Reality check for outbound medical tourism

 

Much of what is written about medical tourism in the US and the UK makes the assumption that worldwide medical tourism depends almost entirely on Americans and Britons.

Figures from several countries over the past year have proved that this is not true, as the main sources of business are Continental Europe, Asia and the Middle East.

The number of Americans leaving the country is debatable. Despite major reports, there are no real figures around. Those desperate to sell their services to overseas hospitals and government bodies have a vested interest in using the largest figure possible. The once regularly used 250,000 has mostly been replaced by either 500,000 or 750,000. These are all conveniently big and nicely rounded up numbers. The higher figure came from Deloitte which last year suggested that by 2010 a massive six million Americans would go overseas.

The real truth is that these are wild guestimates with no statistical backing. No advocate of any version has ever cited a believable source. They have become medical tourism folk tales.

There is some evidence that the number of Americans going overseas is growing slowly, but particularly with US healthcare reform, the giddy heights of six million is now pure fantasy.

Deloitte’s report entitled Medical Tourism: Consumers in Search of Value also estimated that in 2008 over 400,000 people came into the US for medical treatment, and that numbers were growing.

A much faster growing trend, but as yet with no statistics, is domestic or internal medical tourism where Americans travel within the US for medical treatment.

For one, Healthplace America offers self-insured employers access to a specialty network of 31 US hospitals and clinics. It has signed contracts covering a total of 600,000 workers at companies since January 2008. Chief Executive Ken Erickson said he expects the contract total to hit US$1.3 million by the end of this month and 1,500 employees to use the network in 2009.

Erickson said Healthplace America’s network can offer self-insured savings of 30 to 50 percent over rates negotiated by traditional insurers because the company pays the providers up front in cash based on fixed per-case rates. Typically, insurers pay providers after the surgery has been done.

Other agencies now offer similar services, but individuals paying for their own treatment tend to deal direct with hospitals, which is why estimating numbers is so difficult.

Uninsured Americans are shopping around for surgery in the US in record numbers, and using new services such as Healthbase, one of several medical tourism agencies that are either offering the US as an option, or see so much potential in inbound that they have followed Healthplace America in ceasing to offer treatment overseas.

Meanwhile, Florida medical facilities actively, if quietly, market to attract overseas business. Many offer special services geared toward foreign customers with international services divisions that help patients with everything from applying for tourist visas to scheduling airline reservations and hotel stays. Miami Children’s Hospital, for example, has negotiated special hotel rates for its international patients and their families.

In Jacksonville, Mayo Clinic Florida draws between 1,400 to 1,500 international patients each year with very little marketing. Much of the international patient traffic results from relationships that Mayo cultivates with physicians around the globe. Last October, the Mayo Clinic opened an information office in a large medical office building in Guatemala, a country from which it receives a large number of patient referrals.

Baptist Health South Florida treats 12,000 foreigners each year, many from the Caribbean. The Laser Spine Institute in Tampa is aggressively marketing laser surgery, so now 70 percent of the facility’s customers come either from foreign countries or other US states, which would be 4,000 people in 2009.

American hospitals, clinics, tourist boards and cities are all starting to actively market their service to patients from overseas or other states at a much faster pace than Deloitte envisaged last year.

By the end of 2009, inbound and internal medical tourism in American could together outnumber outbound.

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