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How to Attract American Medical
Tourists to Colombia:
Some Strategic Recommendations
Dr. David G. Vequist IV
Founder/Director
Center for Medical Tourism Research (CMTR)
University of the Incarnate Word (UIW)
San Antonio, Texas, USA
Agenda
 Describe the CMTR
 The Healthcare Situation in the U.S.
 Some Findings from Our Research
 Analysis of the Trends
 How Colombia Can Benefit from
  Medical Tourism
     ROI defined
   Recommendations
About Us
   Center for Medical Tourism Research
    ◦ First and leading academic-based
      research center in this industry
     (Medical & Retirement Tourism/Travel)
    ◦ Non-profit
    ◦ Focused on the truth
    ◦ Motivated to spread the word and
      influence key stakeholders
    ◦ Key members have years of healthcare
      and international business experience
Model for Understanding the
Drivers of Medical Tourism


  Globalization      Technology
           Medical Tourism




         Consumerism
The Healthcare Situation in the
U.S.

                   OECD Data




CBO Data
U.S. Healthcare Resources




  OECD Data
Aging Population

                    Census Data




    Stanford Data
Aging Population: Worldwide




          Stanford Data
Aging Population: Healthcare


                  AHA Data




       AHA Data
How Healthcare Reform
(PPACA) Affects Medical
Tourism- more
 The increase of the number of insured, the removal
  of lifetime/annual caps, the reduction of the pre-
  existing conditions, and patients increasing paying
  with government „low margin‟ programs will result
  in greater patient volumes at U.S. facilities and
  lower profits.
 Currently, the U.S. overall healthcare capacity (due
  to increased volumes, lack of human capital, and
  increased utilization by an aging population) will
  not be able to handle the increased load (this is the
  surprisingly under-researched and under-debated
  issue in the reform debate) thus resulting in longer
  wait times, reduced quality, „rationing‟ of care, and
  ultimately the increased need to „outsource‟ extra
How Healthcare Reform
(PPACA) Affects Medical Tourism
 Many of the procedures currently very common in
  medical tourism will not be significantly affected by
  health care reform (such as dental, cosmetic, and
  alternative therapies) and some surgeries (such as
  ortho, oncology, cardio, and neuro) may be
  affected by extended wait times.
 In addition (and probably most importantly),
  employers will still be faced with increasing
  healthcare costs, additional pressures on lowering
  premiums, and required to cover more employees.
  This is the least served of the stakeholders in the
  U.S. and therefore one of the most important for
  medical tourism providers.
Healthcare Outsourcing
Market
Benefits from Healthcare
   Trade




Source: Mattoo and Rathindran (2006)- Health Affairs
Summary of Healthcare Situation
in the U.S.
 Not enough future capacity
 Not enough call for changes
 Not enough „political will‟ to change
  the system

Is outsourcing of capacity going to be a
necessity for the U.S. healthcare
system?
Medical Tourism Growth
   According to Frost & Sullivan (2010):
    ◦ The medical tourism industry is currently a
      $78.5bn industry [end-2010], catering to over
      three million patients who travel around the globe
      for medical care.
    ◦ The sector is growing at a whopping 20-30%
      annually and is bound to continue its growth
      pattern in the years to come.
    ◦ It is expected to be a $100bn industry by 2012.
 JCI Accreditation (300+ facilities)
 Growing without traditional advertising
  (35% CAGR)- Deloitte
Evidence of Medical Tourism
 Gallup reports that 4% of Europeans received
  medical treatment in another EU Member State
  over the past 12 months
 UCLA forecasted that just under 500k Californians
  traveled to Mexico for health services
 Dept. of Commerce reports that over 200k traveled
  to international destinations for health services
 Based on a survey of 1,800 Americans- the CMTR
  forecasts that, in 2009, perhaps1 million citizens
  went abroad for health services
 Texas Medical Center receives over 18,000
  international patients in 2009
Medical Tourism:
Continuum of Health Services
POTENTIAL AMERICAN
MEDICAL TOURISTS
    N = 2,000+
Potential Medical Tourist‟s Views
of Medical Tourism: Procedures




                              Source:
                              CMTR,
                               2010
Why Travel? Value, of course!


 Mapping
the Market
for Medical
  Travel-
 McKinsey
    2008
Don‟t Forget Cost!
Potential Medical Tourist: Reasons
What Do Medical Tourism Patients
  Want? (Deloitte, 2008) (1)
What Do Medical Tourism Patients
  Want? (Deloitte, 2008) (2)
What Do Medical Tourism Patients
  Want? (Deloitte, 2008) (3)
Consumerism
 Information more readily available
 Driven by the internet
    ◦ Yelp/Angie‟s List models springing up
      everywhere in healthcare
 Employers/Governments are seeing
  some of the benefits of free market
  economics in healthcare (retail
  clinics?)
 Porter‟s Five Factors Lesson-
    ◦ Consumer Choice can bend the price
Potential Medical Tourists:
Research
   Internet was #1 by a wide margin



                                       Source:
                                       CMTR,
                                        2010
Social Media Usage
   60% of e-patients, or one-third of
    adults, access social media related to
    health.
    ◦ In sum, 60% of e-patients, or 37% of U.S.
      adults, have done at least one of these
      eleven social media activities related to
      health and health care.
      As health economist Jane Sarasohn-Kahn
       writes, health-related social technologies
       capture “the exchange of health information
       and personal stories in a way that transcends
       both medical textbooks and chatting with a Source:
       friend on the phone – yet offers some of thePew,
       benefits of both.”                          2009
On-line Health Tools



                       Source:
                        Pew,
                        2008
Potential Medical Tourists:
How to Arrange



                              Source:
                              CMTR,
                               2010
EMPLOYEE BENEFIT
DECISION MAKERS
    N = 42
Type of Employer‟s Insurance
Employer‟s Views: Employees
Abroad
Employer‟s Views: Comfort
Employer‟s Views:
Perceptions
Employer‟s Views: Tourism?
Employer‟s Views:
Procedures
Employer‟s Views: Reasons
Employer‟s Views: Timing
Employer‟s Views: Arrange
Possible Trendlines in American
Medical Tourism
COLOMBIA AND THE
MEDICAL TOURISM
CONTINUUM
Colombia‟s Strengths &
Weaknesses
Strengths
 Close proximity to a $2.5 trillion USD market
 Increasing perception in U.S. of quality
 Low cost infrastructure (personnel, legal, etc.)
 Positive cosmetic surgery perception (Mrs.
  Universe & Super Models)
Weaknesses
 Infrastructure issues and perceptions of these
  issues (violence, poverty, disease, views on
  business, etc.)
 Waiting for the Government to act
 Difficulties in coordinating stakeholders
Offer a Continuum of Services
Medical Tourism Country
         Investments (Potential)
                 Investments in High Tech and
Higher   Commercial Research (e.g., Pharma, Energy, etc.)     Higher         Higher

         Investments in HC & Medical/Retirement Tourism
             Investments in Technology Manufacturing/
             High-end Consumer/Commercial Products
                                                            Intensity of
                Investments in Service Outsourcing              the         Intensity of
                                                                           the Current
ROI                                                         Regulatory
                                                                           Competitive
                        Investments in Basic                 Changes       Environment
                                                             Required
                          Tourism Activities

                      Investments in Low-end
                       Consumer/Commercial
                             Products
Lower                                                         Lower            Lower

                    Estimates based on the CMTR
Colombia: ROI and
    Investments
   ROI described:
    ◦ Job growth (great jobs too!)
    ◦ Brings opportunities for new direct (and indirect)
      revenue streams
    ◦ Fills a community need


   Ask yourselves, based on the economic and
    environmental factors-
    “Will there be a time in the next 20-30 years
    when great healthcare will not be in demand?”
My Humble
Recommendations
   Government-
    ◦ Create a good business environment!
      Tax incentives, tax holidays, prioritize infrastructure and
       regulatory improvements
   Private Industry-
    ◦ Prioritize investments in this area and invest!
      Healthcare facilities and particularly retirement tourism-
       aligned developments
      And, new technologies/procedures/treatments in
       healthcare
   Education-
    ◦ Get involved (and private industry- get them
      involved!)
Finally!
   Carpe Diem
    ◦ Don‟t wait for the U.S. stakeholders
      Physicians
      Hospitals
      Government
    ◦ Don‟t wait for the Colombian Government
    ◦ Research, decide, and invest!

    ◦ And don‟t forget the „Gray Gold‟ trend!
Good News!
   The CMTR and Stackpole & Associates are
    working with ProExport Colombia to
    conduct specific research on possible
    medical tourism from the U.S. so as to
    develop specific strategies for Colombian
    facilities
    ◦ In some previous work for the country of Korea,
      the CMTR helped to develop strategies that
      increased American medical tourism by 52% and
      led to a total of $23 million in medical tourism
      revenues
Don‟t Believe Me?
IFC is:
• the private sector arm of the World Bank
• invests in private sector projects in developing countries
• world‟s largest multilateral investor in the private health sector
Questions
   Thank you!

Contact me at vequist@uiwtx.edu

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2. contexto del turismo de salud en estados unidos y resultados preliminares del estudio de mercado

  • 1. How to Attract American Medical Tourists to Colombia: Some Strategic Recommendations Dr. David G. Vequist IV Founder/Director Center for Medical Tourism Research (CMTR) University of the Incarnate Word (UIW) San Antonio, Texas, USA
  • 2. Agenda  Describe the CMTR  The Healthcare Situation in the U.S.  Some Findings from Our Research  Analysis of the Trends  How Colombia Can Benefit from Medical Tourism  ROI defined  Recommendations
  • 3. About Us  Center for Medical Tourism Research ◦ First and leading academic-based research center in this industry (Medical & Retirement Tourism/Travel) ◦ Non-profit ◦ Focused on the truth ◦ Motivated to spread the word and influence key stakeholders ◦ Key members have years of healthcare and international business experience
  • 4. Model for Understanding the Drivers of Medical Tourism Globalization Technology Medical Tourism Consumerism
  • 5. The Healthcare Situation in the U.S. OECD Data CBO Data
  • 7. Aging Population Census Data Stanford Data
  • 9. Aging Population: Healthcare AHA Data AHA Data
  • 10. How Healthcare Reform (PPACA) Affects Medical Tourism- more  The increase of the number of insured, the removal of lifetime/annual caps, the reduction of the pre- existing conditions, and patients increasing paying with government „low margin‟ programs will result in greater patient volumes at U.S. facilities and lower profits.  Currently, the U.S. overall healthcare capacity (due to increased volumes, lack of human capital, and increased utilization by an aging population) will not be able to handle the increased load (this is the surprisingly under-researched and under-debated issue in the reform debate) thus resulting in longer wait times, reduced quality, „rationing‟ of care, and ultimately the increased need to „outsource‟ extra
  • 11. How Healthcare Reform (PPACA) Affects Medical Tourism  Many of the procedures currently very common in medical tourism will not be significantly affected by health care reform (such as dental, cosmetic, and alternative therapies) and some surgeries (such as ortho, oncology, cardio, and neuro) may be affected by extended wait times.  In addition (and probably most importantly), employers will still be faced with increasing healthcare costs, additional pressures on lowering premiums, and required to cover more employees. This is the least served of the stakeholders in the U.S. and therefore one of the most important for medical tourism providers.
  • 13. Benefits from Healthcare Trade Source: Mattoo and Rathindran (2006)- Health Affairs
  • 14. Summary of Healthcare Situation in the U.S.  Not enough future capacity  Not enough call for changes  Not enough „political will‟ to change the system Is outsourcing of capacity going to be a necessity for the U.S. healthcare system?
  • 15. Medical Tourism Growth  According to Frost & Sullivan (2010): ◦ The medical tourism industry is currently a $78.5bn industry [end-2010], catering to over three million patients who travel around the globe for medical care. ◦ The sector is growing at a whopping 20-30% annually and is bound to continue its growth pattern in the years to come. ◦ It is expected to be a $100bn industry by 2012.  JCI Accreditation (300+ facilities)  Growing without traditional advertising (35% CAGR)- Deloitte
  • 16. Evidence of Medical Tourism  Gallup reports that 4% of Europeans received medical treatment in another EU Member State over the past 12 months  UCLA forecasted that just under 500k Californians traveled to Mexico for health services  Dept. of Commerce reports that over 200k traveled to international destinations for health services  Based on a survey of 1,800 Americans- the CMTR forecasts that, in 2009, perhaps1 million citizens went abroad for health services  Texas Medical Center receives over 18,000 international patients in 2009
  • 17. Medical Tourism: Continuum of Health Services
  • 19. Potential Medical Tourist‟s Views of Medical Tourism: Procedures Source: CMTR, 2010
  • 20. Why Travel? Value, of course! Mapping the Market for Medical Travel- McKinsey 2008
  • 21. Don‟t Forget Cost! Potential Medical Tourist: Reasons
  • 22. What Do Medical Tourism Patients Want? (Deloitte, 2008) (1)
  • 23. What Do Medical Tourism Patients Want? (Deloitte, 2008) (2)
  • 24. What Do Medical Tourism Patients Want? (Deloitte, 2008) (3)
  • 25. Consumerism  Information more readily available  Driven by the internet ◦ Yelp/Angie‟s List models springing up everywhere in healthcare  Employers/Governments are seeing some of the benefits of free market economics in healthcare (retail clinics?)  Porter‟s Five Factors Lesson- ◦ Consumer Choice can bend the price
  • 26. Potential Medical Tourists: Research  Internet was #1 by a wide margin Source: CMTR, 2010
  • 27. Social Media Usage  60% of e-patients, or one-third of adults, access social media related to health. ◦ In sum, 60% of e-patients, or 37% of U.S. adults, have done at least one of these eleven social media activities related to health and health care.  As health economist Jane Sarasohn-Kahn writes, health-related social technologies capture “the exchange of health information and personal stories in a way that transcends both medical textbooks and chatting with a Source: friend on the phone – yet offers some of thePew, benefits of both.” 2009
  • 28. On-line Health Tools Source: Pew, 2008
  • 29. Potential Medical Tourists: How to Arrange Source: CMTR, 2010
  • 31. Type of Employer‟s Insurance
  • 40. Possible Trendlines in American Medical Tourism
  • 41. COLOMBIA AND THE MEDICAL TOURISM CONTINUUM
  • 42. Colombia‟s Strengths & Weaknesses Strengths  Close proximity to a $2.5 trillion USD market  Increasing perception in U.S. of quality  Low cost infrastructure (personnel, legal, etc.)  Positive cosmetic surgery perception (Mrs. Universe & Super Models) Weaknesses  Infrastructure issues and perceptions of these issues (violence, poverty, disease, views on business, etc.)  Waiting for the Government to act  Difficulties in coordinating stakeholders
  • 43. Offer a Continuum of Services
  • 44. Medical Tourism Country Investments (Potential) Investments in High Tech and Higher Commercial Research (e.g., Pharma, Energy, etc.) Higher Higher Investments in HC & Medical/Retirement Tourism Investments in Technology Manufacturing/ High-end Consumer/Commercial Products Intensity of Investments in Service Outsourcing the Intensity of the Current ROI Regulatory Competitive Investments in Basic Changes Environment Required Tourism Activities Investments in Low-end Consumer/Commercial Products Lower Lower Lower Estimates based on the CMTR
  • 45. Colombia: ROI and Investments  ROI described: ◦ Job growth (great jobs too!) ◦ Brings opportunities for new direct (and indirect) revenue streams ◦ Fills a community need  Ask yourselves, based on the economic and environmental factors- “Will there be a time in the next 20-30 years when great healthcare will not be in demand?”
  • 46. My Humble Recommendations  Government- ◦ Create a good business environment!  Tax incentives, tax holidays, prioritize infrastructure and regulatory improvements  Private Industry- ◦ Prioritize investments in this area and invest!  Healthcare facilities and particularly retirement tourism- aligned developments  And, new technologies/procedures/treatments in healthcare  Education- ◦ Get involved (and private industry- get them involved!)
  • 47. Finally!  Carpe Diem ◦ Don‟t wait for the U.S. stakeholders  Physicians  Hospitals  Government ◦ Don‟t wait for the Colombian Government ◦ Research, decide, and invest! ◦ And don‟t forget the „Gray Gold‟ trend!
  • 48. Good News!  The CMTR and Stackpole & Associates are working with ProExport Colombia to conduct specific research on possible medical tourism from the U.S. so as to develop specific strategies for Colombian facilities ◦ In some previous work for the country of Korea, the CMTR helped to develop strategies that increased American medical tourism by 52% and led to a total of $23 million in medical tourism revenues
  • 49. Don‟t Believe Me? IFC is: • the private sector arm of the World Bank • invests in private sector projects in developing countries • world‟s largest multilateral investor in the private health sector
  • 50. Questions  Thank you! Contact me at vequist@uiwtx.edu