medical tourism: care beyond boundaries mr. abhay soi ...schcpune.org/assets/ns2016/10. medical...

Private & Confidential 1 1 Private & Confidential

Medical Tourism: Care Beyond Boundaries Mr. Abhay Soi - Chairman & Managing Director


Thoughts for discussion

• What is Medical Tourism (‘MT’)

• What drives MT

• Global Trends

• Case Study: Bumrumgrad

• Competitive landscape

• Challenges for MT

• MT India

• Advantage India

• Key Challenges

• Way ahead for MT in India


What is Medical Tourism:

Medical Tourism refers to

people travelling beyond their boundaries,

to obtain healthcare solutions,

preventive and curative in nature.

Part of our civilization for a long time


What drives MT: Unavailability of Quality Healthcare driving people to travel

KPMG in India Analysis, 2014

• Most of Africa

• Afghanistan

• Iraq

• CIS countries like Kazakhstan, Uzbekistan, Kyrgyzstan


What drives MT: Other Features

Unavailability of experts – doctors,

nurses, etc.

Unavailability of Advanced

Technology

Below par Quality of care

Affordability & Cost

Immediate service (vs. long queues)

Privacy / Anonymity

High Cost of service in countries with Govt. funded health programs

developed county problems Developing / third world problems


Global Trends: Sudden Rise in MT, Globally, with supernormal growth rate

10.5

32.5

0

5

10

15

20

25

30

35

2014 2020

Global MT Value ($ Billion)

Top 5 specialties: • Cardiac Sciences • Orthopedics: Joint replacements & Spine • Neuro Sciences • Oncology • Transplant programs: Liver, Kidney, Bone Marrow

Source: KPMG FICCI Heal 2014


Global Trends: Sudden Rise in MT, Globally, with supernormal growth rate

• Ageing population

• Increased Awareness

• Improved Physical Connectivity

• Seamless Digital Connectivity Globally

US, EU, Canada, MEA Japan, Korea, Australia, NZ

15% of world

population

Africa South America

SAARC China Russia

85% of world

population


Global Trends: MT leading to growth in other associated sectors

• Spill-over impact on other sectors…

Medical Tourism Retail

Logistics Travel Forex Earnings

Aviation

Hospitality Tourism

Many countries and private hospitals run focused programs to attract medical tourists from around the world: Turkey, Thailand, Singapore, Malaysia, India


Global Trends: Choice of Destination determined by …

Systemic Hospital specific

• Availability of relevant expert Doctors

• Credibility of the Hospital

Credibility of the Country: • Overall perception about people • Cultural acceptability

• Proximity to Visitor, physical connectivity

• Facilitation by the Govt / country

Support and facilitation provided by the Hospital

Ease of process to take regulatory approvals

Comfort with the pre-visit services provided by the hospital: Tele-

consults with doctors, diagnosis, counselling, etc

Cost benefit to the MT visitor vis-à-vis other options

Cost of living (travel, acco, food, etc) for family members


Challenges for MT

Concerted effort by government and private hospitals in developing countries is essential to achieve the purported super-normal growth in MT

First world’s MT Visitors’ challenge

Developing world’s MT Visitors’ challenge

• Affordability

• Language Barriers

• Cultural Differences

• Regulatory process for Med-Visa

• Market infested by unorganized

intermediaries: leading to

increase in cost and

misinformation to patients

• Insurance Portability across

jurisdictions

• Unavailability of outcome data

• Poor perception of Hygiene

• Lack of awareness

• Poor perception and

understanding of quality of care

in evolving MT hubs

• Regulatory process for Med-Visa


Competitive Landscape: Top 5 countries cater to over 75% of Global MT

DESTINATION NO. OF MVT PATIENTS

THAILAND 2,500,000

MEXICO 1,000,000

USA 800,000

SINGAPORE 500,000

INDIA 200,000

MALAYSIA 200,000

BRAZIL 180,000

TURKEY 110,000

TAIWAN 90,000

COSTA RICA 50,000

• 60% MT driven by lack of relevant expertise and technology in own country

• 15%+ MT driven by cost benefit


Medical Tourism in India Majority driven by SAARC and Middle East countries

• $ 250 million market in India, set to grow @ 20%+ y-o-y

• Majority from Bangladesh, Maldives, Afghanistan, Iraq, Nigeria

Bangladesh, 22%

Maldives, 17%

Afghanistan, 9%

Iraq, 8% Nigeria, 6%

Russia, 3%

Oman, 3%

Sri Lanka, 3% UAE, 2% USA, 2%

Others, 25%


Medical Tourism in India Anchored in Metro cities

Spread over 4 to 5 hospitals




Medical Tourism in India Case Mix change over the years

Then Now

2010 till 2016 Early 2000’s

Cardiac Sciences

Specialties

• Primarily CABG, Valve surgeries • Angioplasties

• Min. Invasive Cardiac Surgeries • Ventricular assist devices; • TAVI: Valve replacement without

surgeries

Solid Organ Tx

• Primarily Kidney Transplants • Mainly Liver, Bone Marrow Tx • Kidney Transplants

Ortho. • Spine Surgeries • Joint Replacement

• Minimally invasive spine surgeries • Joint Replacement

Neurology • Brain tumors • Spinal deformities

• Functional neuro-surgeries • Interventional neuro-surgeries

Oncology • Medical, Surgical, Radiation onco • Cyberknife, Robotic surgeries • Targetted chemotherapies • Organi specific onco programs


Advantage India Strengths / Competitive Advantages

• Medical Talent:

– Doctors: amongst the best globally

– Excellent Nursing care

– Education system provides 30,000 doctors and nurses each year

– India is the largest exporter of medical talent to the world

– Quality of Care: at par with the best

• Culture:

– English speaking population in general

– Acceptance of patients from all races: Absence of racial discrimination

(especially relevant for African travelers)


Advantage India Strengths / Competitive Advantages

• Technology: Latest Technology, Equipment, Facilities and Infrastructure:

Int’l standards

• Holistic Offer: Options for multiple Alternative Systems of Medicine like

Ayurveda, Yoga, Unani, Siddha, Homeopathy, etc.

• Unmatched Cost Advantge: @ 10% cost of developed world

– Cheap cost of living for long stay visitors, attendants, family members

• Access: Within 7 hours flying time from 70% of world’s population

• Tourism: Exotic tourism circuit around all metro cities


Advantage India Government Support


Advantage India: Price Advantage:

30%

65%

90%

45%

80%

65%

40% 45%

55%

75%

65%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

India: Amongst the cheapest and the best provider of ‘quality healthcare’

Cost of healthcare delivery: % discount to cost of service in USA


Key Challenges India still lags behind Competition!!!

• Regulatory process flow for issuing M-visas: ‐ No separate fast track process for M visas; common queues for

Med & other Visitors @ airports;

Regulatory support

• Public / Civil infra. lags even some developing countries

• Limited number of quality tertiary / quaternary care facilities

• Majority of MVT flow is from non-English speaking countries:

‐ Need trained linguists to assist Arabic, African, CIS visitors

• While cost of treatment is less in India, ancillary costs may be high,

especially for visitors from low income economies

Public and Private

Infrastructure

Market Structure

• Patient flow driven by unorganized middle-men

• Few players have formal, transparent protocols for patient

counselling and communication for MT visitors

• Competition from other Asian countries


Way forward for MT in India

Aspect Issues Plan

Regulatory framework

• Complicated visa regulations

• Stringent laws for surrogacy, organ donation

• Ease the medical visa policy • Streamline norms around organ

transplant, surrogacy, etc.

PR & Marketing • Inadequate PR backed by government

• Adequately promote India’s competitive advantages: Price, Talent, Quality of Care

• Structured promotion program with marketing by govt. forum

Quality of healthcare

• Limited number of high-end facilities

• Government support to facilitate greenfield facilities dedicated for MT

Hospitality • Lack of quality affordable accommodation in MT hubs like Mumbai, Delhi

• Dedicate health cities for MT visitors providing space for developing all ancillary services like accommodation for long stay patients & family members


Way forward for MT in India

Aspect Issues Plan

Public Infrastructure

• Poor quality public infrastructure hampering overall service quality and perception

• Develop and connect micro-markets in each healthcare hub with key public utilities like airport, train, BRTS, etc.

Beyond Allopathy • Inadequate promotion of alternative treatments

• Canvas all alternative treatment systems under one roof and take them to international markets: Unani, Naturopathy, Siddha, Yoga, Homeopathy, Ayurveda,

Government Initiatives

• Below-par use of digital campaigning, promotion

• Absence of single nodal agency for promoting healthcare to MT visitors

• Budget level allocation to establish India as MT hub with global footprint.

• Engage experts to take India to the world via multiple marketing platforms


Our Experience BLK Super Specialty Hospital, Delhi

• Dedicated End-to-End Eco-system:

– Annual traffic: 40,000+ OPD & 3,000+ IPD MT visitors

– Tie-ups: 15+ Health Ministries, 3 Universities, 15

embassies, Int’l TPAs

– Website: Multi-lingual website for target nations 0

10000

20000

30000

40000

50000

FY '12 FY '13 FY '14 FY '15 FY '16

Annual MT patients at BLK

– International OPDs: Teams of 2-5 doctors travel every week: From ‘Fiji to Finland’

– Pre-Travel support: Tele-consults, Skype calls, diagnostic support

– Translators: Pool of translators supporting 18 different languages

– Logistics: Direct pick-up from the Tarmac for Int’l patients

– Visa & currency: End-to-end handholding for entire travel schedule

– Food: Dedicated Chefs for 12 different cuisines, prepared every day

– Quality of care: International patients lounge, in-room admission & discharge

– Accommodation: Tied-up hotels at affordable rates for attendants

– Tourism: Packages via hospital vendor network


Thank You!!!

BLK Super Specialty Hospital, Delhi Nanavati Super Specialty Hospital, Mumbai


Global Trends: Case Study of MT oriented business: Bumrungrad, Bangkok

• One of the largest private hospitals in Southeast Asia

• Most popular MT destination

• Of the 1 million patients/ yr, 50% are foreign nationals

• Marketing offices in 16 countries (Australia, Bangladesh, UAE, China)

• Multi-lingual website

– End-to-end online assistance to patients

– Pre & post consults, Appointment, travel, stay, etc.

• Medical coordination office, dedicated team of 30+:

– Collaborates with patient’s primary doctor, even after the patient is discharged

• Wide range of accommodations from low-priced four-bed rooms to suites

• 51 room serviced apartment complex, for inbound long stay patients

– Patients can rent this accommodation for a day, a week, or a month.

medical tourism: care beyond boundaries mr. abhay soi ...schcpune.org/assets/ns2016/10. medical...

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