Medical Tourism Assessing New Opportunities Healthcare Revenue-cycle Management - Dubai Tuesday - 9 th May 2006 Prof. Dr. Dr.h.c. Fried Oelschlegel Vice

Medical TourismMedical TourismAssessing New Opportunities

Healthcare Revenue-cycle Management - Dubai Tuesday - 9th May 2006

Prof. Dr. Dr.h.c. Fried Oelschlegel Vice President SGHGroup International Projects

F.F.O. Health Care Tourism 09.05.06

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Points Of Discussion

1. A look on the Market – Dubai Health Care City.

2. Medical Tourism.

3. Strategies to attract Foreign and Local Patients.

4. Conclusion and Recommendations.


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Speculating the Road for Health Care Services UAE

• Fast developing Country; attractive centre for international business & tourism

• Strategic Location at the Center of the Middle-East Region.

• Easy to handle procedures & regulations facilitation from the Government.

• Access to Low-Cost Labor Market.

• Center of Attraction for Regional and Foreign Investments.


4

Population ( Nationals )Statistics

0500

100015002000250030003500400045005000

1994 1998 2002 2006

UAE Populationin thousands


5

Population Classification

UAE NAtionals 19%

Other Arab andIranian 23%

South Asian50%

others (includesWesterners andEast Asians) 8%

19%

50%

23%

8%


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Dubai Health Care City


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8



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??? How many Hospitals more ???

50 Bed Safa Specialty Hospital

100 Bed Al Zara Specialty

120 Bed Welcare Ambulatory

250 Bed SGH Specialty

Al Zahra Medical Centre (Polyclinic)

17 Bed Emirates Hospital

20 Bed Cedars hospital

50Bed Neuro Spinal Hospital

Bumrungrad, Jebal Ali (Exact Location not known)

Hospitals

Clinics/ Small Hospitals


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Hospital Beds Future Expansion

0

1000

2000

3000

4000

5000

2006 2010 FuturePlans

Planned HospitalBeds 1.461

ApprovedHospital Beds 780

Private HospitalBeds 879

Public HospitalsBeds 1.717

+ 30%+ 30% +86%+86%


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Hospitals Beds Occupancy Rates(Average)

72%80%65% 64% 60% 58% 56% 54% 53% 52% 45% 37%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


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UAE Healthcare Providers Where to???

It is very obvious that the rate of developing new hospitals is uncoupled by an equal growth for the population figures in the U.A.E.

Creating a state of high supply of Medical Health Care Services, met by a low volume of national demands.

Consequences are inevitable: Scenario could be Price war between Hospitals. strong competition on a market for a limited amount of patients – patient acquisition !!! decreasing rates of Hospitals-Bed Occupancy. Low Profit Margins, if any. Negligible return on Investments. Unsatisfied Medical Team.

EMPTY HOSPITALSEMPTY HOSPITALS (GHOST HOSPITALS).


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How to change the future for these Hospitals???

MEDICAL TOURISM


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Medical Tourism

Definition:

The term refers to the increasing tendency among people from the UK, the USA and many other third world countries, where medical services are either very expensive or not available, to leave their countries in search for more affordable health options, often packaged with tourist attractions.

WHO defines it as:•Medical care•Sickness & well-being•Rehabilitation & recuperation


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Countries Promoting Medical Tourism

Example-South Africa specializes in medical safaris Visit the country for a safari, with a stopover for Plastic Surgery, a Nose Job, and a chance to see lions and elephants


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Medical Tourism

• Medical Tourism is growing rapidly and turning out to be an immense business opportunity for nations that are positioning themselves correctly.

• Last year ( 2005), just five countries in our global region – Thailand, Malaysia, Jordan, Singapore and India- pulled in over 1.3 million medical travelers and earned over $1billion (in treatment costs alone).

• Medical travel spends are growing at 20% plus year-on-year.

• Around the world, Hong Kong, Lithuania and South Africa are emerging as big medical/healthcare destinations. And a dozen other nations plan to make themselves attractive healthcare destinations.


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Medical Tourism

Medical Travelers Clusters

• The first is made up of the Americans

• The second major group - the British

• The third big group of medical travelers comes from the Middle East

Americans

British

Middle East

Others

• The last group of medical travelers is diversified.


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Medical Tourism

Why Medical Travelers Clusters seek Treatments Abroad ?

SOUTH ASIA , AFRICA, MIDDLE EAST• No advance care available e.g. Afghanistan , Nepal and Bangladesh etc.• Limited specialized care.

WEST• Long waiting list’s for standard performances – UK.• Insurance unaffordable leading to semi insured and uninsured population; very high prices – US.• Private hospitals very expensive .


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Tourist Arrivals Forecast

Tourist arrivals by receiving regions, 1950-2020

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

1950 1960 1970 1980 1990 2000 2010 2020

mil

lio

ns

South AsiaMiddle EastAfricaEast Asia/PacificAmericasEurope

Actual Forecasts

699 mn

1.006

1.561


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Medical Tourism - India

Medical tourism in India could become a multi-billion Medical tourism in India could become a multi-billion business by 2012. Investors predict that: "By 2012, if business by 2012. Investors predict that: "By 2012, if medical tourism were to reach 25 per cent of revenues of medical tourism were to reach 25 per cent of revenues of private up-market players, up to Rs 10,000 core will be private up-market players, up to Rs 10,000 core will be added to the revenues". added to the revenues".

The Indian government predicts that India's $17-billion-a-The Indian government predicts that India's $17-billion-a-year health-care industry could grow 13 per cent in each of year health-care industry could grow 13 per cent in each of the next six years, boosted by medical tourism, which the next six years, boosted by medical tourism, which industry watchers say is growing at 30 per cent annually. industry watchers say is growing at 30 per cent annually.


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Benefits of Medical Tourism ( 1 )

Tangible:• Source of additional national income through wealth

transfer from foreign countries .• Cost advantages in tariff over the developed countries.• Creating attractive working places• Improve information sharing.• Increase efficiency of patient care process, reducing /

cutting of waiting lists.• Strategic alliances with business partners within and

outside the country. • Technology and knowledge transfer.• Better logistics performances both in internal and

external.


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• Better utilization of Infrastructure and skilled manpower.

• Opportunity for development in infrastructure in Health, Tourism and Travel

• Connectivity & synergy effects with air, road, rail and information and communication industries.

• Clustering of medical Travelers – new business fields.• Health opportunities for foreign patients may lead to

better health care standards for Nationals.• Scope for Research and Development to offer

comprehensive medical solutions.


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Intangible:

• International acceptance and reputation for the country as a global healthcare provider

• Social and cross cultural experience• International customer relations• Global Marketing and Medical Trade relations• Brand image of nation as world class healthcare

destination – attractive investment place !!!• Patient satisfaction & Competitive advantage• Strategic Public - Private Partnerships


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Prerequisites for successful Medical Tourism

• Competitive pricing ( will be the most important bench-mark in future ! )

• High quality of services ( medical & non-medical ; JCIAHO certificated )

• Proximity to large international markets ( traffic infrastructure )

• High qualified medical & managerial staff ( the severe shortage of healthcare professionals )

• concerted and integrated promotion and marketing ( synergy effects between different business fields )

• Improvement of immigration procedures • Liberalize and coordinate advertisement of healthcare

facilities


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Medical Tourism

Supplier Industries

Cluster Foundations

Hospitals, Hotels, Restaurants, Airports, Local Transportation, Shopping Malls, etc

Medical Tourism ClusterMedical Tourism Cluster

Supplier Industries

Human Resources

Physical Infrastructure

Sustainable Environment

Promotion/ Image Framework

Policy/ Regulatory


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Medical Tourism Perceptions & Medical Tourism Perceptions & WorriesWorries

Negative Perceptions

Hygiene/Unsanitary

Pollution

Backward &Bureaucratic

Foreign Patient’s Point of View

Accreditation

No Uniformity

ISO, CRISIL, ICRA

WEST: JCIAHO

Medical Insurance

Inadequate Cover

Underdeveloped

Insurance Frauds

No Global Players

Overseas CompaniesRefuse

Reimbursements

Connectivity

No Flights!!

Bad Roads

Backward

Instability

Terrorism Prone

Communal Unrest


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- US delay in granting Visas

Consequences:• Number of Visas issued for medical reason plummeted

from 56.912 in 2001 to 14.403 in 2002.• Number of patients treated at Boston-area Hospitals

declined from 459 in 2001 to 163 in 2005.• Saudi Arabia shut down a program that brought patients

to the US, and is will sharply scale two similar programs.• Saudi patients are traveling to other countries for

treatment (e.g. Germany, Britain, and India).• US Medical Institutes are scrambling to open Hospitals in

the Middle East (e.g. Harvard Medical Center at Dubai).


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Strategies to attract foreign and local Patients

• Dubai is already seen as a major tourist destination, attracting tourists from around the globe. In 2003, nearly 5 million tourists visited Dubai.

• Dubai has a long term objective to attract 15 million visitors by 2010; their presence will create substantial demand for healthcare and new medical facilities.


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• A world-class hospitality infrastructure, already in place in Dubai, will lend support for smooth development of medical tourism.

• WTO forecasts the Medical Tourism market in Dubai to be close to one billion dollars by 2012.


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Maximising the Value Proposition.

Establishing a Facility Centre in a foreign Country.

Pairing up with a Service Provider to enhance your offering.

Launching an aggressive Marketing Campaign to capture the market.

Creating a seamless Single-Window Facility for a maximum patient experience.


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Maximising the Value Proposition ( 1 )

DEFINITION:

Ways a Business (Hospital) proposes to use its resources to deliver superior value to its customers (Patients).

POTENTIALassessment

IMPROVEMENTSImplementation

Value Proposition Maximization

Value Proposition Maximization Formula Value Proposition Maximization Formula Value Proposition Maximization Formula Value Proposition Maximization Formula

GOVERNMENT & INDUSTRY HAND-HOLDING: A MUST !!!

++


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Doctors & Paramedics

Expertise Recognized

Cost Advantage

Language Skills

Vibrant Industries

IT Strength

Management Skills

Pharmaceutical Industry

Tourism Potential

Service Industry Mindset

POTENTIALMedical Treatment & Education based on International Standards & Accreditation Industry Accreditation StandardsTarget-oriented Infrastructure Investment

More Medical Colleges for Medical professionals & Health Care ManagementActive Regulatory Bodies

Government soft loan to private investors in Health Care & Health Care EducationTax Holiday & Further Duty Roll Back Governmental Support for National Medical Associations & Scientific SocietiesGreater Industry & Govt. InteractionMedical Insurance Reforms Govt. is promoting UAE as a 1st class global Medical Tourism Destination

IMPROVEMENTS++


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High quality medical services to low costs - price difference

between low cost countries and the developed countries by

comparable performances & quality till 75 %


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Procedure

in $

US UK Burmungrad Bangkok

Max Healthcare

India

Raffles

Singapore

Angioplasty 30000 21000-27000

4000 - 5000 4000 - 5000 5000

Angiography 2500 - 3000

2000 1100 400 800

Hip replacement

19000 13000-16000

4300 6000 6600

Knee replacement

27000-

32000

16000-18000

6000 6000

Lasik 2250-2900

750 400


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Establishing a Facility Centre in a Foreign Country (1)

National Healthcare Group Singapore – UAE (Case Study)

The National Healthcare Group provides comprehensive primary to tertiary public healthcare services through a network of four Hospitals, one National Centre, nine Polyclinics, three Specialty Institutes and five Business Divisions.

NHG – Institutes:Alexandra Hospital,National University Hospital, Tan Tock Seng Hospital, Woodbridge Hospital, National Skin Centre,Johns Hopkins Singapore International Medical Centre.


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NHG – GULF:• Incorporated in 2004 at Dubai & Abu Dhabi.• NHG Gulf makes it easy for patients in the Gulf

Cooperation Council countries to access NHG Singapore's world-class healthcare services.

• Provide assistance with: • Information on the specialized care available in NHG Hospitals• Medical Referrals• Scheduling of Appointments• Direct Admission Arrangements• Billing and Financial Enquiries• Transportation & Accommodation in Singapore.

Establishing a Facility Centre in a Foreign Country (2)

National Healthcare Group

Singapore – UAE (Case Study)


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Pairing up with a Service Provider to enhance your offering (Case Study).

unich

The AirportClinic M opened at the Munich International Airport in November 2002, and is the realization of an

innovative "full service concept" for patients from Germany and abroad.

The Well-known medical specialists, state-of-the-art medical technology and a comfortable interior design guarantee the best individual medical care with the highest level of quality

available.

The AirportClinic M offers a comprehensive diagnostic and therapeutic concept for inpatient and outpatient care.


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Pairing up with a Service Provider to enhance your offering (Case Study).

The AirportClinic M offers:• Inpatient and outpatient treatment (as a general rule, with a stay lasting up to three nights).

• Ambulatory treatment in the AirportClinic M can be combined with a comfortable overnight stay at the linked first-class hotel.

• For every patient tailored service to meet the patient's needs, from the time they arrive in Munich until they return home.


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Launching an aggressive Marketing Campaign to capture the market. (1)

The Good Old 4P’s of the Marketing MixThe Good Old 4P’s of the Marketing Mix

Price

ProductPlace

Promotion


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PRICE

PRODUCT

PR

ICE

PR

OD

UC

T

Rule: Offering a better Service Standards, while making it available at a lower coast, than thepatients Homeland Service prices.Actions:

•Fixed Price Strategy.•Tax Treatments.•Customs Clearance.•Premium Mark-ups.

•Specialties in specific clinical areas.•Strong Medical Research.•State of Art Technology & Equipment.


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PLACE

PL

AC

E

PR

OM

OT

ION

PROMOTION

Rule: Offering Tailored Service Specialties, that cover deficiencies of Traveler’s Homeland Service, at an attractive tourism package.Actions:

• Research Other Countries Service needs.•Medical Breakthrough.•Service Providers Networking.•Visa facilitation.

•Referral Agencies.•Advertisement.•Internet Marketing.


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Creating a seamless Single-Window Facility for a maximum patient experience. (1)

Definition:The bringing together of Medical tourism services, or information about in order to reduce the time and effort patients must expend to find and obtain the service they need.

Purpose:• Improve accessibility through “SW Gateways”.• Improve convenience through “One Stop Shopping”.• Overcome Countries boundaries by providing “Seamless Services”.


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Single Window “Gateways”:Single Window “Gateways”:

• SWs should provide a “gateway” to Medical Tourism SWs should provide a “gateway” to Medical Tourism services through government information and referral services through government information and referral

services such as Call-centers, Internet sites, services such as Call-centers, Internet sites, and Information Bureaus.and Information Bureaus.

• Patients can get information before preparing to Patients can get information before preparing to travel for medical procedures.travel for medical procedures.


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“One-Stop Shopping”:

SWs should allow medical tourists toaccess many or all of the services delivered by the Medical Tourism

Providers, Governments, andRegulatory Bodies in one convenient

location (physical or electronic).

The continuing development of Medical Tourism services delivered through the internet offers new opportunities for that.



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“Seamless Service”:

• Sws should provide “Boundless Service” in a specific service sector (Medical Tourism), or for a specific client group (Foreign Traveler Patients).

• It should be delivered between Countries, Governments, Districts, and Departmental boundaries.

• So, it meets a service need that is spanned between countries and all facilities of treatment chain and refers organizations.



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CONCLUSION

• The supply of Health Care Services is growing very fast, Uncoupled by a parallel increase on the need side.

• Medical Tourism is the only possible way to increase the need for Health Care Services.

• Implementation of new evolving strategies is a must to be able to attract Foreign and Local Patients.

• Creative Thinking and Innovation is the only competitive edge that keeps you on the Leading Position.


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Shifting Responsibilities for Medical Tourism Development

Old ModelOld ModelOld ModelOld Model

• Government droves economic development through policy decisions and incentives

• Government droves economic development through policy decisions and incentives

New ModelNew ModelNew ModelNew Model

• Economic development is a Collaborative Process involving government at multiple levels, companies, teaching and research institutions, and Medical care institution.

• Health care Tourism will be considered as a National Challenge of Strategic Dimensions.

• Economic development is a Collaborative Process involving government at multiple levels, companies, teaching and research institutions, and Medical care institution.

• Health care Tourism will be considered as a National Challenge of Strategic Dimensions.

Recommendations


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“It is not the strongest of the

species that survives, not the most intelligent,

but the one most responsive to change.” Charles Darwin ( 1809 – 1882 )

Thank You;

END.

Documents

Medical Tourism Assessing New Opportunities Healthcare Revenue-cycle Management - Dubai Tuesday - 9 th May 2006 Prof. Dr. Dr.h.c. Fried Oelschlegel Vice