Health Travel Technologies, a technology and services platform for medical travel management, has signed an agreement with Mexicali Health Care to provide the technology infrastructure for managing its international patient operations. Mexicali Health Care was formed in response to the long-term trend of US patients particularly from California and Arizona crossing the border for dental and surgical care at significant savings over US prices. A recent study by the UCLA Center for Health Policy Research estimated that a million people from California alone seek medical, dental or prescription services in Mexico each year. Mexicali Health Care’s partnership with health Travel Technologies is designed to keep pace with that demand. Carlo Bonfante at Mexicali Health Care comments. Mexicali is very serious about becoming a major international healthcare provider. As a new business starting at ground zero, we need to work with a company that can guide us in building procedures for establishing a professional system for processing and managing patients. Working with Health Travel Technologies has helped us to get up and running with minimal up-front investment. Now we have the capability to grow our business and focus on health care delivery instead of the details of handling medical tourism. Herb Stephens at Health Travel Technologies says, Our core business is providing behind the scenes operational support for international health care providers. Our technology platform has been architected specifically to take the headache out of providing medical tourism services for large international hospitals, and our experience on the consumer end enables us to help newer entries into the medical travel field develop a brand and quickly begin generating requests for surgery quotes and patient flow. Health Travel Technologies supports the marketing, operations and brand objectives of medical tourism providers; our business model means our success is always aligned with our clients. Health Travel Technologies is a subsidiary of Health Travel Guides. A technology and services company, HTT operates and licenses a platform specifically developed to handle the many demands of health travel. Founded in 2006, and based in San Francisco and San Diego, California, it is a private company. The company’s systems currently process more than 1 million international travellers representing more than $500 million in financial transactions per year. Health Travel Technologies provides a centralized, automated system for managing medical tourism - not just booking procedures and travel, but also strategic marketing, web page hosting, quote management from multiple sources, as well as accounting, billing, collections, loan servicing and insurance offerings. Mexicali Health Care is a network of northern Mexico’s top physicians and two major hospitals, Hospital de la Mujer and Hospital Hispano Americano. Mexicali Health Care was formed specifically to provide Americans with quality, comprehensive medical and surgical care options at prices far below those in the US. Although Mexicali Health Care’s medical tourism programme is newly developed, their hospitals already treat 8000 medical travellers a year who cross the border on foot and by car from nearby US towns. Herb Stephens concludes, We are well beyond the point of asking, is this a safe, quality option? The superb level of health care in Mexico is indisputable. The question now is how can the growing volume of international patients be most effectively managed?

The Malaysia Tourism Promotion Board (MTPB, Tourism Malaysia) is embarking on a three-year project to collect market data on health tourism, as the country seeks to increase the number of people visiting the country for medical treatment. According to analysts Frost & Sullivan, healthcare expenditure in Malaysia is driven by increased privatization within the healthcare service provision. The market for healthcare services has also received a positive impetus from health tourism. According to Frost & Sullivan’s Dr. Pawel Suwinski, "Malaysia healthcare tourism grew at a rate of 25.3 percent a year since 1998, while revenues posted a growth of 37.9 percent during the same period. Revenue per patient has also grown 2.5 fold from $92 in 1998 to $241 in 2008. By 2010, medical tourism revenue per patient is estimated to reach $590. This signifies the growth of foreign confidence in more advanced medical care services in Malaysia. Most international patients come from neighboring countries with less developed medical infrastructure (mainly Indonesia), and other developed countries from the West. Malaysia is also a preferred destination for these international patients due to the higher foreign exchange rate in Singapore and unstable political scene in Thailand." In 2006, the bulk of foreign patients came from Indonesia (65-70 percent), followed by Japan (5-6 percent), Europe (5 percent) and India (3 percent). There are an increasing number of patients from Middle Eastern countries (particularly U.A.E., Qatar and Saudi Arabia). The Malaysian government has set up several referral gateways to assist medical tourists. One of them is the health tourism website www.malaysiahealthcare.com, that assists medical tourists globally. Private hospital groups and major private hospital providers have set up departments to deal with international patients. Gleneagles Intan Medical Centre and Pantai Hospitals are among those that have set up international customer departments specifically for the admission and support of international patients. KPJ Medical Group, Mahkota Hospital and Subang Jaya Medical Center have established tie-ups with several travel agencies and hotels to provide comprehensive tourism packages in conjunction with healthcare services, as well as setting up representative or referral offices. Healthcare in Malaysia is mainly dominated by private hospitals. 62 percent of the total hospitals in Malaysia are privately owned. The number of private hospitals increased dramatically from 50 in 1980 to an estimated of 223 private hospital last year. The government has built 10 public hospitals in the past 4 years to increase the number to 140. The Malaysian government is promoting medical tourism. It has extended the visa period for health tourists from one month to six months. Major hospitals in Malaysia are targeting new markets such as Vietnam and Cambodia. Africans are now coming to Malaysia because it is cheaper to do so rather than go to Europe where they used to go previously. Malaysian prime minister Najib Razak recently said. Medical tourism is a high priority to position Malaysia as a world-class healthcare services provider. The government will invest in education and technology. The key is to make sure Malaysia’s regulatory environment is ready to support investment.

HighRoads, a consultancy advising US companies on controlling their health care costs, recently undertook a medical travel survey to compare procedural ethics, quality and costs around the world. Initial results show that flat pricing, surgeon compensation and use of electronic medical records vary dramatically from hospital to hospital. The survey looked at 66 leading hospitals including 50 US hospitals and 11 outside the U.S. Healthcare organizations including BridgeHealth, Healthplace America, HIMA Health, Intermountain Healthcare and Scott & White, responded to requests for information based on their desire to introduce procedural cost and quality transparency and reduce health care costs. The survey was designed to provide Fortune 500 employers comparable ethical, quality and flat fee data to make the best choice for superior medical procedures for employees at the lowest possible cost. The HighRoads Medical Travel RFI included questions such as: * When patients come to your hospital/clinic for a surgical procedure, are such patients screened by impartial physicians, other than the physician who will perform the surgery?* If your hospital/clinic provides a flat price for eight major procedures including aortic valve replacement, total hip replacement, cholecystectomy, please provide your prices in US dollars, the average number of cases per month, mortality rates and infection rates. Some of the initial survey findings include: * Flat pricing varied up to $40,000 for the same services. Example flat prices for coronary artery bypass surgery ranged from $19,000 to $59,279, and for total hip replacement from $9,900 to $29,005.* 48% of responses indicated patient or plan sponsors would have to pay fees to third parties who have negotiated their flat fees.* 57% of respondents indicated they use electronic medical records. Tom Emerick, of Emerick Consulting, comments, I have been leveraging medical travel for the past 14 years to improve the quality of medical care, reduce the practice of unnecessary procedures in order to improve the health of US employees, while reducing health care costs. HighRoads’ application of its technology to provide a transparent database of worldwide ethics, quality and flat prices for medical procedures will accelerate the adoption of medical travel and can dramatically reduce health care costs for patients, insurers and employers. Michael Byers at HighRoads says, Employers need an efficient mechanism to compare the ethics, quality and cost of medical procedures at top healthcare centres. It is too complex and time consuming to attempt alone. This is why HighRoads has developed a technology platform that will automate this data collection and comparison so employers have increased choices when it comes to the safest and healthiest options for their employees. What the survey clearly illustrates that simplistic comparisons of US and overseas prices, are an out of date approach. While individual medical travellers may be persuaded by price comparisons, businesses look at a lot of other factors too; they will not just take an agency or hospital’s word; they want detailed price, service, quality, disease, and satisfaction comparisons.

Aitken Spence Hotels, one of Sri Lanka’s top hotel firms, has resumed talks with Six Senses Spas, an international spa chain, on building an up-market resort on the south-west coast. The firm, part of the Aitken Spence group, owns or manages nine hotels in Sri Lanka, five resorts in the Maldive Islands, five hotels in India and five hotels in Oman. Aitken Spence Hotels managing director Malin Hapugoda says the project is near Ahungalla, in Beruwala, a prime beach resort where it has two properties, Heritance and Neptune, Six Senses are keen to re-look at it and now we’re having talks to restart the project," The project had been mooted several years ago but shelved because of the island’s ethnic conflict. But the 30-year war ended in May when government forces defeated the Tamil Tigers and there has been an immediate revival in tourist arrivals, with economic growth also expected to pick up. Aitken Spence already has a tie-up with Six Senses that operates spas in the firm’s Heritance Kandalama hotel in the north-central region and at the Tea Factory, a hill-country hotel. The new project with Six Senses, originally billed as Evason Hideaway, Ahungalla, is for a combination of beach villas and several villas on stilts on a private island in the nearby backwaters of the Madhu Ganga river. Sixth Senses is an international spa manager and developer. Aitken Spence Hotels, one of the island’s top hotel firms, is aiming at exploiting opportunities thrown up by the fast growth of the market of health/wellness, where rates are higher. Neptune Hotel, a 500-roomed resort on the popular Beruwela beach on the south-west coast that is the oldest in the group’s chain, is being turned into a health resort. The hotel has been closed and will be re-opened in November 2010 after a complete refurbishment and conversion. Malin Hapugoda comments, Health tourism is one of the fastest growing segments in the tourist trade. We decided to make Neptune Hotel exclusively a yoga, meditation and ayurveda hotel. We are drawing up plans at the moment for its conversion. We already have our ayurveda section in the present property that is operational. We’ve made a good name for authentic ayurveda. We want to expand to yoga and meditation which is a growing market, especially in Europe." Rates at Neptune, when re-opened, will be "much, much higher" than what it would be able to derive if it remained in its present state, Hapugoda adds. This contrasts with recent price cuts across the country, as hotels struggle to regain visitors lost by the war and the recession. In Sri Lanka, the health tourism sector is growing in popularity, especially with Western tourists, who look to treatments, such as the ancient Ayurveda methods of herbal medicines and massage, as a way to recover from their fast paced life back home. To put the potential into perspective, Sri Lanka currently receives only 440,000 tourists a year, and a small proportion are health tourists. President Mahinda Rajapaksa wants more hotels and increased room capacity in order to attract 2.5 million tourists annually by the year 2016, with a focus on China. Most tourism investment is from overseas companies, with the Japanese, having already invested in two hospitals, sending a large investment delegation in November to assess potential.

The University of Pittsburgh Medical Center (UPMC) has acquired majority ownership of Dublin’s independent Beacon Hospital, a hospital in the network of at least one US medical tourism agency. It has taken a 66 per cent stake in return for a €68 million investment. This is €25 million for the original investors, €25 million capital expenditure on the facility and €18 million to provide it with working capital to run its operations. The hospital’s original backers were led by businessmen Michael Cullen, Paddy Shovlin, John Delaney and consultant Mark Redmond. They will remain as owners of 33 per cent of the hospital itself. The renamed UPMC Beacon Hospital is part of UPMC’s 20-hospital network. UPMC Beacon Hospital’s Joel Yuhas says, Our plans are for significant expansion of UPMC Beacon Hospital. A full-service hospital opened in 2006, it has seen rapid growth in patient admissions and surgical procedures since UPMC began managing the hospital more than a year ago. Its initial future investment plans include opening a cardiac/ chest pain unit, which is in the final stages of commissioning. It is also planning to add another 31 beds. UPMC Beacon Cancer Centre, one of more than 40 cancer centres operated by UPMC worldwide, offers patients advanced treatment options, including surgical intervention, chemotherapy and radiation oncology. UPMC became the operator of the cancer centre in 2007, followed by its management of the entire hospital in February 2008.  UPMC has acquired majority ownership of the hospital management company and the entity that owns the hospital property from Beacon Medical Group. UPMC Beacon Hospital and Cancer Centre are part of UPMC’s international division that includes the UPMC Whitfield Cancer Centre in Waterford and one of Europe’s leading transplant centers, ISMETT, in Palermo, Sicily, that attracts patients from all around the Mediterranean. UPMC recently announced an agreement to manage a planned health center in Cyprus and a partnership with GE Healthcare to develop cancer centres throughout Europe and the Middle East. UPMC has reached an agreement with officials in Guam to manage a hospital there, with plans for a 2012 opening. Currently, more than 300 residents of Guam leave the island every month for medical care because of a lack of health facilities there. Located in south Dublin, UPMC Beacon Hospital provides world-class acute care services, including heart surgery, neurosurgery, comprehensive cancer care, and emergency medicine services. The hospital, opened in October 2006, has 183 acute care beds, eight operating theatres, two endoscopy suites and 14 dedicated critical care beds. Many world-renowned healthcare providers, including UPMC, are seeking to invest many hundreds of millions of euro in the provision of more world-class healthcare facilities in Ireland. The demand for private healthcare is growing faster than new hospitals and clinics can be built.

The Health Travel Industry Research Society of Thailand (HTRIS), a non-profit, private sector initiative, has been established focusing on Thailand’s international health travel industry, with new Secretary-General Chatree Niramitvijit. HTRIS will help Thailand’s medical tourism industry; hold its lead in the regional market against challenging Asian nations including Singapore, Malaysia, India, Korea and the Philippines. It will compile reports with data from media, the market, international industry consultants, national industry leaders and government advisers. The new organisation will work with Thailand’s Ministry of Foreign Affairs, the Office of the Prime Minister, various government bodies, non-government organizations and representatives of the international medical travel industry. Chatree Niramitvijit says, The society’s role as industry watchdog and its goals of industry improvement and trade promotion meet an urgent need. The purpose is not only to analyze how the world market views the international service industries such as healthcare, travel, security, hospitality, wellness and tourism in Thailand, but also to ensure that the increasingly aggressive promotion from competing nations in the region do not overshadow Thailand’s primacy in the region as a favourite medical travel destination. Thailand is more popular among Western European medical tourists for cosmetic surgery. Singapore and India specialize in complex procedures with India having a cost advantage and Singapore a technology advantage. The Thai tourist industry earns US$ 15.4 million each year, 6 % of Thailand’s gross domestic product and employing 7 % of its workforce. Recent statistics released by the Tourism Authority of Thailand show that visitor arrivals went down 19% in Jan-March this year, by 3.2 million, compared to the same period last year. Thailand’s Prime Minister Abhisit Vejjajiva is highlighting medical tourism to revive Thailand’s tourism industry during his personal visits and road shows around the world. He highlights measures taken by his government including the waiving of all visa fees, the reduction of take-off and landing charges for airplanes, the lowering of entrance fees to national parks and the provision of travel insurance to foreign visitors. He is also promoting spas and health checks. HTRIS has launched a monthly publication to promote Thailand’s medical travel industry. Medica Tourism Magazine highlights the very best of Thailand’s medical, hospitality, tourism, travel and wellness industries,The full-colour, 120-page glossy magazine is distributed to more than 60 countries every month through embassies and consulates, chambers of commerce, trade promotion offices and tourism information centres throughout the world. In its Thailand Investment Review February-March 2009, the Board of Investment of Thailand (BOI) announced new government policies that directly and immediately assist the tourism industry including advertising campaigns as well as measures to reduce tourism-related fees and service costs. Medium-term plans include expansion of the tourism and service sectors by increasing the diversity of service businesses, adding value, enhancing competitiveness, and improving skilled labour in quality and language skills. The BOI adds, The country has tremendous potential to serve as a centre for medical tourism and the government is exploring how to maximize that potential. The government also plans to review all tourism-related laws to ensure that they are up to date and complementary.

The three leading Indian hospital groups have or plan deals that affect their medical tourism business in India and elsewhere. Fortis Healthcare is buying 10 hospitals including 2 under construction, from Wockhardt Hospitals for $187 million. The hospitals; 2 in Mumbai, 5 in Bangalore, and 3 in Kolkata, have a capacity of 1902 beds. The acquisition will give Fortis a stronger foothold in the health-care market. The purchase will help Wockhardt Hospitals to reduce their debt and expand. Wockhardt Hospitals won’t be able to operate hospitals in the three cities for three years, according to the sale agreement. The hospitals will transfer to Fortis in December. Wockhardt Hospitals plans to build hospitals in Madhya Pradesh and Uttar Pradesh after building in south Mumbai and Juhu in the same city. The two Mumbai hospitals are excluded from the no-competition agreement. Wockhardt Hospitals retains seven of its super specialty hospitals in the southern Indian city of Hyderabad and some other smaller cities in western India. Fortis has a network of 28 hospitals with a capacity of 3300 beds. That compares with Apollo’s 43 hospitals in India and overseas, with 7800 beds in India and over 2000 elsewhere, including a multi-speciality hospital in Bangladesh, and a just opened 220-bed multi-speciality hospital in Mauritius. Earlier this year, rival Fortis Healthcare bought a 120-hospital in Mauritius, which it will revamp into a 400-bed multi-speciality one. With the acquisition, when all open, Fortis will own or operate 38 hospitals with 5200 beds across India.Fortis aims to have 6000 beds across 40 hospitals by 2012. India’s largest hospital chain Apollo Hospitals plans to run about 15 hospitals in West Asia and North Africa and a heart hospital in Europe. It is in talks with a Dubai-based business conglomerate for setting up hospitals in West Asian and North African countries on a franchise basis and has offered to run a heart hospital in Europe on contract. We shall establish presence in select countries in west Asia and north Africa where Apollo, as the technical partner, shall be responsible for establishing and managing the hospitals, says Raghava Rao, vice-president for international projects. Each hospital will have 250 super-speciality and 100-150 secondary-care beds. Typically, corporate hospitals such as Apollo charge about 5% of the gross revenue of the franchisee hospital as commission for technical expertise and use of brand. In a separate deal, Apollo is in discussions for establishing a heart hospital in Europe where its role would be to assist in planning, establishing systems, protocols and management, exchange programmes and training of senior doctors. Last year, Apollo was engaged in unsuccessful talks to buy a hospital chain in the UK. Apollo also had a hospital in Sri Lanka but sold its stake in 2006. All three groups are positioning not only to serve the growing global medical tourism market, but also a growing Indian middle class that can afford to pay for quality healthcare, and a significant number of Indians who go outside their local area for medical treatment within India.

The Consumers’ Association of Ireland has published research about the difference in the cost of services between North and South. They claim many services carried out in Northern Ireland are between 25% and 45% cheaper than the same services in the Republic. The study was published in the Consumers’ Association of Ireland’s magazine Consumer Choice. Irish consumers in the Republic of Ireland are paying a third more for routine services than those in the UK’s Northern Ireland for dental treatment, doctors’ services, and chiropractic treatment. Worse still, prices are continuing to rise so the gap is widening. And for those living in Dublin, the gap is wider as the cost of services there is more than elsewhere in the country. A routine dental exam and polish costs €96 on average in Dublin but it can go as high as €140. In Belfast the cost is just €68. The Irish Dental Association (IDA) said the survey highlighted the high cost of doing business in the Republic. Dentists are not immune from the wider economy and the bottom line is that Ireland is a high-cost economy. That impacts on the prices dentists charge their patients," said IDA chief executive Fintan Hourihan. Other excuses regularly used by the IDA, as this is one of several surveys in recent years criticizing the high prices charged by Irish dentists, are that dentists in Northern Ireland or further afield use inferior materials, that treatment overseas is often bodged, and that overseas dentists work too quickly. However, Dermott Jewell of the Consumers Association of Ireland, says he has received no complaints. He adds that dentists have been saying the same thing about price for years. "In the background technicians have been saying that the price for the materials they produce has no resemblance to the end cost for consumers. Jewell accepts that expensive equipment has to be purchased, but maintains that the gap in price is huge, ’The reality is that a significant amount of money can be saved if you are willing to travel for treatment". According to a reader poll by health website Irish Health, after the Consumer Association survey was published, one-fifth of Irish people have gone abroad to get cheaper dental treatment, and a further 58% say they would consider going outside of Ireland to get cheaper dental care. 14% said they were unsure while 8% said they would definitely not go abroad for dental care. A total of 541 adults took part in the poll. Poland is one of the more popular destinations for Irish people considering dental treatment abroad, particularly dental implants, along with Hungary and the Czech Republic. Dental treatment in Poland costs up to 70% less there when compared to Ireland. Dental implants in Poland cost between €1,070 and €1,615. In Ireland, they cost between €2,690 and €3,365. That represents a saving of up to 60%. Although these figures refer to the procedures only, even after adding in flights, accommodation and any follow-up appointments, savings are considerable. Ireland is well served with cheap flights to many European cities.

South Korea has seen a growing number of foreigners visiting the country for medical treatment in the first half of 2009 due to the weak Korean won and eased regulations. Local hospitals have raised medical services fees for foreign patients, as they had to spend more on marketing and translation services. According to the Bank of Korea (BOK), foreigners’ payment for medical services were $40.5 million in the first half, up 31.1 percent from $30.9 million recorded during the same period last year. The first-half payment by medical tourists stood at $23.9 million in 2006 and $31.5 million in 2007. By month, the figures came to $7.2 million in January, $6.9 million in February, $7.4 million in March, $7.3 million in April, $6.2 million in May and $5.5 million in June. According to the Ministry for Health, Welfare and Family Affairs, the number of foreign patients receiving treatment at 21 major hospitals and medical institutes reached 9075 between January and April, up 32.1 percent from the same period last year. By region, the number of patients from the Middle East posted the highest growth rate of 167.9 percent, followed by Russia with 96 percent and Japan with 82.6 percent. In an absolute number, the US was the highest at 3043.By subject; obstetrics and gynaecology attracted 559 foreign tourists. Medical tourism is also outbound as Koreans’ spending on medical services abroad reached $43.3 million for the first six months, down 39.9 percent from the same period last year. The drop was due to rising overseas treatment costs caused by the weak won and falling income. The government has begun piloting information centres on skincare, beauty treatment and health check-up packages, to provide a one-stop service for medical tourists coming into Incheon International Airport. There are plans to build an air city at Seoul’s Incheon International Airport. The complex will include a clinic designed for medical tourists. It will provide commonly sought treatments and services that don’t require long hospitalization, such as lasik operations, Asian herbal medicine and eyelid surgery. The facilities and the airport terminal will be connected by a new magnetic levitation train system. The air city project is scheduled for completion in 2020.Incheon International, one of the world’s largest airports, has a huge amount of spare land, about the size of Manhattan. Korea is now looking beyond Asia and into untapped markets such as Europe. Korea Tourism Organization (KTO) recently hosted a seminar in London to introduce a package, together with Hanatour, Hanyang University Hospital, Wooridul Hospital and Hanshin Medipia. The package offers a seven-day program to experience the medical service through receiving health checkups to be followed by a tour around the metropolitan and Jeju regions. The KTO has prepared 14 other such packages targeting Japan, China, USA and Russia. A manual has been produced by KTO with help from medical consulting firm Medi Members and Cheongshim International Medical Center to provide basic guidelines for medical-related businesses seeking to offer medical tourism. KTO has established an English service on their website and plans to add the additional languages of Japanese, Chinese and Russian.