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How to make money investing in the medical travel industry

By now, you’ve heard all the hype about the potential growth of the medical travel industry and how US patients are fleeing the country to get affordable care. Unfortunately, the experts agree, that there are few reliable statistics about the size and growth of the market, there are no common definitions of a medical traveler, comparisons of revenues and costs are hard to make, and there remain persistent, nagging barriers to widespread adoption by patients, payers and physicians.

That said, investors are still clinging to the promise of big returns fueled by patients losing their health benefits because of high unemployment, the aging population requiring more units of care and exploding costs of healthcare. If you think the medical travel industry is set to explode, there are some areas of investment to consider:

Foreign Healthcare infrastructure

  • Hospitals and systems
    Ambulatory surgery centers
    Clinical labs and imaging centers
    Disease specific treatment facilities like cancer centers, stem cell centers, etc
  • Foreign Travel and hospitality infrastructure

  • Hotels and Surgical Hotels
    Spas
    Airport development

  • Tools and support companies

  • Players in global healthcare information exchange
    Data analytics and business intelligence
    Quality, price and value determinations
    Companies offering alternative pricing mechanisms

  • Supporting global healthcare insurance and travel products

  • Trip cancellation
    Follow up care
    Emergency evacuation
    Professional liability
    Infectious disease management
    Geopolitical risk insurance
  • Firms in the medical travel supply chain

  • Travel medicine clinics
    Medical travel facilitators and specialty travel agents
    Medical concierge ground operators
    Currency exchange risk managers

  • Expatriate retirement health cities and communities

    Like other industry sectors, gold, for example, you can invest in the product itself, the people who create the product, or investments that pools risks, like mutual funds or exchange traded funds.

    Look for companies in markets where the supply of care does not meet the demands of a growing middle class, that provide products and services delivering low, cost high volume care, and that provide platforms and infrastructure designed to reduce transaction costs for billing and collecting and value-based information.


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    A Looming Doctor Shortage?

    America will lose an estimated 46,000 primary care physicians by 2025, according to the Association of American Medical Colleges (AAMC). This has created a perfect storm stemming from three factors:

    1) Rising cost of US medical school tuition, ($156,456 in 2009 according to the American Medical Association). Hence, debt-saddled graduates are financially bound to more lucrative careers as specialists.

    2) The first crest of Baby Boomers is reaching retirement age – increasing doctor demand and further straining these thin resources. According to the American Academy of Anti Aging, Baby Boomers accounted for 26.1% of the US population in 2006.

    3) Healthcare reform will soon insure 32 million previously uninsured Americans.

    Scary statistics indeed, however, as with all business, times of great challenge stimulate innovation. Some trends indicate a rise of: nurse practitioners, telemedicine, walk-in clinics, global and domestic healthcare. One such example of filling in the gaps through global healthcare is the Executive Wellness Screen/Executive Wellness Exam, originally designed for busy executive as an efficient über-physical with a host of diagnostic tests such as an electrocardiogram (EKG or ECG) and bioscans. Other trends are emerging…stay tuned!


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    Five things will need to happen before medical travel gets real

    Despite the research reports, eco-devo white papers, industry analyses and industry marketing hype, medical travel/medical tourism is still an early stage industry looking for the right formula for success.

    In my view, five things will need to happen before medical tourism and global healthcare referrals get real traction: 1) the creation of a sustainable business model, 2)global healthcare IT connectivity and integration, 3) a physician generated global healthcare referral network, 4) a global regulatory, legal and socioeconomic ecosystem, and 5) patient awareness and acceptance.

    The creation of a sustainable business model
    Industry players including payors, providers, partners and facilitators are still looking for the the most successful way to make a profit and scale the business. With an eye towards what happened when Expedia disrupted the travel agency business, participants understand that margins for travel arrangement services are thin and that there is high price elasticity for global medical care. Few have found the magic key that fits the lock that opens the doors to profits. Payors and employers are hesitant to accept the value proposition without a better way to reduce their risk and demonstrate tangible, meaningful cost savings to their insureds and employees.

    Global healthcare IT connectivity and integration

    The US national healthcare information architecture is evolving. Eventually, the network will be a portal to the world and will allow for seemless, secure, confidential transfer of personal health information thus assuring some continuity of care and quality improvement. Similarly, it will take a while for health information systems to evolve in host countries that can talk to non-host systems. Short term solutions, like personal health records or mobile health applications, might fill the void temporarily.

    A physician generated global healthcare referral network

    Most medical tourism models connect patients to healthcare facilities, bypassing doctors in the initial stages. Doctors will get in the game when the model feels better, and they have the resources and ability to make referrals to consultants directly, like they do now. Since MedVoy was founded by an American doctor, MedVoy connects patients directly to doctors which is unlike other facilitators. Given the rise of international members, professional medical societies should be more proactive in building global referral networks, rather than seeing them as threats to existing domestic members.

    A global regulatory, legal and socioeconomic ecosystem

    The barriers to adoption and penetration of medical travel are many and include liability, reimbursement, quality assurance and impediments to continuity of care. As healthcare goes global, so will the rules and regulations that facilitate or obstruct its use. How about a World Trade Organization Treaty on Medical Travel?

    Patient awareness and acceptance

    According to the most recent polls, 50% of consumers understand the meaning of the term “medical tourism”, leaving home for care. Social network buzz and media stories find the medical travel story sexy, particularly given all the noise about escalating healthcare costs and consumers, employers and payors are hungry for more information. Moving patients from awareness to intention to decision to action, however, will take more time and use innovative marketing approaches directed towards granular market segments.

    Global medical travel is projected to be a $1B industry by 2012. While the bones are in place, it will take more time to add the flesh. Until then, to quote Karl Mauldin, people won’t leave home without it.


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