Guide to Health Tourism Export Development

GUIDE TO EXPORTING HEALTH SERVICES

Medical Tourism Maria K Todd, MHA PhD

Executive Director

The Healthcare Business Institute

an international nonprofit NGO

About Your Presenter 

Master of Health Administration

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Doctor of Health Administration

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Former Surgical Nurse | Former Travel Agent - AAA Worldwide Travel Agency

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CEO of the largest health tourism company in the world

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Author of 4 Books on Medical Tourism

Health tourism exporters sell billions of dollars of goods and services to international patients every year– and you can be one of them. Exporting health tourism can be an optimum way for you to grow your business.

ARE YOU READY TO EXPORT YOUR HEALTH TOURISM SERVICES? © 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Organizational Commitment 

Is your organization’s executive leadership committed to exporting and willing and able to dedicate properly trained staff and resources?

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Is your organization willing and able to travel internationally, such as attending trade shows and meeting and hosting fam tours incountry with potential foreign buyers/distributors and media representatives?

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Does your organization have a clear process in place to respond to international inquiries from all sources (web, email, phone calls, etc.)?

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

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Planning & Strategy 

Does your organization have or is your organization preparing an international marketing plan with defined goals, strategies and target markets?

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Has your organization updated your website to emphasize your interest/ability to provide transparent services pricing and provide services with cultural and linguistic readiness for foreign patients?

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Does your organization have adequate knowledge on how to protect your intellectual property internationally?

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

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Export Process 

Does your organization have adequate knowledge in arranging health travel logistics and transportation for patients from overseas; such as secure medical records transfer, medical records translation, telehealth consultations with attending physicians, and travel planning?

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Does your organization have adequate knowledge about contracting with thirdparty insurers, foreign employers, and consumers and have payment options such as letters of credit, payment guarantee letters, facilitator contracts, and country representative agreements?

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Does your organization have adequate knowledge of the foreign legal and regulatory requirements specific to your services/products?

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Collaboration and Support BUILDING A SUCCESSFUL MEDICAL TOURISM PROGRAM

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

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Framework Contracts The Healthcare Business Institute – a nonprofit NGO, is active in international development, medical tourism capacity development and institutional readiness assistance.

Whether your hospital, clinic or hotel is new to health tourism or in need of a refresher on the latest ideas and techniques, we will source and manage your project to bring medical tourism experts that provide the nuts-and-bolts information your organization needs to meet the challenges of the health travel and tourism world economy.

Short-term experts and technical advisers will help you meet international customer, foreign investors, and develop meaningful relationships to boost referrals and exports.

We work with government agencies to find ways to leverage government resources and programs to more effectively market and drive inbound referrals from overseas.

Š 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

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International Trade Events The Healthcare Business Institute organizes international trade events – which can include: 

Webinars and seminars on the fundamentals of medical tourism exportation

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Counseling and other support at U.S. and international trade shows;

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Recruitment of foreign buyer delegations to trade shows

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Fam tour arrangements for foreign buyers to visit your facility; and

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Trade missions of delegates to foreign markets for one-on-one meetings with potential customers and partners.

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Planning & Strategy The Healthcare Business Institute has developed the Medical Tourism Export Business Planner for health tourism suppliers to answer critical questions for hospitals and hotels entering export markets.

The Planner provides a discussion and series of worksheets to get your organization thinking about marketing health services to export markets 

Conducting market research about buyers in target markets

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Tips on marketing your medical tourism product or service

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Best practice tips on entering foreign markets

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Identifying customers within your chosen markets

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About international quality and safety accreditation and certifications

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Market Research The Healthcare Business Institute helps international healthcare facilities identify products and services with health tourism export potential through specialised market research and analysis. 

Assessing strengths and weaknesses of services you believe have health tourism export potential

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Select the most exportable health tourism services to be offered

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Evaluate the services to be offered – choose safest, simplest services to start

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Matching health tourism services with global trends and needs

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Identifying the largest, most profitable, fastest-growing foreign markets for those services

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Determining the most penetrable markets for your health tourism exports

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

FACT According to HBI market research, new-to-medical tourism organizations often tend to choose too many markets and too many procedures at first. For most health tourism facilities and programs, choosing one to three foreign markets initially is recommended.

Š 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Services & Markets to Pursue Sustainable Community Benefits / Trade-offs Business Analysis Industry Analysis Services with Export Potential Match Services to Global Trends /Needs Most Penetrable Markets Markets to Pursue

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Health Tourism Goal Setting Summarize your short- and long-term goals for health tourism exports 

For each market, determine: 

Medical Tourism Product Standards

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Accreditation and Certification Requirements Expected by the Market

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Product Modifications / Support Required

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Establish two-year goals for your health tourism export services

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Establish five-year goals for your health tourism export services 

Define key performance indicators

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Develop an action plan and timelines coupled with resources and budgets

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Identify Representatives and Facilitators If you choose to use agencies or medical tourism facilitators, you will need to sign a formal contractual agreement. The agreement will define your relationships: 

Specify performance objectives and brand standards to be upheld

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Describe territories and whether the agent or facilitator will have exclusive sales and representation rights

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Set the length of the term for which the agreement is applicable and agree upon specified minimum sales volumes to retain sales rights

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Outline protection of intellectual property

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Describe other obligations imposed, violations of which would justify termination of the agreement.

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List specific intellectual property rights granted to the agencies or facilitator

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Define financial terms and payment arrangements © 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

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Agency and MTF Agreements

When negotiating and drafting contractual agreements, consult an attorney with experience in international trade and laws of the specified country

Š 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Health Tourism Export Programs PROGRAMMING COST ACCOUNTING

Š 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Health Tourism Service Line Costs This should be calculated separately from your local service costs Implants and Consumables Direct Labor (Doctors, Nursing and Admin) Service Modifications for International Patients Overheads Costs Selling Expenses General Expenses (including debt service) Administrative Expenses Export Marketing Costs Profit Margins Procedure Pricing

Š 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Health Tourism Service Line Costs Additional Costs Foreign Sales Commissions International patient department costs Destination management costs /pass thru costs Professional liability premium costs Translation costs Trade show shipping and customs fees & insurances Trade show staffing costs Cost of credit or capital Bank transaction fees Total Additional Export Costs

Š 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Health Tourism International Marketing Costs Expense Accounting Fees Legal Fees Promotional Material Travel Communication (international and domestic) Advertising allowances Promotional expenses Shipping and customs fees for trade show materials Stand expenses Total Marketing Fees and Costs

Š 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Projected Income – Per Market 

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Gross Profit 

Sales Volumes

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Cost of Goods Sold

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Gross Margin

Track Costing and Revenue per Market.

Don’t smear revenue performance!

International Operating Expense 

International Patient Department Operations

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International Patient Department Training & Development

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Staff Nurse Training & Development (Medical English)

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All previously identified Service Line and Marketing Costs

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International Division’s Domestic Expense Allocation

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Setting Your Prices 

Direct supply and labor costs

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Prorated overheads

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Operating Expenses 

Take volume discounts from the profit, not the direct costs!

All international health tourism export associated costs • • • • • • •

Commissions – if any Consulting fees Communications Foreign advertising Legal expenses Interest payments Market research

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Product modification Promotional materials Provision for bad debt Translation costs Transportation costs Travel expenses Other costs

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Allowance: (for unforeseen production costs, operating expenses, unavoidable risks and simple mistakes that are common in any new undertaking)

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Profit / Markup © 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

UTILIZING TECHNOLOGY FOR SUCCESSFUL HEALTH TOURISM EXPORTING

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Key Elements of E-Commerce 

Online presence for your company (a website)

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Providing information in your target market’s native language(s)

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Key words embedded in your website, so that your company is found by online search engines

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Payment processing

There is one caution for start-up health tourism exporters who plan online sales and the use of credit cards for e-commerce. Market research indicates that the unauthorized use of credit cards for international payments is the fastest-growing fraud in international commerce.

If you plan to have a representative in a certain country that is selling on your behalf and accepting credit cards on your behalf, they must be in compliance with various internet safety regulations. This includes PCI and HI-TECH in the USA and other similar regulations in the EU. © 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Equipping Your International Patient Department for Success 

Conference Calling

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Computers with high-speed internet access

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Contact Management capable of 14-digit dialing

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Antivirus utilities

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Firewalls

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Accounting / healthcare revenue cycle package that can accommodate currency conversions and coding translations

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Web and Video Calling

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Handy/Mobile Phones

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Voice mail with outgoing messages in several languages

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Secure email and fax

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Website – optimized for foreign market SEO

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

TIMETABLE STEPS FOR SUCCESSFUL HEALTH TOURISM EXPORTING

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Timetable Steps 

Identify Key Activities

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Assign responsibility for each activity

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Determine scheduled start date

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Set key performance indicators and performance benchmarks

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Determine “go live” date

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Marketing Plan Summary 

For bankers and lenders

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For management team leaders and key staff

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Potential investors

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For international partners – tailored to each specific or potential audience, as needed

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Conclusion Health tourism exporters sell billions of dollars of goods and services to international patients every year– and you can be one of them. Exporting health tourism can be an optimum way for you to grow your business. 

The Healthcare Business Institute is a nonprofit international NGO that specializes in framework contract management and brings the know-how of more than 100 seasoned international health tourism short-term experts and technical advisors ready to help you achieve success 

Market Research

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Product modification for the international market

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International quality and safety accreditation preparation

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Strategic Planning & Implementation

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Staff Training and Development

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Technical assistance (marketing and e-commerce)

© 2013. Healthcare Business Institute - EXPORTING HEALTH SERVICES: Medical Tourism

All International Rights Reserved.

Contact Information Dr. Maria Todd Executive Director

Healthcare Business Institute, Inc. at the Posner Center for International Development 1031 33rd Street Denver, Colorado 80202 +1.800.209.7263

The Posner Center for International Development houses 30+ organizations, 120 employees, hundreds of interns and volunteers, a farmers’ market, a learning laboratory, a lecture hall, exhibition and meeting space, and more. This unique community serves as a collaborative epicenter of international development.