Understanding the market is a pre-requisite of success in any business sector. And it's certainly true of the evolving medical tourism market in the USA. But the US healthcare system and the drivers of outbound medical travel are complex and diverse. Healthcare providers who target US patients are hampered by weak or non-existent data and confused by exaggeration and hype. Few guideposts exist to direct efforts to reach potential markets.
With an improved understanding of the healthcare industry, key players in healthcare, as well as essential business skills designed for US consumers, opportunities can be identified. The United States can be a lucrative source of patients for foreign providers of healthcare services... when highly targeted services are offered to the right market segments with the right combination of push-pull factors. Understanding the market is a pre-requisite of success in any business sector. And it's certainly true of the evolving medical tourism market in the USA.
1 Executive Summary
3 The Data Issue
3.1 The “medical tourism” market is not a monolithic block
3.2 Moving from one segment to the next
3.3 Creating a uniform taxonomy
4 SECTION 1: Business-to-Consumer
4.1 Size and nature of the US medical travel market
4.1.1 Profile of US residents as consumers of foreign medical services
4.1.2 The number of US travellers
4.1.3 Availability of time to travel for dental and medical services
4.1.4 Ability to pay out-of-pocket for dental and medical services
4.1.5 Destinations - where US travellers are going
4.1.6 Potential factors that motivate US residents to seek treatment abroad
4.2 Qualitative - Psycho-social profile and behaviour patterns of US healthcare consumers
4.2.1 Psychological profile of potential US medical tourists and medical travellers
4.2.2 US women as dominant decision makers
4.2.3 US consumers and internet use
4.2.4 US internet use and health related topics
4.2.5 US internet search volume: “medical tourism”
4.3 Major medical services most likely sought by US patients abroad
4.3.1 Identifying the most common treatments sought
4.3.2 Services paid for out-of-pocket - current and potential future demand
4.3.3 Demographic factors favouring medical travel
4.3.4 Cosmetic surgery - current trends
4.3.5 Bariatric surgery - current trends
4.3.6 Dental services - Current trends
4.3.7 Reproductive health treatments - current trends
4.3.8 Complex medical care
4.3.9 Executive check-ups
4.3.10 Summary of demand
4.3.11 Ethnic diversity
4.4 US healthcare: market dynamics
4.4.1 How US consumers select providers
4.4.2 Advertising and consumer choice
4.4.3 Accreditation and consumer choice
4.4.4 How consumers select foreign providers
4.4.5 Summary of consumer choice
4.4.6 Impact of price on consumer decisions
4.4.7 “Price” versus “Cost”
4.4.8 The perverse role of price in healthcare choice
4.4.9 Price comparisons with other countries
4.4.10 Summary of price
4.5 Portrayal of international medical travel in the US media
4.5.1 Media image
5 SECTION 2: US Market: Business-to-Business
5.2 The US insurance market
5.2.2 Medicare and Medicaid
5.2.3 TRICARE Overseas Program
5.2.4 The US health insurance market and medical travel
5.2.5 Obstacles to overcome
5.2.6 US healthcare spending
5.2.7 Overview - Health insurance in the USA
5.2.8 Uninsured US residents
5.2.9 Private health insurance
5.2.10 Services covered by private health insurance
5.2.11 Paying for health insurance and medical services
5.2.12 Employer sponsored health insurance
5.2.13 Types of health insurance plans
5.2.14 Health savings accounts and high deductible health plans
5.2.15 When medical travel benefits collide with union entitlements
5.2.16 Impact of the recent recession on health insurance coverage and cost
5.2.17 Self-funded health insurance plans
5.2.18 Third Party Administrators (TPAs)
5.2.19 Self-funded employers and medical travel benefits
5.2.20 Summary: private health insurance
5.3 Affordable Care Act (ACA)
5.3.1 Status of ACA implementation
5.3.2 ACA’s impact on healthcare costs
5.3.3 ACA impact on personnel, capacity and wait times
5.3.4 Impact of ACA on medical travel
5.3.5 Summary: US health insurance market
5.4 Medical service providers
5.4.1 Provider market: Hospitals
5.4.2 Provider market: Doctors
5.4.3 Provider market: Dentists
5.5 Professional associations
5.5.1 Summary: Associations
6 SECTION 3: Doing Business in the USA
6.1 Overview: Preparing to do business in the United States
6.2 Legal issues related to medical travel and doing business in the USA
6.3 Regulation of medical travel facilitators, travel agents and insurance agents
6.4 Compliance with Health Insurance Portability and Accountability Act (HIPAA)
6.5 Compliance with Patient Safety and Quality Improvement Act of 2005 (PSQIA)
6.6 Advertising laws in the USA
6.7 Legal, malpractice & liability factors - litigiousness and lack of recourse
6.7.1 Summary: legal factors
6.8 Positioning medical travel services for the US consumer market
6.9 Converting tourists into medical tourists
6.9.1 Case study: a Costa Rican resort
6.1 Destination attractiveness and US consumers
6.10.2 Destination image
6.10.3 Risk and reward including safety, track record, guarantee, and outcome
6.10.4 Geographical proximity including travel convenience - barriers, travel time, travel convenience - access
6.10.5 Infrastructure including accommodation, internal travel, and support services
6.10.6 Cultural proximity (or cultural comfort) including religion, customs and practices, food, and language
6.10.7 Destination environment including tourist attractions, facilities, and climate
6.10.8 The role of price
6.10.9 Summary: success in the US market
6.11 Meeting expectations
6.11.1 What US consumers and businesses expect from international providers
6.11.2 What the insurance industry expects from foreign providers
6.11.3 Credentialing for the insurance sector
6.11.4 Accreditation for the insurance industry
6.11.5 Network contracting/participation
6.11.6 What facilitators expect from foreign providers
6.11.7 What US consumers expect from foreign providers
6.11.8 Summary: Meeting expectations
7 About the Authors
7.1.1 Irving Stackpole
7.1.2 Elizabeth Ziemba
7.1.3 Keith Pollard
1 Annex: Introduction
2 The impact of healthcare reform on the USA's medical tourism industry
2.1 Healthcare reform in the USA
2.2 The insurance myth
2.3 The uninsured American myth
2.4 Why the US reform is not EU style universal healthcare
2.5 Economic and political change in Europe
2.6 The waiting lists of the UK
2.8 Original source
3 International Americans have not arrived, but what about domestic travel?
3.1 The present
3.2 The future
3.3 Original source
4 What does the Affordable Care Act mean for medical tourism?
4.1 What is the Affordable Care Act?
4.2 The major provisions of the ACA as they relate to the medical tourism sector
4.3 The short term and long term challenges for medical tourism
5 A discussion on the legal ramifications of medical tourism in the USA
5.1 How are you involved in medical tourism?
5.2 What are the legal issues for people travelling for “circumvention tourism”, either in their home country or abroad?
5.3 What are some of the potential and current medical tourism legal issues in the USA?
5.4 How do you think the new US Healthcare Bill will impact on medical tourism?
5.5 Do you think insurance companies will use facilitators to send patients abroad or do you think that they’ll send patients directly?
5.6 Are you seeing a growth in law suits in the US courts of people returning from abroad against foreign suppliers?
5.7 What kind of legal risks are facilitators taking - could they be held responsible and at risk from litigation and what can they do to protect themselves?
6 A new study reveals the real numbers of American medical tourism
6.1 13,500 US medical tourists from 45 businesses since start up
6.2 Cost savings for medical travel less than claimed
6.3 IMTJ comment
6.4 Original article
7 How many Americans go abroad for treatment?
7.1 The range of estimates on US medical tourism
7.2 Is it 150,000?
7.3 Is it 500,000?
7.4 Is it 250,000.....is it one million?
7.5 And the latest ""guesstimate""?
7.6 Original article
8 How many Americans go abroad for treatment?
8.1 How do they choose a destination?
8.2 Mexico as a medical tourism destination
8.3 Perception affects choice
8.4 Original article
9 How many Americans would consider medical tourism?
9.1 The Obama effect
10 The hottest location for Americans travelling for treatment
10.1 Original article
11 More information