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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
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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.
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Population ( Nationals )Statistics
0500
100015002000250030003500400045005000
1994 1998 2002 2006
UAE Populationin thousands
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Population Classification
UAE NAtionals 19%
Other Arab andIranian 23%
South Asian50%
others (includesWesterners andEast Asians) 8%
19%
50%
23%
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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Benefits of Medical Tourism ( 2 )
• 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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Benefits of Medical Tourism ( 3 )
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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Strategies to attract foreign and local Patients
• 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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Strategies to attract foreign and local Patients
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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Maximising the Value Proposition ( 2 )
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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Maximising the Value Proposition ( 3 )
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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Maximising the Value Proposition ( 4 )
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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Launching an aggressive Marketing Campaign to capture the market. (2)
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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Launching an aggressive Marketing Campaign to capture the market. (3)
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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Creating a seamless Single-Window Facility for a maximum patient experience. (2)
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.
Creating a seamless Single-Window Facility for a maximum patient experience. (3)
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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.
Creating a seamless Single-Window Facility for a maximum patient experience. (4)
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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.
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