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Medical Tourism Impacting U.S. Health Care

Billions in losses forecast as citizens flock overseas for surgery





July 31, 2008

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Consumers waiting for politicians to reform the health care system appear to be losing patience. More than 750,000 Americans left the country last year for less expensive medical treatments. The number is projected to grow to six million by 2010, potentially costing the U.S. health care system billions, according to the results of a series of research by the Deloitte Center for Health Solutions.

The number of retail clinics in operation has also soared by 220 percent from just 250 clinics in 2006 to more than 800 serving patients by the end of 2007. Both trends suggest that these new innovations are challenging the status quo of the traditional U.S. health care system as consumers seek better care, and greater access at lower costs, the reports found.

"The emergence of disruptive health care innovations, such as medical tourism, retail clinics, medical homes, alternative medicines and cyber visits, present an industry paradigm with new players, new delivery models, new ways of partnering and new value propositions," said Paul Keckley, Ph.D., executive director of the Deloitte Center for Health Solutions. "Our research suggests that while traditional roles in the health care delivery system are being threatened by these innovations -- creating initial worries for physicians, hospitals and allied health professionals – they may also provide new and rewarding opportunities."

The Deloitte Center for Health Solutions research series includes a body of reports centered on disruptive innovations that are creating a shift from conventional models of service delivery and payment to a consumer-centric system of care in which price, quality and service delivery are key.

The three latest reports from the series include:

"Medical Tourism: Consumers in Search of Value," forecasts explosive growth in medical tourism over the next five years in outbound patient traffic.

"Retail Clinics: Facts, Trends and Implications," projects a rise in the number of retail clinics opened and used by consumers.

"Disease Management and Retail Pharmacies, a Convergence Opportunity," outlines the rapid growth of the disease management market and new opportunities for retail pharmacies to include these services to attract and retain consumers.

Among the key findings from the reports:

• Outbound medical tourism currently represents $2.1 billion spent by Americans overseas for care -- $15.9 billion in lost revenue for U.S. health care providers. Americans primarily seek this sort of care for elective surgical procedures.

• The number of outbound medical tourists is projected to rise to 15.75 million in 2017, representing a potential $30.3 to $79.5 billion spent abroad by Americans. As a result, the potential lost revenue for U.S. health care providers could top $228.5 to $599.5 billion.

• Medical care in countries like India, Thailand and Singapore can cost as little as 10 percent of the cost of comparable U.S. care, often including airfare and a stay at a resort.

• In 2008, more than 400,000 non-U.S. residents will seek care in the United States, known as inbound medical tourism, and spend almost $5 billion for health services.

• Many leading U.S. academic medical centers and major health systems are already seizing the opportunity to capture the medical tourism market by leveraging their strong brands and collaborating with international providers.

• Consumers are flocking to retail clinics not only for convenience, but also for the relative low price differences associated with visiting their primary care physicians for the same treatments. The cost of services provided by retail clinics range from $50 to $75, with the majority priced at $59, compared to a physician's office visit, which can cost from $55 to $250. Additionally, the cost for a retail clinic physical, at $25 to $49, can also result in savings compared to a physical at a physician's office that can cost anywhere from $50 to $200.

• The U.S. market for disease management services is projected to reach $30 billion by 2013, providing convergence opportunities for retail pharmacies to add disease management services to attract consumers to their stores for cross-selling opportunities, providing one-stop shopping for health care services.

• Retail clinics and pharmacies positioned for market success may also include pharmacy benefit management (PBM) services that could also attract significant market share, particularly for disease management services to treat chronic conditions.

"Hospitals, physicians and health plans will need to quickly adapt to the competition from non-traditional players and develop long-term strategies, such as M&A, alliances and partnerships, to capture market success," said Keckley. "Those that factor in the unique attitudes and preferences of consumers as they make strategic decisions about partnering and developing new business models and care delivery networks will have a huge opportunity to win the consumer market."



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