Visa restrictions and consumer confidence in the US will likely have a bigger impact on inbound medical travel than COVID-19 economic conditions, according to a report by the US Cooperative for International Patient Programs (USCIPP), and inpatient surgery will likely rebound first.
Speaking at Omnia Health Live in June 2020, USCIPP, a membership programme of the National Center for Healthcare Leadership (NCHL), provided a comprehensive insight into how post COVID-19 medical travel might pan out. Historical contexts and key factors shaping travel were taken into consideration when outlining possible implications.
The future is complex
Pre-COVID US international medical travel was strong - 60 percent of USCIPP members reported volume increases year-on-year.
In contrast, the future looks “complex”. USCIPP presented three possible scenarios for the emergence of new COVID-19 cases in the US: a second wave; more stable control; and local flare-ups with peaks and valleys.
To get a sense of what might happen to international medical travel after the pandemic, USCIPP looked to two specific historic events: 9/11 and the Financial Crisis.
After 9/11 overall tourist volumes took nearly 10 years to recover, but medical travel was even slower to recover, and by 2008 had not fully returned to 2000 volumes. The slow return of inbound travel to the US may be attributed in part to concerns about travel to the US, along with visa restrictions for residents from other countries.
Conversely, travel volumes recovered more quickly after the “Great Recession” of 2008-09. Both travel trajectories had begun to recover after 2010, maintaining growth until 2015. This was in line with general economic recovery across the world.
Recovery will be challenging
USCIPP provided an interpretation of these trends and used this as a basis to forecast post-COVID 19 medical travel. In short, recovery is expected to be “challenging”.
The present economic crisis may have a lesser impact on inbound medical travel once regional economies begin to recover.
The other COVID-19 implication is that consumer confidence about the US as a travel destination and visa restrictions are likely to have a bigger impact.
Many factors will have a say on how the recovery of international medical travel might be shaped, both on demand and supply sides.
They include the resumption of air and cruise travel, the relaxation of travel restrictions, and availability of vaccine and travel-related services, for example.
Other identified factors were hospital downsizing and debt, improved expertise for telehealth, and dramatically delayed diagnosis and care that will result in pent up demand by domestic patients – this will need to be addressed in the near future.
Data published by the Society of Actuaries shows that the services most relevant to international patients (those who are most frequently travelling) are also those with the greatest level of domestic pent up demand.
Barriers to utilising technology
With air travel not currently feasible for many international patients, USCIPP identified barriers to utilising technology for facilitating access to care, named in cultural/institutional, technical and legal areas.
There is a cultural paradigm shift, for example, to healthcare services that are telemediated, that must be accepted by providers. In addition, traditional payers for international patient care, such as international insurers, do not have a comprehensive system in place permitted the replacement of care previously delivered in person with distance health services.
An identified technical barrier meanwhile includes inefficiencies in scaling up and rolling out distance health services, owing to fragmentation in the number of platforms used by US hospitals to deliver services.
The importance of international healthcare collaborations
USCIPP emphasised that US hospitals with international programmes must think more broadly than simply focusing on inbound patient care in order to have viable programmes going forward, adding that it’s important to keep international partners engaged.
As examples of international engagement, USCIPP showed that international observerships are the dominant type of collaboration among its members (75 percent), followed by short courses in the US and international advisory/consulting services. Through international work, other countries working with US hospitals have substantially improved their healthcare services and are able to treat less complex cases at home.
Pre-COVID these relationships were highly prevalent among USCIPP members, and mostly concentrated in the MENA region with a large number also in East Asia. Relationship-building is likely to increase after the pandemic, as hospitals look to diversify.
View on demand
USCIPP Presents: Evolving trends and adaptive responses in the international medical travel industry featured USCIPP’s Callie Lambert, Dr Andrew N. Garman, Jarrett Fowler and Dr Tricia J Johnson, and can be viewed on demand here.