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Medical Tourism Outlook 2015

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1 What is Medical Tourism? Patients traveling to another country for medical treatment/services

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Medical Tourism Categories and Drivers 2 Surgical Dental MedicalInfertility Rehab Cosmetic Cosmetic surgery leads all other treatments, representing 38% of demand. Source: Medical Tourism Association Study 2013

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Most common procedures 3 Cosmetic surgery Dentistry (general, restorative, cosmetic) Cardiovascular (angioplasty, CABG, transplants) Orthopedics (joint and spine; sports medicine) Cancer (often high-acuity or last resort) Reproductive (fertility, IVF, women's health) Weight loss (LAP-BAND, gastric bypass) Scans, tests, health screenings and second opinions.

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The basics of Medical Tourism 4 Hospitals, Surgeons, Dentists and Doctors Accreditation for Providers Medical Tourism Providers The Patient Medical Tourism Medical tourists spend between $7,475 and $15,833 per medical travel trip. Source: Medical Tourism Association Study 2013

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OPPORTUNITY: A new type of branding for countries 5 Sample Markets Countries are now establishing themselves as experts in certain procedures and as a medical or wellness destination

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Top Countries for Medical Tourism - $30- 60B in incremental revenues 6 #1 Thailand 1.2 million patients Procedures 50-70% cheaper than US #2 Mexico 1 million patients Many from the US #3 United States 800,000 patients World class care #5 India 400,000 patients Complex operations are 90% less expensive than US #4 Singapore 610,000 patients 22 Certified Facilities Source: Bloomburg Top Medical Tourism Destinations

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7 BENEFITS: For your Countrys Economy Increase in spending on hotel, restaurants, transportation, spas and shopping Leveraging the skills of your medical professionals Incremental revenue for medical professionals, including a premium over what is charged to local residents

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Medical Tourism Trends 8

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TREND: Global healthcare is shifting 9 People used to travel from third world countries to more highly developed countries in search of qualityhealthcare.

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DRIVER: Cost is the new driver in Medical Tourism 10 In response to rising health care costs, patients are now traveling great distances to obtain quality care at lower cost. Nearly 80% of demand for medical travel is driven by cost savings. Source: Medical Tourism Association Study 2013

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INNOVATION: New providers are emerging 11 Sites like TreatmentAbroad.com help a patient find the right provider, giving them various choices and cost comparisons. Sites like hotelsbyhospitals.com helps a patient find accommodations near the hospital or clinic, for pre- and post- treatment or for their traveling companion.

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Global Impact of Medical Tourism 12

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13 The Medical Tourism Market is Significant $100 Billion USD global market - and growing If you are not currently measuring inbound medical and wellness tourism, we recommend modifying your international arrival surveys.

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What will drive growth? 14 $228 Billion USD In medical care predicted to leave the US

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15 Other growth drivers Aging world population and growing affluence Technology Sites that help patients find providers Improved search engines Sites that help book travel to the medical facility Patient blogs and social sharing Corporate health plans and employers providing assurance of safety by endorsement of medical tourism

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Case Study Israels Medical Tourism Growth 16 Since 2011, Israels medical tourism has more than doubled from $60 million USD to $137 million USD 30,000 patients expected in 2014

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Case Study: Taiwan 17 50% cheaper than the US Source: Patients Beyond Borders 90,000 medical tourists in 2014 22 certified health care facilities (just 2 fewer than China) Certified by US organization

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Case Study: Singapore 18 4 th most visited medical tourism destination 610,000 medical tourists in 2012 22 facilities certified by Joint Commission International

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Wellness Tourism is also growing 19 74% think wellness is going to become more important in the future 86% believe they have the power to change their own level of wellness 57% wish they had more say in leading a healthy life. that number skyrockets to 88% in China and is higher for 18-34 year-olds (61%) than 55+ (44%) 66% believe doctors should focus more on prevention The main goal of wellness tourism is to preserve or improve the mind, body and spirit Source: 2014 Medical Tourism Association Wellness Tourism Study

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20 Wellness Tourism Impact Wellness tourism accounts for about 14% ($438.6 billion) of all domestic and international tourism expenditures. Wellness tourism generates 11.7 million direct jobs, delivering $1.3 trillion of global economic impact (1.8% of global GDP in 2012). Source: The Global Wellness Tourism Economy 2012. Stanford Research Institute

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Top Wellness Tourism Services 21 Beauty treatments Sport & fitness services Leisure and recreational spas Spa & wellness resorts Wellness tourism is projected to grow on average 9.9 percent annually over the next five years, nearly twice the rate of global tourism overall, reaching $678.5 billion by 2017, or 16 percent of total tourism revenues. Source: Medical Tourism Association Study 2013

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Research Distribution Regional Cooperation Accreditation Marketing &Promotion Insurance Partnerships Development and Cooperation Opportunities 22

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How to become a world class leader in Medical and Wellness Tourism? 23 World Class Leader Assess Assets Get Accredited Model Success Promote to top Inbound Markets

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Key Success Factors 24 Investment in Healthcare Infrastructure Commitment to Quality and Transparency International Patient Flow (Marketing) Clear Cost Savings on Key Procedures Political Transparency and Social Stability

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Additional Factors 25 Excellent Tourism Infrastructure Reputation for Clinical Excellence History of Innovation and Achievement Best Practices and State of the Art Technology

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26 The Industry is young and data are scant We need to know more! Research on Patient Satisfaction Research on Patient Care MARKET RESEARCH Understanding Destination Choice for Medical Procedures

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+ Thank You! Laura Mandala, Managing Director www.mandalaresearch.com 5108 Belle Meade Lane Alexandria, Virginia 22311 Phone +1 703-820-1041 Laura@MandalaResearch.com 27