategies for the various customer sectors and segments,” said study author Ian Youngman. The study, an updated and expanded revision to IMTJ’s 2010 compendium, puts previous forecasts about medical tourism into the context of today’s reality. “Medical tourism has settled in certain patterns and is going in new directions,” the report states. New directions Most medical travel is to regional destinations – US to Mexico, for example – or domestic destinations, according to the study. And most patients from well-off countries travel for cosmetic, dental and fertility treatment. The study also found that medical travelers are not necessarily seeking the least-expensive destinations: the top three European destinations are the region’s most expensive. Also, the US sees as many inbound medical travelers as outbound, according to the IMTJ findings. Another segment of medical tourism comprises well-off patients from countries with inadequate medical facilities who travel for surgeries. Within this sector, the biggest growth markets are China, Russia and the Arabian Gulf, which has well-off residents seeking “value for money but top of the range care,” according to the study. Will health insurers pay? The study forecasts that medical travel will remain “a self-pay industry” – because health insurers are not interested, Youngman writes. For health insurers, “the downsides seem too many,” he stated. Because of their buying power, health insurers “are paying between a third and a half of the retail price for healthcare in the U.S. and Europe, so they cannot make the huge savings claimed by some,” he said. “Also, they work with global networks of hospitals, so they do not need the help of small intermediaries.” Youngman cited a February article in U.S. News quoting Paul Keckley, executive director of the Deloitte Center for Healthcare Solutions, who said that US healthcare inflation had been running at just 4 percent for the past two years, so employers are under less pressure to cut those costs. While savings remain a top priority, Keckley said, “Medical tourism doesn’t show up as a top-tier issue.” That’s a significant statement because Deloitte, in its much-cited 2008/2009 Medical Tourism studies, forecast that US health insurers would drive 35 percent annual growth in outbound medical tourism and that 1.6 million Americans would travel for medical services in 2012.