Tuesday - 9th May 2006
Healthcare Revenue-cycle Management - Dubai
Medical Tourism
Assessing New Opportunities
Prof. Dr. Dr.h.c. Fried Oelschlegel
Vice President SGHGroup
International Projects
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 MiddleEast 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
5000
4500
4000
3500
3000
2500
2000
1500
1000
500
0
UAE Population
in thousands
1994
1998
2002
2006
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Population Classification
UAE NAtionals
19%
8%
50%
Other Arab and
Iranian 23%
19%
23%
South Asian
50%
others (includes
Westerners and
East Asians) 8%
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Dubai Health Care City
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Dubai Health Care City
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Dubai Health Care City
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Dubai Health Care City
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??? How many Hospitals more ???
Al Zahra Medical
Centre (Polyclinic)
17 Bed
Emirates
Hospital
50 Bed Safa
Specialty Hospital
50Bed Neuro
Spinal Hospital
Bumrungrad,
Jebal Ali (Exact
Location not known)
100 Bed Al Zara
Specialty
Hospitals
120 Bed
Welcare
Ambulatory
20 Bed Cedars
hospital
250 Bed SGH
Specialty
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Clinics/ Small
Hospitals
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Hospital Beds Future Expansion
5000
4000
Planned Hospital
Beds 1.461
Approved
Hospital Beds 780
Private Hospital
Beds 879
Public Hospitals
Beds 1.717
3000
2000
1000
0
2006
2010
+ 30%
Future
Plans +86%
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Hospitals Beds Occupancy Rates
(Average)
90%
80%
70%
60%
50%
40%
80%
30%
72%
65%
64%
60%
58%
56%
54%
53%
52%
20%
45%
37%
10%
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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 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-onyear.
• 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
Americans
British
Middle East
Others
• The third big group of
medical travelers comes
from the Middle East
• 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
1,800
Actual
Forecasts
1,600
1,400
millions
1,200
1,000
800
600
South Asia
Middle East
Africa
East Asia/Pacific
Americas
Europe
1.561
1.006
699 mn
400
200
0
1950
1960
1970
1980
1990
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2000
2010
2020
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Medical Tourism - India
Medical tourism in India could become a multi-billion
business by 2012. Investors predict that: "By 2012, if
medical tourism were to reach 25 per cent of revenues of
private up-market players, up to Rs 10,000 core will be
added to the revenues".
The Indian government predicts that India's $17-billion-ayear health-care industry could grow 13 per cent in each of
the next six years, boosted by medical tourism, which
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 Cluster
Medical Tourism
Supplier Industries
Hospitals, Hotels, Restaurants, Airports,
Local Transportation, Shopping Malls, etc
Cluster Foundations
Human
Resources
Physical
Infrastructure
Promotion/
Image
Policy/
Sustainable
Regulatory
Framework Environment
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Medical Tourism Perceptions &
Worries
Foreign Patient’s Point of View
Negative Perceptions
Hygiene/Unsanitary
Medical Insurance
Instability
Pollution
Inadequate Cover
Terrorism Prone
Backward &
Bureaucratic
Underdeveloped
Communal Unrest
Insurance Frauds
Connectivity
Accreditation
No Global Players
No Uniformity
No Flights!!
Overseas Companies
Refuse
Reimbursements
ISO, CRISIL, ICRA
WEST: JCIAHO
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Bad Roads
Backward
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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 SingleWindow 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).
Value Proposition Maximization Formula
POTENTIAL
assessment
+
IMPROVEMENTS
Implementation
Value Proposition
Maximization
GOVERNMENT & INDUSTRY HAND-HOLDING: A MUST !!!
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Maximising the Value Proposition ( 2 )
POTENTIAL
+
Doctors & Paramedics
Expertise Recognized
Cost Advantage
Language Skills
Vibrant Industries
IT Strength
Management Skills
Pharmaceutical Industry
Tourism Potential
Service Industry Mindset
IMPROVEMENTS
Medical Treatment & Education based on
International Standards & Accreditation
Industry Accreditation Standards
Target-oriented Infrastructure Investment
More Medical Colleges for Medical
professionals & Health Care Management
Active Regulatory Bodies
Government soft loan to private investors in
Health Care & Health Care Education
Tax Holiday & Further Duty Roll Back
Governmental Support for National Medical
Associations & Scientific Societies
Greater Industry & Govt. Interaction
Medical Insurance Reforms
Govt. is promoting UAE as a 1st class global
Medical Tourism Destination
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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
Angioplasty
30000 2100027000
Angiography
2500 3000
Hip
replacement
19000 1300016000
Knee
replacement
27000 1600018000
32000
Lasik
2000
22502900
Burmungrad
Bangkok
Max
Healthcare
India
Raffles
Singapore
4000 - 5000
4000 - 5000
5000
1100
400
800
4300
6000
6600
6000
6000
750
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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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Establishing a Facility Centre in a
Foreign Country (2)
National Healthcare Group
Singapore – UAE (Case Study)
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.
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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 Mix
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Launching an aggressive Marketing
Campaign to capture the market. (2)
PRICE
Rule: Offering a better Service Standards, while
making it available at a lower coast, than the
patients Homeland Service prices.
Actions:
•Specialties in specific
•Fixed Price Strategy. clinical areas.
•Strong Medical
•Tax Treatments.
•Customs Clearance. Research.
•State of Art Technology
•Premium Mark-ups.
& Equipment.
PRODUCT
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PRODUCT
PRICE
Launching an aggressive Marketing
Campaign to capture the market. (3)
Rule: Offering Tailored Service Specialties, that
cover deficiencies of Traveler’s Homeland
Service, at an attractive tourism package.
Actions:
PROMOTION
PLACE
PROMOTION
• Research Other
Countries Service needs.
•Medical Breakthrough.
•Service Providers
Networking.
•Visa facilitation.
•Referral Agencies.
•Advertisement.
•Internet Marketing.
PLACE
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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”:
• SWs should provide a “gateway” to Medical Tourism
services through government information and referral
services such as Call-centers, Internet sites,
and Information Bureaus.
• Patients can get information before preparing to
travel for medical procedures.
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Creating a seamless Single-Window Facility
for a maximum patient experience. (3)
“One-Stop Shopping”:
SWs should allow medical tourists to
access many or all of the services
delivered by the Medical Tourism
Providers, Governments, and
Regulatory Bodies in one convenient
location (physical or electronic).
The continuing development of Medical Tourism
services delivered through the internet offers new
opportunities for that.
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Creating a seamless Single-Window Facility
for a maximum patient experience. (4)
“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.
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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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Recommendations
Shifting Responsibilities for Medical Tourism
Development
New Model
Old Model
• Government droves
economic development
through policy decisions
and incentives
• 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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“It is not the strongest of the
species that survives, not the most intelligent,
but the one most responsive to change.”
Charles Darwin
( 1809 – 1882 )
Thank You;
END.
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