By Eleanor Hunt
Be it a nip-and-tuck, cardiac bypass, knee replacement or another procedure, people are traveling away from home to get the medical care they need and want. Foreign nationals cite advanced medical technology and sophisticated physician training as key reasons for hopping on a plane to the United States. Americans cite low-cost medical procedures and hospital stays, as well as Western-accredited facilities abroad, as major drivers for heading out of the contiguous states.
Generally the term, “medical tourism,” refers to people traveling from their home country to other destinations to take advantage of medical services. However, most patients aren’t vacationing in the normal sense or touring for recreation, so the term is somewhat misleading. Yet, it has taken hold in a relatively young, nascent industry.
Much variation exists regarding statistics and the market value of the medical tourism industry. According to the U.S. Centers for Disease Control and Prevention, nearly one million Americans go overseas for procedures every year. According to medical travel and health company Patients Beyond Borders, 600,000 to 800,000 foreign patients chose treatment in the United States in 2013.
Some insiders cast a wide net of $10 billion to $60 billion when estimating the value of the global medical tourism market. U.S marketing intelligence firm Transparency Market Research projects the industry to be worth $32.5 billion in 2019.
Nonetheless, the number of patients traveling from their home countries and communities for medical work and the amount of money they spend for those services appear to be growing. Consequently, around 80-plus countries now claim to be medical tourist destinations. A slew of hospital groups and companies are springing up to facilitate and guide patient choices. For example, Health City Cayman Islands, that region’s first tertiary care hospital, began operating in April 2014. The hospital has the benefit of the Caribbean’s beautiful landscape and coastline to entice international patients. Officials hope to create another economic stream in medical tourism for the Cayman Islands.
Established U.S. medical groups have remained at the forefront of international patient care for decades. One such group is Texas Medical Center in Houston, the world’s largest medical complex comprising of 21 widely acclaimed hospitals, along with public health organizations, research institutions, nursing programs, universities and several medical, pharmacy and dental schools. Thousands of international patients visit the center yearly for healthcare.
Texas Medical Center states, “The main reasons that patients come here are because of the great intellectual capital in terms of top doctors, research and development, and the best equipped hospitals. Many of the Texas Medical Center institutions are the premier institutions in their medical field, and the rankings constantly show that.”
One hurdle to overcome when seeking care away from home is lodging. Surrounding the Texas Medical Center is a variety of hotels, some of which offer special rates for medical travelers; shuttle service to and from the medical center complex, shopping and tourist attractions; and other amenities. The University of Texas MD Anderson Cancer Center owns a full-service hotel, Jesse H. Jones Rotary House International, which is dedicated to serving patients and families visiting the world-renown cancer center. Joe’s House, a nationwide online lodging resource for cancer patients and their families, has created lists of Houston-area lodging options specifically for MD Anderson patients and visitors. In addition, temporary housing rentals abound, and some apartments accommodate short-term leases. Along with lodging options, public transportation and taxis featuring wheelchair lifts make it easy to navigate the city.
Catering further to foreign visitors, 70-year-old MD Anderson hosts an International Patient Center with 22 full-time staff members. These employees assist with admissions, clinical care, transportation, lodging, visas, hotel amenities, cultural concerns, languages and dietary requirements. Eleven international patient assistants hail from the major regions that MD Anderson serves, including Mexico, Japan, China, the Middle East and Turkey. The hospital also maintains a separate in-house language assistance center with 40 staff members.
In 2013, MD Anderson received around 2,000 new international patients from 90 countries. The majority of medical travelers come from Saudi Arabia, followed by Mexico, United Arab Emirates, Qatar and Kuwait. International patients represent 6 percent of the hospital’s new patient registrations. Approximately 50 percent of medical travelers seeking services at MD Anderson pay for their healthcare out of pocket.
“International patients come here for the very best expert opinion,” says Martha Coleman, director of the International Patient Center. “Our sole focus is on cancer, and our specialists have spent their entire careers studying and becoming very educated on one facet of one disease. Being able to help someone at a time when they feel most vulnerable is such an honor, and we take it very seriously.”
Along with MD Anderson Cancer Center, other Texas Medical Center member institutions, including Memorial Hermann, Houston Methodist, Texas Children’s and Baylor St. Luke’s Medical Center, actively attract international patients by offering signature suites and multilingual interpreters. These facilities handle many of the details, so medical tourists have a smooth experience.
Less than two years ago, Christina deMoraes founded International Medical Tourism Chamber of Commerce (IMTCC) to provide training and protocols for the industry and a trustworthy source of information for patients and service providers. deMoraes garnered 14 years of experience advocating for international patients receiving cosmetic procedures and bariatric surgeries in Brazil. According to deMoraes, in lieu of cost-adding commissions paid by medical providers, IMTCC espouses fee-for-service patient advocacy and concierge support services.
“Patients need to have their own best interests represented, and it can only truly be done transparently, fairly and with accountability when hiring an advocate, contracted to navigate them through the process, rather than make a sale for the doctor or hospital,” she says.
To advocate, IMTCC operates medical concierge desks in Brazil and Uganda. “Our concierge desks help to eliminate the fragmentation of information exchange and lack of proper support services and aftercare delivery inherent in current medical travel experiences,” explains deMoraes, who was once a medical tourist in Brazil. “It is this fragmentation which is a direct cause of poor outcomes, hidden/undisclosed costs, patient abandonment issues, and many preventable complications that can erase the savings in medical travel and cause overall dissatisfaction with the medical tourism experience. The three tenets of the IMTCC are advocacy, aftercare and accountability, which are lacking in medical tourism and healthcare in general.”
Another company providing a business model aiding medical travelers is MedToGo International (MTGI) based in Phoenix, Ariz. Owned by U.S. physicians, MTGI operates a healthcare and travel referral service that matches medical expertise in Mexico and Costa Rica with patients needing timely, affordable healthcare. MTGI works with designated travel agencies, hotels, doctors, medical financing and complication insurers. Assigned to each patient is an English-speaking medical liaison who coordinates daily schedules and provides information.
“Our relationships and expertise have yielded us the best surgeons in the country, and that’s what we offer to patients,” says Robert Page, MTGI vice president of operations. “We’re there to make sure the doctor delivers a quality service because it’s to his advantage to treat our patients like gold. We have a very involved process for vetting doctors. It’s all about the patient being able to choose based on pricing, availability and trust.”
MTGI facilitates eight to 15 medical procedures monthly in Mexico or Costa Rica for an average stay of 10 days. The most popular are those not covered by insurance like cosmetic surgeries and dental work. A registered MTGI patient can receive surgical savings of up to 80 percent of what they would pay in the United States. In addition to a bundled packaged cost of medical services, lodging, travel, etc., MTGI charges a booking fee of $225.
“People are buying into the fact that we’ve successfully written and published three books on the subject, done extensive research, and recruited doctors with skills on par with their U.S. counterparts,” Page says.
Located in Cuenca, Find Health in Ecuador is a personalized medical tourism company that assists patients at every step of their medical procedure. Find Health in Ecuador searches out the best doctors who meet high American standards and forms relationships with them. The company receives a discount from doctors, hospitals, hotels, taxis, tour and language interpretation companies, so that its facilitation and referrals are free for medical tourists. Find Health in Ecuador serves roughly 300 U.S. medical tourists per year.
“For medical tourism patients, we are the middle man and simply triage, guide and assist them, so they have a fantastic medical tourism experience,” says Nicholas Barringer, operations manager for Find Health in Ecuador. Originally from Wisconsin and Minnesota, Barringer became involved in healthcare in Ecuador after hearing positive stories from expatriates who had received quality, low-cost care in Cuenca.
No doubt, people will continue to cross borders, states and regions in their quest for the best medical care they can afford. When they do, a growing number of hospital groups, facilitators and advocates will be there to assist them, making sure they don’t go the distance alone.
Baylor Business Review, Fall 2014