Baja California Medical Tourism Campaigns

By Janet Lavelle  - Hospital Angeles in Tijuana caters to medical tourists seeking lower cost procedures or treatments that aren’t performed in their home countries. For decades, U.S. residents have crossed the border in search of cheap dentistry, alternative health care and pharmacies providing easy access to prescription drugs. Now, health providers in Tijuana say they have much more to offer in the way of sophisticated medical office procedures and hospital care, and have created business groups aimed at getting that word out to U.S. consumers.

“In the past, the focus was on low cost. But in the last five years, doctors have been offering more complex treatments, hiring more bilingual personnel and doing more professional marketing,” said Flavio Olivieri, executive director of the Tijuana Industrial and Economic Development Corp. and cofounder of the Tijuana Medical Tourism Association.

The biggest draw still is low cost, medical tourism experts said, with fees for services such as dentistry, laser eye surgery, plastic surgery, cancer treatment and bariatric weight-loss procedures generally running 40 percent to 70 percent lower than in the U.S. Dental implants that may cost $2,800 north of the border can be as low as $800 in Mexico, while a $50,000 hip replacement in the U.S. could run $13,000 down south.

Olivieri said the marketing campaign is critical in helping Tijuana recover from a drastic drop in cross-border visitors. Long waits into and out of Mexico have traditionally been a problem, but crossings plunged in 2008 with the recession and a surge in drug-related violence in the Tijuana region, followed in 2009 by travel warnings when the H1N1 flu proved deadly in central Mexico.

“The market shrank overnight,” said Olivieri, a speaker on medical tourism Monday at Tijuana Innovadora, a two-week, $5 million conference aimed at boosting the international profile and economic clout of one of Mexico’s largest metropolitan areas.

Today, the flu is a vague memory and perception of Tijuana as a violent city held hostage by warring drug gangs is beginning to wane. Homicides dropped from a high of 844 killings in 2008 to 664 in 2009 and 638 as of last week, in part because of a coordinated crackdown by military and civilian authorities.

According to the Baja California Secretary of Tourism, about 250,000 people a month visit Tijuana for health products and medical services, most of them Californians.

Roughly 60 percent are Hispanics living in the U.S. The next largest group is people seeking alternative medical treatments, followed by “Anglo middle-income Americans” wanting high-quality yet low-cost care.

It’s the last segment that Mexican government and business groups are targeting, with the hope that more multi-day medical visitors will fuel the local economy.

The Baja tourism office, the Tijuana Convention and Visitors Bureau, and new medical tourism business groups in Tijuana, Mexicali, Rosarito Beach and Ensenada are working on promotional strategies.

“The expectation is that medical tourism is one of the most promising sectors in Baja California,” said Patrick Osio, vice president of the Baja California Medical Tourism Association, a San Diego-based nonprofit that promotes south-of-the-border medical services to Southern Californians. “(Practitioners) just haven’t known how to promote themselves.”

The 119-bed private Hospital Angeles focused on just such medical tourists when it opened in 2004, said business development director Carlos Zavala. The facility offers private rooms, a medical fitness center, an auditorium and gardens.

Seventy-five percent of patients came from the U.S. until more local people learned about the hospital, Zavala said. The numbers of U.S. inpatients has held steady at 100 to 150 per month, he said.

Most foreigners come for weight-loss surgeries — lap band, gastric bypass or gastric sleeve — although they also come for orthopedic, neurological and cardiac procedures.

The hospital is certified by the Mexican General Board of Health, and Zavala said it is seeking to raise its international standing by applying for accreditation from Joint Commission International, a branch of the Joint Commission, the largest hospital accreditation program in the U.S.

The hospital has gotten some foreign patients through medical tourism companies and has now formed its own company to offer travel, accomodations and other services to foreign patients.

Wouter Hoeberechts, chief executive of medical tourism company WorldMed Assist in Concord, said people often feel trepidation about the quality of care in foreign countries. He said he sends many patients to Hospital Angeles and Excel Heart Center in Tijuana.

“Part of our service is that we’ve personally visited each hospital, looked at hospital outcome data and physician outcome data,” Hoeberechts said. “We select the best of the best.”

Olivieri and others agreed that quality concerns need to be addressed, although exactly how is unclear. The Tijuana Medical Tourism Association may start collecting licensing and certification information on practitioners to give tourists, Olivieri said.

Related to quality concerns is that few U.S. insurance companies offer coverage in Mexico. Since insurers do their own quality assessments, coverage provides reassurance to both insured and cash patients.

Blue Shield, Health Net and Aetna contract with the Mexican health insurance company SIMNSA to offer HMO plans to California companies whose employees want to cross the border for health care. Coverage generally is restricted to providers in Mexican border cities. Delta Dental Insurance also provides coverage in the border region.

Dr. Juan Pablo Eng said gaining insurance coverage has made a tremendous difference in his DentiCenter practice. Eng opened his first dental office in Tijuana in 1991 to serve cross-border patients exclusively. Born and raised in Mexico, Eng is a University of Southern California-trained periodontist and a U.S. citizen living in Chula Vista.

“The biggest challenge in the beginning years was the lack of trust with insurance companies,” he said. Four years ago, Delta Dental and Aetna began offering plans with DentiCenter. Eng now has offices along the border from Tijuana to Reynosa, near the Gulf of Mexico.

Eng said his formula is to provide affordable, U.S.-style care within a short walking distance from a border crossing. He also offers packages that include transportation, hotel stay and other services.

“You have to have all the components in place to be successful,” he said, “and consistency is a must to keep the confidence of your patients.”





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