Running Head: Domestic medical tourism 1

Domestic medical tourism

Institution

Name

Date
Domestic medical tourism 2

(Kamal et al., 2020) states that wealthy countries, spend more per person health-wise. Health-
care costs averaged $6096 in the year 2007 shooting to $10,966 in 2019 per person. This is 42%
higher than the next highest per capita health spending. This gap has been increasing
significantly since 1980.

To remedy this, domestic medical tourism is a worthy opportunity to consider while also
embracing the fact that U.S hospitals can’t compete with those in Thailand and India due to their
low cost of service. Surgeries which cost below $ 20,000 are better options for domestic tourism
which can also serve those won’t go overseas. According to (Medisetter, 2019), “a 21-year-old
who is living in Alaska pays more than double on the same insurance premium as one who living
in Utah. Additionally, in some cases, the cost of surgery varies by as much as 40% from state to
state, making it worthwhile to go to a different state for a surgery like joint replacement. If the
surgery is of little urgency and one can travel, domestic tourism is a good place to start.
Corporations today would rather send one of their employees to a state a few hours away than to
a country more than ten hours away.

The CDC has claimed that outbound medical tourism, (one of the three types of medical
tourism), can be risky. The country, facility where operation is performed and a patient’s
psychological and physical state all determine the risk complication rate. Secondary issues that
may increase risk complications are; infectious diseases, quality of care, air travel (which may
cause one to develop embolisms) and continuity of care.

“People in the United States can save around 20-40% on the cost of a surgery by using the
services of hospitals in other states or even the services of the Free Market Medical Association.
These cost savings are significant, but they are still much higher than the costs found in Asian
hospitals, such as those in India or Thailand. Hospitals in the United States are also becoming
more transparent about their pricing, making it possible to shop by state and compare prices.”
(Medisetter, 2019)

This industry should in any case be significant for organizations and insurance agencies to use. A
Las Vegas-based company discovered that it could save $70,000 per year by using a domestic
medical tourism company. As the only requirement is a 2-4 hour flight to a medical clinic in
another state, these administrations are consequently extremely valuable for organizations and
insurance agencies. The worldwide clinical the travel industry was esteemed at around $15.5
Domestic medical tourism 3

billion as indicated by Zion Market Research, with Americans spending generally $2.1 billion of
this sum. Quite possibly the homegrown clinical the travel industry market could catch a portion
of this worth pushing ahead. Notwithstanding the development of minimal expense arrangements
found in certain emergency clinics in the United States, 1.7 million Americans will in any case
travel abroad for clinical treatment this year, which shows that clinics in the United States can at
last not contend on an expense reason for some methods.

Domestic medical tourism is being promoted by corporations. Those same huge companies have
negotiated lower fees for a wide variety of use cases. Some insurance companies also have
contracts with specialty clinics for competitive pricing. The goal is to reduce medical costs and
insurance rates while still providing employees with high-quality care. The goal of this strategy
is to reduce the country's medical costs.

Businesses and insurance companies have noticed this trend. As a result, there has been an
increase in domestic private medicine. With this recognition, some medical tourism companies
have begun to focus more on it. Stephens Media, a newspaper publisher, refers employees and
family members in need of hip and knee replacements to health care facilities, including one in
Orange County that has assented to predefined surgeries. In one case, the employer paid for the
patient's and companions entire bill, including a $1,000 cash payment. Kroger Co., a major
grocery retailer, has teamed up with Hoag Orthopaedic Institute as well as several other hospitals
to provide hip, knee, and spinal-fusion surgeries. This deal saves companies money while also
offering the employees with a higher level of care.

Factors influencing the US outbound medical travel decision making

(Collins et al., 2019) stated that outbound medical travel is determined by the following;

1. Host country environment.

Several studies on the impact of the "host country environment" when choosing a country for
travel/medical tourism have been conducted. These environmental concerns centre on the
county’s image. Prospective patients begin their search for a destination by using various Internet
information resources, followed by hospitals and medical specialties such as heart, dentistry,
surrogacy, and beauty, hip or knee replacement surgery. Various projects in the national context
Domestic medical tourism 4

implement this structure in the form of a fixed exchange rate, lack of corruption, and social
savvy.

2. The tourist destination of the host country.

Countries like Thailand, India, Malaysia, Dubai, Mexico, and Greece are the top destinations for
medical tourists. Potential medical tourists base their travel decisions on the tourist attractions,
image, trust, and safety of a country, as well as JCI-accredited healthcare facilities. Travel
prospects, travel health and welfare, lodging, the quality of name brand hospitals, certified
hospitals, similarity with the local language and culture, and connectedness with the non-English
language and culture are all examples of this.

3. Medical tourism expenses.

When prospective medical tourists seek information, they compare the cost of surgery and
overall savings potential, as well as travel and lodging expenses. (Burns, 2015) defines medical
tourism as “traveling abroad (sometimes to international centres of excellence) to greatly reduce
costs or (for those who travel to more modern nations) to improve the quality of obtaining
medical services one wishes to receive.” As a result, patients from developed economies who are
uninsured or underinsured travel to emerging countries in search of accessible health quality,
from which they can save lot of money, indulge in tourist destinations, and take vacations when
their health allows.

4. Medical tourism facilities and services.

People from other nations and U.S patients, particularly those traveling long distances or
crossing borders for surgery in Mexico, are concerned about the recognized quality of JCI
certification, clinical performance, surgeons, and hospital nurses in achieving positive medical
outcomes. American medical tourists are looking for good value for money in exchange for good
health care outcomes. Hospitals that attract medical tourists face the challenge of providing JCI-
certified medical services of comparable or higher quality to foreign patients. The Joint
International Commission (JCI) is a non-profit, tax-free agency headquatered in the United
States that was founded in 1998 that certifies healthcare organizations and programs and certifies
hospitals around the world. JCI requires Continuous Quality Improvement (CQI) for the
International Patient Safety Goals (IPSG), which is an important topic involving patient safety.
Domestic medical tourism 5

The goal of JCI certification is to evaluate organizations' care, standardize hospital procedures,
provide education, and promote CQI. JCI certifies medical services on a global scale and
advocates for practice and compliance with the CQI standard. Americans will keep travelling
abroad for treatment due to a variety of factors, chief of which is elevated quality of healthcare
procedures in other countries at a lesser cost.

(Johnson et al., 2015) says “The primary reason for inbound medical care to the United States is
to seek higher quality care than is available in one's home country.” The healthcare system in the
U.S. is widely regarded as among the most desirable for elevated tertiary and quaternary care.

Developing conceptual framework

In (Connell, 2006) it is described as a “distinct segment that has emerged from the expansion of
what has become an industry, in which people travel often far and wide to overseas countries to
get medical, dental, and surgical care while also being holidaymakers.” As a result of changes
occurring and growth in perceptions, medical tourism may become an innovative type of tourism
and an emerging market component. There is also a scarcity of research on medical tourism. This
is especially true when it comes to analyzing the characteristics and experiences of medical
procedure participants. Consumer demand is expected to vary depending on how medical
treatment and tourism are combined and integrated. Furthermore, it is expected that the factors
that consumers will consider imperative when engaging in medical tourism will vary depending
on their country of origin. As a result, what a consumer prioritizes when considering medical
tourism participation must be understood, as well as how they are different from each other as
this data can be critical in providing a proper analysis for the medical-tourism market.

According to the Guadalajara Convention & Visitors Bureau (CVB), there are “push” and “pull”
factors that influence medical travelers' decisions. Push factors are defined as factors that
encourage medical travelers to engage in medical tourism rather than accept what is currently
available to them. Push factors arouse a person's desire to travel, whereas pull factors assist that
person in selecting a destination that meets their needs. The demand for better health care is a
push factor. They primarily concern consumers and include socio-demographic or health-related
factors that drive demand for better health care. Pull factors, on the other hand, concentrate on
the medical tourism offer. They are closely linked to the destination for medical tourism, such as
the overall national environment, the country's hospitals and tourism industry and the quality of
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medical facilities and services rendered. These factors are critical in determining a patient's
decision to travel. The push-pull model as explained by (Walker & Walker, 2011) says “People
travel because they are pushed by internal, psychological forces and pulled by external forces of
destination attributes.”

The Medical Tourism Index

To understand such a complex trend and compare countries in a meaningful and manageable way
in a global and highly competitive environment, analysts frequently turn to composite indicators
or indexes provided by national or international institutions. An index is a quantitative,
qualitative, or mixed measure derived from numerous observations that shows countries' relative
positions for specific phenomena. Indexes are useful because they provide a simple number for a
complex phenomenon and allow for a relative objective comparison across countries. The
Medical Tourism Index is a four-dimensional construct. It evaluates these dimensions to
determine a country's attractiveness as a destination.

1. Country environment - A variety of factors influence a country's attractiveness. An

imperative factor is the country’s image. Without a good global image, attracting tourists in any
capacity would be indeed difficult. It can project both stability of the country while also
showcasing its beauty. Other factors on a county’s environment to consider are; how far it is
from your location. The further the more expensive it gets. Exchange rates can also be a factor to
consider and lastly socio-cultural factors. People prefer to go to places where there would be a
level of understanding between you and the native speaker.

2. Tourism destination - While on vacation, consumers frequently have to go for miles to

have a medical procedure done. A country's overall attractiveness has become a major factor in
choosing where to go get medical procedures. Countries known for their tourism industries have
now added state of the art hospitals so as to attract more tourists and keep the frequent fliers. An
example is a country like Malaysia. Once a premier tourist destination now home to some of the
best hospitals in the world and their services are considerably cheaper than the U.S and if a
patient needs time to recuperate, there are added benefits to the tourist industry, particularly the
hotel sector, which are significant
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3. Medical facilities and services – Research shows that patients who travel from
America for medical reasons have factors that they consider before deciding to go. The general
factor is how good the hospital and the doctors are. Another factor they consider is they type of
service given and how the staff treat the patients.

4. Medical tourism cost - The steadily rising hospital and medicine costs in the U.S, in
(Connell, 2006) view and a slew of other researchers, are fueling demand for medical tourism.
Cost is the most frequently cited reason for Americans traveling abroad for healthcare.

Practical implications

The MTI evaluates a country's potential to be a hub for health related tourists. Countries have
been putting in little effort in growing this market with the fear that they might lose money by
investing where there is lack of health consumers. Trying to market your country without proper
knowledge of what consumers are looking for will end up failing at that endeavor. MTI helps
countries understand consumer needs better allowing them to create plans that can draw in those
that looking for these services. These countries inability to define a medical tourist for the
purpose of measuring them, as well as the lack of statistical support for measuring the
effectiveness of promotional strategies, can be improved by different countries of origin using
the MTI over time and benchmarking with each other. A country working to develop a medical
tourism brand promotion plan may use the MTI to assess the country's view prior to and after
program implementation in order to determine its relevance and efficiency in a specific target
market. In this regard, the MTI allows for the assessment of the efficacy of such programs.
(Fetscherin & Stephano, 2016)

According to the evidence, access barriers, in specific, are a problem affecting US performance.
More, particularly those with long term illnesses, avoid hospitals due to cost when compared to
residents of other countries. Such attitudes, may reflect both underinsurance and no insurance,
may lead to poor health outcomes. (Berenson & Docteur, 2009) Despite this, research has shown
that America has among the best facilities, doctors and services in the world.
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trade*. International Journal of Healthcare Management, 8(1), 15–26.

https://doi.org/10.1179/2047971914Y.0000000091

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medical travel from the USA. Tourism Review, 74(3), 463–479.

https://doi.org/10.1108/TR-06-2018-0083

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https://doi.org/10.1016/j.tourman.2015.08.010

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Medical Tourism Magazine. (2021, June). Companies Search for Fixed Rate Surgeries.

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Walker, J., & Walker, J. (2011). Tourism: Concepts and Practices.

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