1. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Opportunities in Medical Tourism & Health and Wellness for Las Vegas Jonathan Edelheit CEO- Medical Tourism Association MedicalTourismAssociation.com | MedicalTourismMag.com | HealthTourismMagazine.com

2. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Medical Tourism Association The Medical Tourism Association advocates creating a transparency in the medical tourism industry in quality of care and pricing so patients know exactly what quality of care they are receiving and what they are paying for such care. Transparency in Quality & Pricing The MTA creates a forum for communication amongst all of the players in the medical tourism industry, allowing competitors to work together for the first time to promote their country or region first as a medical tourism destination. Communication The MTA provides education to patients, insurance companies, employers and new players in the medical tourism industry about all of the issues involved in medical tourism ~ legal, economic, accreditation, best practices, strategic marketing Education

3. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association MTA Platforms & Activities MTA Membership MTA Congress Medical Tourism Magazine Health Tourism Magazine Webinars Familiarization Trips Quality of Care Projects Certification programs Promotional Programs Research and Survey Consultancy Programs

4. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association About the Medical Tourism Association Only Non Profit Association in Medical Tourism Industry Offices and Representatives in over 10 countries Working in over 90 countries Approximately 300 members across the globe Over 120,000 Global Readers of our Publications

5. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association MTA Platforms & Activities MTA Membership MTA Congress Medical Tourism Magazine Health Tourism Magazine Webinars Familiarization Trips Quality of Care Projects Certification programs Promotional Programs Research and Survey Consultancy Programs

6. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Medical Tourism Magazine Through the Years

7. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Medical Tourism Destination Guides The destination guides are an exclusive focus on a destination, country or city with detailed information about the quality of healthcare in the destination and the healthcare infrastructure found in that region. The guide will include information on hospitals, clinics, medical spas, wellness centers, hotels and tour operators for patients. It will also feature tourism information for patients with full color photos. This will help you pursue your expectations for a particular medical tourist destination.

8. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Medical Tourism Definition People traveling from one country to another for medical treatment based upon the perceived personal value. Affordability, Accessibility, Availability Quality Perception of Tourism Value

9. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Terminology Medical Tourism Health Tourism Healthcare Travel Medical Travel Medical Value Travel Wellness Travel Health & Spa travel Patients traveling out of a country Outbound Patients coming into a country Inbound Patients traveling within a country Intrabound Organization / Agency providing support services to the patient Facilitator

10. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Global Struggling Healthcare US High Cost Uninsured Population Canada High waiting time Shortage of healthcare resources Europe Aging Population Shrinking Revenue UK Lack of Private Participation High waiting time Japan Baby Boomers Over Hospital Stay Africa Lack of Appropriate Healthcare Services Lack of Quality HealthCare Services GCC Population Growth Chronic and Affluent Disorder Genetic Disorders

11. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Key Factors for Global HealthCare Crises High Cost of Services in Developed WorldLack of Availability of Healthcare Services in Under Developed WorldNeed of Better Healthcare Services in Developing WorldBaby Boomers and Ageing PopulationLack of Healthcare Professionals WorldwideHigh Pharmaceutical Cost ( Research and Trade Mark Expenses)High Malpractice CostHigh Documentation and Accreditation costLack of Preventive Measures Worldwide

12. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Baby Boomers (US Study) The number of Americans aged 65 or over will double by 2050The number of people age 85 or over will quadruple by 2050By 2030 over half of U.S. adults will be over age 50The over 65 population will nearly triple as a result of the aging Boomers.More than six of every 10 Boomers will be managing more than one chronic condition.More than 1 out of every 3 Boomers – over 21 million – will be considered obese.One out of every four Boomers – 14 million – will be living with diabetes. Nearly one out of every two Boomers – more than 26 million – will be living with arthritis. 8x more knee replacements will be performed in 2030 than today. Reference: ~ A joint report from First Consulting Group and the American Hospital Association, titled “When I'm 64: How Boomers Will Change Health Care.”

13. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association The Global Shortage of Healthcare Workers Fifty-seven countries face a severe health workforce crisis. WHO estimates that at least 2,360,000 health service providers and 1,890,000 management support workers, or a total of 4,250,000 health workers, are needed to fill the gap. Without prompt action, the shortage will worsen.

14. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Medical Tourism Drivers & Factors Medical Tourism AffordabilityAvailabilityAccessibility Quality of Care Additional Benefits Increased Global Access, Affordable Transport Globalization of Workforces Acceptance by Employers & Health Plans Global Establishment of Quality Standards Increased Demand for Cosmetic and Dental Procedures Increased Demand for Medical & Surgical Procedures

15. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Who will use Medical Tourism? Developed World Travel for Affordability Travel for Accessibility Developing World Better Healthcare or High end Healthcare Affluent will Travel for Better and Privileged Healthcare Under Develop World Travel Because of Lack of Healthcare Affluent will Travel for Better Healthcare

16. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Cost Saving in Medical Tourism Knee Replacement (2009 survey) USA India Thailand Singapore Costa Rica Mexico Korea Turkey $50,000 $7,000 $10,000 $11,100 $11,000 $12,000 $24,100 $13,000

17. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Cost Saving in Medical Tourism Heart Bypass (2009 Survey) USA India Thailand Singapore Costa Rica Mexico Korea Turkey $130,000 $9,000 $11,000 $16,500 $24,000 $22,000 $34,150 $17,000

18. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association What Services they seek? Hips, Knees, Back and Spine Orthopedics Diagnostics, Cyberknife, Stem Cell Cancer Treatment Angioplasty, Bypasses, Valve Replacements, Stem Cell Heart Procedures Liver, Kidney, Lung Transplants Implants, Veneers, Crowns Dental Treatment Lap Band, Gastric Bypass, Gastric Sleeve Bariatric Surgery Acupuncture, Preventative, Homeopathy, Indigenous Alternative Annual Comprehensive Testing Executive Health Checkups Face Lifts, Breast Implants, Corrective Cosmetic Surgery IVF, Fertility, Hormonal Disorders Infertility Treatments Acute and Chronic Conditions, Geriatric Care Rehabilitation & Geriatric

19. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Medical Tourism a Growing Phenomena Worldwide

20. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association US Medical Tourism Trend & Forecast Deloitte Study 2009 ~ Recession Adjusted Forecast 2007 2008 2009 2010 2011 2012 Number of Patients 750,000 540,000 648,000 878,000 1,283,000 1,621,000 Forward -20% -10% 20% +35% +35% +35% Growth Rate USA Today puts Medical Tourism as one of the Top Ten Growing Trends

21. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association 29% Americans will travel for Medical Tourism Gallup Poll May, 2009 5050 Americans Polled Up to 29% of Americans would consider traveling abroad for medical procedures such as heart bypass surgery, hip or knee replacement, plastic surgery, cancer diagnosis and treatment.

22. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association 62% of Canadians will travel for Medical Tourism Deloitte 2009 Poll Canadians Polled Up 59% of Canadians would travel outside of Canada for an elective surgery if it was paid for, 62% would travel outside of Canada if it was paid for and necessary.

23. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Gallup Poll ~ Quality Assumption

24. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Gallup Poll ~ Insurance

25. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association How a Patient Decides upon Medical Tourism

26. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Quality of Care Circle Quality of Care The First Response The Decision Transition to Treatment Delivery of Promise Recovery & Post Op Care Recovery & Long Term Outcome Monitoring Communication of Risk & Informed Consent Transfer of Medical Records Diagnostic Assessment & Pre Op Testing Confirmation of Nature & Scope of Treatment Continuum of Care Post-Operative

27. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Role of Facilitator Travel Airline Local Transport Healthcare Identification Price Negotiation Monitoring Quality of Care Tourism / Concierge Translators Personalized Services Representative Tourism related arrangements Documentation Legal Documents Patient Records Reports Claim Submission and Reimbursements

28. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Role of Hotels Package Transparent Pricing Services Modifications Dietary / Menu Privacy Nursing Support Entertainment Tourism / Concierge Translators Personalized Services Appropriate Tourism Transportation Communication Sensitizing Staff Communication Training Coordinated Emergency Response

29. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Why Las Vegas Can Play an Important role in the growth of Medical Tourism High Quality Healthcare Perception of The Destinatio n Tourism Benefits Affordable Healthcare Las Vegas Medical Tourism Opportunity

30. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Brand Challenge to Establish a strong Brand among other well known Destinations Language The perception of Las Vegas and being able to accommodate other languages Healthcare Quality Demonstrating and Exposing Healthcare, Wellness and Spa advances Marketing Developing Marketing Strategies in target Market Unified Approach Bringing Public & Private Sector together for unified approach Key Challenges for Las Vegas

31. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association How Las Vegas can establish Brand name in Medical Tourism & Health and Wellness Focus on Quality Healthcare Implementation of Accreditation or certification Quality Developing Value for Money Strategies Developing Competitive Price Strategies Price Develop Sound Support System with the help of government bodies Support System To develop International and Domestic Patient Departments in Healthcare Facilities International Patient Care Affiliation with Reputed International Association Affiliation By developing and implementing a unified marketing plan at the national level and working towards one objective Unified Marketing

32. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Advantages of Las Vegas Already has a focus on hospitality and customer service Already has a brand for tourism Has Reputation for spas Wellness, Spas, Checkups, Dental Is Major Conference location International Destination for Foreigners Now just need to turn that into: Partnering with travel agencies for health and wellness Building the brand for healthcare

33. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Definition of Healthcare Cluster “A healthcare cluster is an association of leading hospitals, clinics, providers, hotels, tourism operators and government officials who are working together to promote their services and location to medical tourists.”

34. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Benefits of Healthcare Clusters  Creating Credibility  Budget  Power in Numbers  High Standards and Qualifications (Putting Rules in place on who participates)  Control over Reputation  International Organization Support  Assistance in Marketing  Alternative Funding

35. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Cluster Examples Houston, Texas Miami, Florida Jacksonville, Florida Monterrey, Mexico Chihuahua, Mexico Sonora, Mexico Baja, Mexico Costa Rica El Salvador Guatemala Korea Singapore Germany Malaysia Turkey Jordon Recife Brazil Porto Alegre Brazil Medellin Colombia Many other countries to come (Egypt, Israell)

36. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Global Health Insurance Policies Most have multiple different levels, with rich plans allowing for coverage outside the country and in the US Many patients want to come to US because of reputation International insurers in future will figure out ways to encourage patients not to come to the US – centers of excellence International Insurers all renting major insurers networks, ie Green Crescent Insurance Company – UAE – renting UHI network

37. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association First Starters in Medical Tourism Medical Tourism Aetna Wellpoint BCBS Swiss ReEmployersUS NowBCBS - SC

38. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association How Employers/Insurance Co’s Provide Incentives for Medical Tourism Waiving Deductibles/Coinsurance Example - $2,500 Deductible for Surgery and 20% coinsurance up to maximum out of pocket of $7,000. Paying for all expenses (travel, hotel, etc) for an employee and a loved one. In some cases giving cash incentives or extra vacation days. Employee saves thousands of dollars, in some cases make a profit. Even with employers providing an incentive to employees there is still potentially over 80% in savings.

39. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Domestic Medical Tourism Growing Segment of industry Patients Traveling within the US to other cities/regions for healthcare Doing on Individual Basis, but also Corporate Lowes-Cleveland Clinic

40. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association How to Increase Your Patients Cost, Quality and ability to speak the patient language Need to listen to the patients Follow up consistently via phone, email, and more. Be aggressive with your communication. Many clinics/hospitals fail with this. Assist with travel arrangements. Quote in the patients home currency if you can. Have a great website. Be transparent with your quality and pricing Referrals and Word of mouth advertising is extremely important.

41. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Marketing Myths & Failure  Many Hospitals/Clinics fail when it comes to marketing to patients.  Create a pretty glossy brochure  Can’t just open your door and think patients will come.  Can’t just build a website and think patients will come.  Can’t just partner with one company for referrals and think the patients will start to come.  Can’t just attend one conference and think people will come.  Can’t think people will come.

42. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Actively Marketing  Need to actively market aggressively and have a strategic marketing plan.  Need to know what region/patients you want to attract and how you will market to those patients.  Need to make sure for every patient that comes they have an amazing experience, - word of mouth marketing. If they don’t you won’t get patients.  Need to create tie-ups, business relationships with medical tourism companies/facilitators, Travel Agents, and insurance companies.

43. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Don’t Wait – It can take years to build a brand Marketing, Marketing, Marketing You have to get aggressive to start promoting and branding Las Vegas and Nevada Cannot wait until you have all the “pieces” of the puzzle fitting together perfectly.

44. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Value of Medical Tourism/Health and Wellness for Las Vegas Costa Rica found that Medical Tourists Spend 5 X the amount of normal tourists in the local economy. Almost 85% Medical Tourists travel with a companion and both will stay on average 2 -3 weeks in Las Vegas Both will spend a lot in Las Vegas but Companion will be spending even more.

45. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Las Vegas Health and Wellness Destination Guide

46. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association The Las Vegas Health and Wellness destination guides will have an exclusive focus on a Las Vegas with detailed information about the quality of healthcare in the destination and the health and wellness available in Las Vegas. The guide will include: Information on hospitals, clinics, medical spas, wellness centers, hotels and tour operators for patients. It will also feature tourism information for patients with full color photos. This will help you pursue your expectations for a particular medical tourist destination. Tourism Information for Patients and their Companions during their medical stay Expectations of patients and companions when traveling to specific countries and cities Full Color photos of the hospitals and tourism opportunities unlike other industry guides

47. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association Almost 90% of patients gather information on healthcare online People will travel to where they are “comfortable” traveling to – Where they can get information People need to be comfortable about Las Vegas Healthcare Quality and Commitment. Las Vegas Health and Wellness Guide will be available for patients to view online at www.medicaltourism.com for free. www.medicaltourism.com Why is the Healthcare Guide to Las Vegas so Important?

48. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association MTA Annual Convention

49. Medical Tourism 101 – Renee Marie Stephano – Medical Tourism Association MedicalTourismAssociation.com | MedicalTourismMag.com | HealthTourismMagazine.com Thank You Renee-Marie Stephano, Esquire President - Medical Tourism Association Editor - Medical Tourism Magazine Editor - Health Tourism Magazine Jonathan Edelheit CEO - Medical Tourism Association