The document analyzes strategic marketing opportunities for medical travel from the US and Puerto Rico to Colombia in light of US health insurance reforms. Secondary research found that over 150,000 people traveled abroad for healthcare in 2010, with the top sources being Massachusetts, New Jersey, New York, Florida, and Texas. Primary research through consumer surveys and mystery shopping of competitors found that dental care, cosmetic procedures, and other non-traditional treatments have high demand. While competitors offer average customer service, there is an opportunity for Colombia to attract more medical travelers through superior English skills, communication, customer experience, and addressing misperceptions about the country.

1. Strategic Marketing Analysis
Medical Travel to Colombia from the US & Puerto Rico
Irving Stackpole
Stackpole & Associates, Inc.

2. Research Approach
–Secondary research – review of market
research & literature
–Insurance markets
• Review of ACA
–Primary research – consumer surveys
–Primary research – mystery shop
competitors

3. Overview of the Project
–Goals of the analysis
• Increase medical travel to Colombia
–The importance of international medical
travel to Colombia
• MT among the top strategic issues
• The potential of the US market
–Health reform in the US
• ObamaCare / Affordable Care Act (ACA)

4. ACA / ObamaCare – What is it?
–Insurance Market Reform
–Individual responsibility / “mandate”
–Subsidized insurance purchases

5. Pre-ACA Health Insurance
Health Insurance Coverage: 2010(Numbers in thousands)
Total
2010 306,110 256,206 195,874 169,264 30,147 95,003 48,580 44,327 12,849
Year
Total
people Employ't
based
Direct
purchase
Total Medicaid Medicare Military
Covered by private and / orgovernment health insurance
Private health insurance Government health insurance
Total
US Health Insurance Market

6. ACA – The Basics
–10 Titles (chapters)
• Title I: Affordable Coverage – HI market reforms
• Title II: Public programs – Medicaid and CHIP
• Title III: Improving quality & efficiency
• Title IV: Chronic disease & improve public health
• Title V: Health care workforce
• Title VI Transparency & program integrity –
• Title VII: Access to innovative medical therapies –
• Title VIII: CLASS (repealed)
• Title IX: Revenue provisions
• Title X Manager’s Amendment

8. ACA – The Basics
• Impact on covered individuals
• Employer based
• Group market
• Impact on individuals w/o HI
• Those who will remain uninsured

9. ACA – The Basics
• Impact on currently uninsured
• ~ 25 Million will obtain coverage
• Original est. – 32 Million
– Medicaid was to cover +16 Million
– States now may “opt out”

10. ACA – The Basics

11. ACA – The Basics
–Medicare & Medicaid – relevant
changes
•Medicaid – financial pressure
•Medicare - $500 Billion “haircut”
for hospitals

12. ACA – The Basics
–Likely effects –
•Health insurance premiums
•Medical/healthcare costs
•Minimum benefits plans (“mini
meds”)

13. Conclusions and
Recommendations
–Payers who may be open to
medical travel as a “disruptive
solution”

14. Conclusions and
Recommendations
–Consumers who will, and will not
–Who will remain uninsured?

15. Stackpole & Associates, Inc.

16. Conclusions and
Recommendations
–Likely best channel partners in
the post-ACA US market

17. Resultas
–Secondary Research:
• Sources of travel – healthcare
Massachusetts 2.40%
New Jersey 2.10%
New York 1.70%
Florida 1.20%
Texas 0.90%
California 0.80%
The top cities
New York City 13.0%
Los Angeles 4.0%
Houston 3.0%
Miami 3.0%
Washington D.C. 4.0%

18. Results
Secondary Research: Derived Numbers
2010
154,847
464,542
Combined US & PR Travel
(exc. land to CN +MX)
38,711,842
Purpose Int'l Healthcare
Main Purpose Int'l Healthcare

19. Stackpole & Associates, Inc.
15 million
~7 million
More realistic – 1.75 – 4.2

20. The research question…
–Who would travel to Colombia
•And why, for what?

21. Respondents
– Primary Research:

22. Results
– Primary Research: Respondents who had traveled to Latin America

23. Results
Primary Research: Respondents Interested in Traveling to Latin America

24. Results
– Primary Research: Received Healthcare Abroad

25. Results
– Primary Research:

26. Results
Primary Research: Types of treatments (check all that apply)

27. The Product Array
HighLow
HighLow
Frequency
Copyright © Stackpole & Associates, Inc.
Acuity / Frequency Curve – Medical Travel Utilization

28. Forced Choice Questions

29. Results
– Primary Research:
Rank Colombia % of Tot
1st 88 5.97%
2nd 118 8.01%
3rd 114 7.73%
4th 108 7.33%
5th 144 9.77%
6th 136 9.23%
7th 147 9.97%
8th 174 11.80%
9th 267 18.11%

30. Survey Research
Primary Research: Stackpole & Associates w/ CMTR
– Size of the target population / market
–The source locations - highly focused
–Demand for specific services
–Issue of national v. local brand
–Short term v. long term brand strategy

31. Results
Primary research: Mystery shopping of competitors
- Methodology
Identified strongest competitors
Selected: Brazil, Costa Rica, Dominican Republic, Mexico –
Cancun, Mexico – Puerto Vallarta, Mexico – Monterrey, Panama
Two representatives - Google search for top 3 providers in each
region for a total of six providers in each competitive market
Mystery shop examined:
Web sites
Telephone skills
Email responsiveness

32. Results
Primary research: Mystery shopping & competitive SWOT
Results: Customer experience offered by competitors is weak. Web sites
were slightly above average but telephone skills were fair and email
responsiveness was poor.
Web sites able to attract interested consumers but lack of telephone and email
skills prevents competition from converting inquiries into clients.
Major issues identified: Poor or no English skills; lack of communication –
weak telephone skills, lack of responses to voice messages/emails; lack of
information available; web sites that are indistinguishable.

33. Results – Websites

34. Telephone Skills
-
1,00
2,00
3,00
4,00
5,00
6,00
7,00
8,00
9,00
10,00
Brazil Costa Rica Dominican
Republic
Cancun Monterrey Puero Vallarta Panama
Overall telephone

35. Results – Email Overall
0
1
2
3
4
5
6
7
8
9
10
Brazil Costa Rica Dominican
Republic
Cancun Monterrey Puero Vallarta Panama
Overall email quality

36. Results – Mystery Shop
Primary research: Mystery shopping competitors
Recommendations:
Deliver a superior customer service by:
– Excellent English skills – clinical and non-clinical staff
– Integrated communication systems
– Distinctive web sites
– 24/7/365
– Measure customer service skills of staff and link to compensation

37. Conclusions so far…
Previously visited = more wiling to go for medical care;
Take care of your tourists and promote medical care to them
Build tourism sector in general
Competitors are delivering average to weak customer care
Opportunity to do better!
Measure your own efforts – Are you doing better than they are?
Improve the customer/patient experience
English!
Branding issues need work –
Today’s Colombia is not what US citizen’s
Minds need to be educated and changed.

38. A few bright spots - #1
• Targeted consumers in certain MSAs are
more willing than previously thought
–Ethnic Hispanic / Latino markets can
be reached w/ messages
–This segment spends freely on
personal appearance
–Growing segment (size & wealth)

39. Stackpole & Associates, Inc.
Where is Bogota??

40. A few bright spots - #2
Few w/ dental insurance; dental not part of
“Reform”
Out of pocket costs will still be high
Demand for Dental, Cosmetic and Non-
Traditional, Lifestyle Treatments and
Services will grow as population ages
(Millennials have perfect teeth)

41. A few bright spots #3