ITIC MENA: The rise of cross-border care in the GCC

Laila Al Jassmi, CEO & Founder, Health Beyond Borders

Looking first at drivers in demand for healthcare in the Gulf Cooperation Council (GCC), Laila cited a significant growth in population, with the elderly population in particular expected to grow to three times the current level, and a high prevalence of chronic diseases (cardiovascular diseases etc) among middle-aged people. Looking at healthcare spending, Laila showed the distribution of spending between the government, health insurance and out-of-pocket payments by individuals. “The largest burden on healthcare is borne by government spending in the GCC, with a growing share of private insurance in the KSA in particular,” said Laila. Furthermore, the rise in healthcare spending, supported by insurance penetration and inbound and outbound medical tourism, and the growing adoption of digital health solutions, means that opportunities for healthcare providers in the GCC is rising.

Challenges that must be overcome in order to maximise these opportunities, however, were identified as workforce shortages, a lack of physical infrastructure, poor technological facilities in rural areas, a lack of integration of healthcare systems, and a need for new investments in technology such as telemedicine and electronic medical records. “Medical city developments should act as a catalyse for the development of stronger health economies and to attract and develop a high-quality workforce,” Laia noted.

Key markets for GCC-based healthcare providers to target who are seeking medical tourists include South Asia and Iran, Russia and the Baltics, and North and East Africa. Western Europe and Scandinavia are viable targets, but more for wellness tourism, rather than for specific services.

Pre-Covid, approximately 100,000 UAE residents travel abroad for health services, of which 7,000 patients were UAE nationals whose medical travel was sponsored by the government. Patients being sent abroad were mainly seeking orthopaedics, oncology, paediatric sub specialties, long-term care and rehabilitation and cardiology treatments, said Laila. However, the number of cases referred abroad have been reduced significantly (50 to 70 per cent decrease) looking at data published by local authorities and patients are encouraged to visit health facilities in the respective country. Most of the patients travelling across the GCC countries are paying for their treatment out of pocket or through health insurance reimbursements.

Identifying ways in which challenges to the medical tourism market in the GCC can be overcome, Laila noted the importance of governments’ role in local investment in healthcare services, in particular on centres of excellence, collaboration between governments and medical tourism facilities, and regulation to ensure quality and consistency of services.

Factors impacting the patient choice in terms of destination for their care include appointment availability, the willingness of the treating doctor to listen to the needs of the patient, professionalism of medical staff, the convenience of having the consultation and diagnosis in one location, and the ability of a facility to cater to cultural and religious needs. The government’s role in developing a destination as a viable medical tourism hub is vital, said Laila, as there need to be ta incentives, policy regulation and working with the travel industry to ensure a smooth visa process and travel experience for patients. The issue of the availability of a skilled workforce is an ongoing challenge, concluded Laila: “Governments and their partners need to develop a balanced regulatory framework that reconciles the most adequate level of patient and practitioner protection to attract highly skilled healthcare professionals,” concluded Laila.

Christian Deloughery, International Business Development Europe, MENA and Asia, Penfield Care

Christian’s presentation focused on how to combat the rising cost of healthcare for individuals and insurers (private or government) paying for treatment in another country, considering how partnerships and a proactive and collaborative approach to patient management can result in cost savings. “Heathcare data,” said Christian, “is essential. Just imagine if you as a payer or user could choose, upfront, the best possible provider based on quality and cost, all the way down to the physician steering the scalpel.” Using data from the Centers for Medicare and Medicaid Services, Penfield has developed proprietary software that enables users to do just that. “Penfield Care Finder empowers patients and insurers to select their healthcare team,” said Christian. “Users can compare cost and quality against a number of physician specialists and facilities and maximise the value of their healthcare.”

Features of the software include physician and hospital bios, comparative analysis of physicians and facilities, number of cases per procedure, average provider cost by diagnosis-related group (DRG), and average provider charges by DRG. Christian then demonstrated the software, and showed savings that have resulted for users so far at the different stages of medical care. The overall average savings, he said, were 52.8 per cent. “Although Penfield is primarily a negotiations company, we do have access to over 35 national and regional preferred provider organisations throughout the US,” he told attendees. “Our networks include over 6,000 hospitals, 164,000 ancillary care providers, 1.2 million physicians and an extensive national Rx network.”