Difference between revisions of "Offshore Health Solutions"
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=The Market= | =The Market= | ||
+ | |||
+ | American consumers are the prime growth force behind medical tourism. As many as 750,000 | ||
+ | sought offshore medical care in 2007, spending an estimated $2 B. | ||
+ | |||
+ | ==Current Healthcare System== | ||
+ | US health care spending continues to rise at the fastest rate in history. | ||
+ | |||
+ | In 2007, total national health expenditures increased 6.9 percent — two times the rate of | ||
+ | inflation. Total spending was $2.3 T in 2007, or $7600 per person. Total health care spending | ||
+ | represented 16 percent of the gross domestic product (GDP). | ||
+ | |||
+ | U.S. health care spending is expected to increase at similar levels for the next decade reaching | ||
+ | $4.2 T in 2016, or 20 percent of GDP. | ||
+ | |||
+ | In 2007, employer health insurance premiums increased 6.1 percent - two times the rate of | ||
+ | inflation. The annual premium for an employer health plan covering a family of four averaged | ||
+ | nearly $12,100. The annual premium for single coverage averaged over $4,400. | ||
+ | |||
+ | Experts agree that our health care system is riddled with inefficiencies, excessive administrative | ||
+ | expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These | ||
+ | problems significantly increase the cost of medical care and health insurance for employers and | ||
+ | workers and affect the security of families. | ||
+ | |||
+ | ==Business Drivers== | ||
+ | The number of Americans heading abroad for medical procedures is surging as domestic medical | ||
+ | costs reach unaffordable levels. Mexico has long attracted American travelers looking for cutrate cosmetic surgery or dental work, and countries like India, Malaysia, Thailand and the | ||
+ | Philippines continue to lure medical tourists as well. Last year, India attracted 150,000 medical | ||
+ | tourists from the United States, Britain, Africa and elsewhere in South Asia, largely by offering | ||
+ | an enticing trio of advantages: highly trained English-speaking doctors, quick appointments and | ||
+ | bargain-basement prices. | ||
+ | |||
+ | The benefits of medical tourism are compelling. | ||
+ | *Potential Savings - The driving force behind the medical tourism market is the potential | ||
+ | cost savings. For those without insurance or those needing operations that insurance | ||
+ | won't cover, medical tourism can be an affordable alternative to the skyrocketing costs of | ||
+ | health care. Costs for major surgeries in the United States can run into the hundreds of | ||
+ | thousands of dollars while the same surgery in a country like India or Thailand can be as | ||
+ | little as a tenth of that. | ||
+ | *Shorter Waits - Even people who live in countries with public health care coverage (UK | ||
+ | and Canada) often choose to take their treatment abroad as overburdened hospitals and | ||
+ | doctors can have long waiting periods for surgeries on conditions that are not lifethreatening. | ||
+ | *Quality - Many of the countries where medical tourism has become popular have made | ||
+ | significant investments in the industry to ensure that patients are happy and healthy. | ||
+ | Many doctors have been trained abroad, and some are leaders in their fields. | ||
+ | *Relaxing Recovery - Traveling for medical treatment offers the added benefit of a | ||
+ | relaxing vacation while in recovery. | ||
+ | *Growing Insurance Coverage - An increasing number of insurance providers are | ||
+ | offering coverage for foreign medical alternatives provided that it isn't an elective | ||
+ | procedure. | ||
+ | *Bring Friends and Family - Because of the significant cost savings on treatment abroad, | ||
+ | it is often possible to bring others along and still spend less. | ||
+ | *World Class Facilities and Equipment - With medical tourism growing rapidly, | ||
+ | hospitals are making big investments in equipment and technology to help them draw | ||
+ | more patients. | ||
+ | *Package Deals – Several companies specialize in providing patients with not only their | ||
+ | treatment, but vacations afterwards, travel to and from the airport and all of the | ||
+ | accommodations needed. | ||
+ | *Surgical Options - While the most popular options with medical tourists are cosmetic | ||
+ | and dental surgeries, there is a growing market for a wide variety of procedures including | ||
+ | heart surgery and orthopedic hip and knee replacements. | ||
+ | *Luxury Accommodations - Many hospitals that cater to medical tourists are corporately | ||
+ | owned and therefore are in staunch competition with other hospitals to draw you in to | ||
+ | their facilities. | ||
+ | *Service - Patients can usually expect a high level of personal care and attention from | ||
+ | hospitals and clinics that are popular with medical tourists. | ||
+ | *Travel is Affordable - While fuel costs have risen in the past few years, air travel is still | ||
+ | an affordable and relatively convenient way to travel. | ||
+ | |||
+ | ==Facts and Figures== | ||
+ | In the United States, an estimated 49 MM people are without health insurance and 120 MM are | ||
+ | without dental coverage - numbers that are both expected to grow. Countries like Britain and | ||
+ | Canada have public health care systems plagued by long waiting lists for most major surgeries. | ||
+ | This stimulates the need for foreign health care alternatives. | ||
+ | |||
+ | In addition, the high cost of the U.S. health care system has put many US businesses at a | ||
+ | competitive disadvantage with foreign firms. The US automotive industry is the poster child for | ||
+ | the dilemma posed by high employee medical costs: GM, Ford, and Chrysler's medical costs | ||
+ | amount to $1,000 to $1,500 per sold car, which greatly exceeds the medical costs for Japanese, | ||
+ | Korean, and European competitors. Simply put, countries such as India, Thailand, Mexico, and | ||
+ | Costa Rica can provide equivalent healthcare treatment at much lower prices than in the United | ||
+ | States. | ||
+ | |||
+ | The cost of surgery in India, Thailand or South Africa can be one-tenth of what it is in the United | ||
+ | States or Western Europe, and sometimes even less. A heart-valve replacement that would cost | ||
+ | $200,000 or more in the U.S., for example, can be had for $10,000 in India--and that includes | ||
+ | round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth | ||
+ | $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days of physical | ||
+ | therapy costs about one-fourth of what it would in the States, and Lasik eye surgery worth | ||
+ | $3,700 in the U.S. is available in many other countries for only $730. Cosmetic surgery savings | ||
+ | are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South | ||
+ | Africa. | ||
+ | |||
+ | Faced with surging global popularity, numerous countries are creating options for this lucrative | ||
+ | market including: Argentina, Costa Rica, Cuba, Jamaica, South Africa, Jordan, Malaysia, | ||
+ | Hungary, Latvia and Estonia. | ||
+ | |||
+ | ==Future Outlook== | ||
+ | Employers make a push for 'medical tourism' | ||
+ | |||
+ | U.S. health care costs have gotten so outrageous that some small employers save money by | ||
+ | flying workers to foreign countries for inexpensive medical procedures. | ||
+ | |||
+ | Until recently, medical tourists were mostly individuals seeking low-priced cosmetic and elective | ||
+ | surgery not covered by insurance. But more than one million Americans will travel overseas for | ||
+ | procedures this year, and a rising proportion are getting insurers or employers to pay part of the | ||
+ | cost. | ||
+ | |||
+ | While global medical tourism has yet to make major inroads with U.S. employers, some small | ||
+ | employers and benefit providers such as BlueShield and BlueCross are starting to take the idea | ||
+ | seriously. Experts predict that the medical tourism industry will grow to $40 B by 2010. | ||
+ | |||
+ | Medical tourism will grow regardless of possible U.S. universal health | ||
+ | plan. | ||
+ | |||
+ | While president Obama is calling for a universal healthcare system, experts predict the adoption | ||
+ | of a universal health plan will not affect medical tourism. The industry will continue to grow for | ||
+ | the same reasons it is growing in countries like UK and Canada. | ||
+ | |||
+ | The demand simply outstrips the supply. Medical tourists will continue to use foreign alternatives to avoid long waiting periods, and save on costly elective procedures that are not covered by any healthcare plan. | ||
+ | |||
+ | Insurance companies are beginning to embrace ‘Medical Tourism.’ | ||
+ | |||
+ | According to David Boucher, an assistant vice-president of health-care services at Blue Cross & | ||
+ | Blue Shield of South Carolina, Blue Cross and other insurers would like to see more | ||
+ | policyholders traveling abroad for medical care. “As healthcare costs continue to rise in the U.S., | ||
+ | medical travel is going to be part of the solution.” | ||
+ | |||
+ | Like manufacturing facilities and call centers, health care is moving offshore. According to | ||
+ | Jonathan Edelheit, president of the Medical Tourism Assn., “All of the largest U.S. insurers are | ||
+ | starting to educate themselves or are putting [offshore] programs in place.” | ||
+ | |||
+ | Insurance companies could waive all deductibles and co-pays, offer to cover travel costs for the | ||
+ | patient and family members, even throw in a cash incentive, and still save tens of thousands of | ||
+ | dollars. | ||
+ | |||
+ | Blue Cross took the lead in medical “offshoring” when its Companion Global Healthcare | ||
+ | subsidiary formed its first partnership, with Bumrungrad Hospital (Bangkok, Thailand), in | ||
+ | February 2008. Since then, Companion Global Healthcare has signed similar pacts with the | ||
+ | Parkway Group Healthcare, owner of three hospitals in Singapore, and with hospitals in Turkey, | ||
+ | Ireland, and Costa Rica. Three members of India's Apollo Hospitals Group are also joining the | ||
+ | network. And another large Indian chain, Wockhardt Hospitals, is working with U.S. insurers as | ||
+ | well. | ||
+ | |||
+ | Charles Cutler of Aetna notes that the savings for his firm are not as great as they may be for | ||
+ | some others, since it gets volume discounts from American hospitals thanks to its size. Travel | ||
+ | abroad for Aetna’s clients makes sense only for procedures costing $20,000 or more, which | ||
+ | might include heart and orthopedic surgeries. He remains bullish, observing that quality at the | ||
+ | best foreign facilities can be much better than at the average American hospital, thanks to greater | ||
+ | transparency and better information technology. He thinks this is inspired by the Asian hospitals’ | ||
+ | need to market to a skeptical foreign audience. | ||
+ | |||
+ | ==The Booming Cruise Ship Industry== | ||
+ | The Cruise Industry is the fastest growing sector of the Travel Industry. Its economic benefit to | ||
+ | the US economy was estimated at $35.7 B in 2006. An estimated 12.5 MM people took a cruise | ||
+ | in 2007; up nearly half a million from 2006. | ||
+ | |||
+ | The number of new ships continues to grow, reflecting optimism about the future. Nearly 40 | ||
+ | ships were built in the 1980s; nearly 80 in the 1990s, and roughly 100 new ships will have been | ||
+ | introduced since 2000. Additionally, there are an increasing number of small niche operations, | ||
+ | catering to more specific markets. Overall, the market is by no means exhausted; only about 17 | ||
+ | percent of US adults have taken a cruise. | ||
+ | |||
+ | The average cruiser is now 49 years of age, down from the stereotype "older" market of the past. | ||
+ | Average household income of cruisers is $104,000. Florida, California, and Texas are the big | ||
+ | three states for cruise patrons. | ||
+ | |||
+ | ==Cruise Vacation as an Ideal Solution for Recuperation== | ||
+ | Increasingly, medical tourism operators are emphasizing the vacation aspect of the medical | ||
+ | tourism excursion to lure patients to their facilities. By way of example, some destinations in Africa offer safaris, a few in Thailand offer jungle excursions, and several in India provide daytrips to the Taj Mahal. | ||
+ | |||
+ | In recent years the cruise experience has become increasingly luxurious. Major cruise lines now | ||
+ | offer larger rooms, bigger beds, and marble lined bathrooms. In addition, many staterooms now | ||
+ | include butler services. | ||
+ | |||
+ | The newest addition in cruise line luxury is the spa-focused retreat. Carnival Cruises is | ||
+ | introducing the line's first spa staterooms, with private access to a luxurious 6,400-square-meter | ||
+ | spa. Cruises have become the ideal recuperation experience; with therapeutic spas, world-class | ||
+ | entertainment, and 5-star dining, surrounded by the calm of the sea. | ||
+ | |||
+ | Cruising is considered to be one of the most comfortable holiday options. Compared with other | ||
+ | types of vacations, cruising has the highest percentage of extremely satisfied customers (45%), | ||
+ | outpacing all-inclusive resorts (42%) and visiting friends and relatives (40%). 82% of cruisers | ||
+ | gave the industry high marks and ratings fell in the ‘very’ satisfied and ‘extremely’ satisfied | ||
+ | categories. Moreover, the comfort level associated with cruising is also high as compared with | ||
+ | other vacation alternatives. About 57% of respondents in a survey stated that cruises are superior | ||
+ | to other types of vacations in terms of overall pampering, and about 52% of people rated it as the | ||
+ | most luxurious vacation option. | ||
==Economics== | ==Economics== |
Revision as of 15:23, 6 April 2012
Contents
- 1 Abstract
- 2 Business Summary
- 3 General Franchise Description
- 4 Franchise Overview
- 5 The Market
- 6 Operational Plan
- 7 Management and Organization
- 8 Financial Model
- 8.1 Start up costs and capital projection
- 8.2 Break even
- 8.3 Cash flow
- 8.4 Return on investment
- 8.5 Unit economics
- 8.6 Franchisor economics
- 8.7 Projected rate of growth for the franchise system
- 8.8 Projected rate of growth for company-owned system
- 8.9 “Cost out" of each material operational, training, legal and marketing obligation included in legal documents
- 8.10 Define what needs to be measured and reported
- 8.11 Assess and determine exit strategies
- 8.12 Threshold Analysis
- 8.13 Gap Analysis
- 8.14 Competitive Analysis
- 8.15 Assessment of each available route to market
- 8.16 Fees
- 8.17 Description of the financial risks and advantages of the expansion models selected
- 8.18 Financing Programs
- 9 Unit Financial Plan Format
- 10 Exhibits
- 10.1 Brochures and advertising materials
- 10.2 Industry studies
- 10.3 Blueprints of vessels
- 10.4 Wave maps of location
- 10.5 Magazine or other articles
- 10.6 Detailed lists of equipment owned or to be purchased
- 10.7 Copies of leases and contracts
- 10.8 Letters of support from future customers
- 10.9 Any other materials needed to support the assumptions in this plan
- 10.10 Market research studies
- 10.11 List of assets available as collateral for a loan
- 11 See also
- 12 Guiding principles
Abstract
Business Summary
General Franchise Description
Offshore Health Solutions is a global franchise of medical and research facilities located aboard oceangoing vessels and seasteads. Medical procedures are conducted in international waters to avoid unnecessary red tape, and to allow increased availability of health alternatives at a lower cost in an environment of practical consumer-based accountability and service.
Mission Statement
To facilitate advanced and state-of-the-art health and medical services with the highest standards of quality at a significantly lower cost by capitalizing on offshore provision, international competition, and market-based regulation.
Franchise Goals
1) Providing access to alternative care that would otherwise be highly regulated - with an initial focus on less controversial treatments and procedures. Allow the marketplace to prove itself as the best regulator.
2) Lowering the cost and increasing the quality of provision of medical services by allowing greater competition among providers. Medical tourism is driven mostly by the lower cost of foreign medical care for comparable treatment.
3) Granting insurance companies a greater role in the evolution of offshore medical practices and in directing the finance of medicine. Any factor determined to be quantitative by actuarial science is the natural basis for pricing - including lifestyle, genetics, preexisting medical conditions, demand, &c.
Franchise Objectives:
1) Complete a pilot unit on an existing vessel and cruise line within the year.
2) Initiate the franchise with three vessels (one franchise unit per vessel), one Master Franchisee, and one Area Representative within a year after the pilot.
3) Allow Master Franchisees to expand the number and scope of sub-franchisees with a maximum of two each until three Master Franchisees, and then allow additional Master Franchisees. Each will be limited to forty nine percent of the number of patients served and to twenty one percent of the total cost of each type of procedure conducted within the franchise (including follow-up, recuperation, and other settlement) after the sub-franchisee is added.
4) Support franchisees in the purchase and operation of vessels or in establishing or expanding to stationary or floating SeaSteads.
Business Philosophy:
1) Offshore Health Solutions will offer the ultimate price-quality guarantee. The combined costs for any medical procedure and the entire trip will be less than one half that of a comparable unsubsidized procedure done in the United States, and meet or exceed quantifiable quality measures for a comparable procedure.
2) Offshore Health Solutions will provide an enjoyable and seamless experience with advanced logistics, a state-of-the-art international medical informatics infrastructure, and continued follow-up.
3) Offshore Health Solutions will achieve the highest safety standards possible by accepting full financial accountability for unanticipated outcomes.
4) Offshore Health Solutions will provide an environment for cutting edge and alternative medical care at a significantly reduced cost by capitalizing on the global marketplace for the provision of medical services.
5) Offshore Health Solutions will encourage a close relationship between medical professionals and insurers in order to meet the highest standard of quality possible at competitive rates.
6) Offshore Health Solutions will provide access to certification tools and rating services in order to ensure the highest level of competence among medics.
Franchise Overview
Products and Services
1) Offshore Health Solutions will begin offering medical procedures with the widest disparity of costs such as the following:
- Heart valve replacement
- Heart bypass
- Hip and knee replacement
- Spinal fusion
- Angioplasty
The offerings will then expand into additional procedures that uphold its price/value guarantee.
2) Offshore Health Solutions will offer a variety of health solutions and coordinate on-board activities and infrastructure with the various cruise lines:
- Health food store with OHS approved products
- On-board on-call pharmacist/nutritionist
- Coordinated health and diet maintenance
- Coordinated gym and physical activities/therapies
Operational Framework
Executive Office
Training, operational support, overall vision and structure of franchise and all of its components.
CEO answerable to Las Portadas (actions and decisions may be vetoed by 40% of BOI, HLR, GCI, or CUALP)
Financial Office
Financial analyses, payment structures, marketing, pricing
Medical Informatics Office
Availability of medical records, procedures, outsourcing resources
Actuary
Advises underwriters regarding mathematical feasibility of coverages
Area Representation
Government and legal interface issues
Master Franchisee
Unit Franchisee
Limited to one vessel or stead
The Market
American consumers are the prime growth force behind medical tourism. As many as 750,000 sought offshore medical care in 2007, spending an estimated $2 B.
Current Healthcare System
US health care spending continues to rise at the fastest rate in history.
In 2007, total national health expenditures increased 6.9 percent — two times the rate of inflation. Total spending was $2.3 T in 2007, or $7600 per person. Total health care spending represented 16 percent of the gross domestic product (GDP).
U.S. health care spending is expected to increase at similar levels for the next decade reaching $4.2 T in 2016, or 20 percent of GDP.
In 2007, employer health insurance premiums increased 6.1 percent - two times the rate of inflation. The annual premium for an employer health plan covering a family of four averaged nearly $12,100. The annual premium for single coverage averaged over $4,400.
Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the security of families.
Business Drivers
The number of Americans heading abroad for medical procedures is surging as domestic medical costs reach unaffordable levels. Mexico has long attracted American travelers looking for cutrate cosmetic surgery or dental work, and countries like India, Malaysia, Thailand and the Philippines continue to lure medical tourists as well. Last year, India attracted 150,000 medical tourists from the United States, Britain, Africa and elsewhere in South Asia, largely by offering an enticing trio of advantages: highly trained English-speaking doctors, quick appointments and bargain-basement prices.
The benefits of medical tourism are compelling.
- Potential Savings - The driving force behind the medical tourism market is the potential
cost savings. For those without insurance or those needing operations that insurance won't cover, medical tourism can be an affordable alternative to the skyrocketing costs of health care. Costs for major surgeries in the United States can run into the hundreds of thousands of dollars while the same surgery in a country like India or Thailand can be as little as a tenth of that.
- Shorter Waits - Even people who live in countries with public health care coverage (UK
and Canada) often choose to take their treatment abroad as overburdened hospitals and doctors can have long waiting periods for surgeries on conditions that are not lifethreatening.
- Quality - Many of the countries where medical tourism has become popular have made
significant investments in the industry to ensure that patients are happy and healthy. Many doctors have been trained abroad, and some are leaders in their fields.
- Relaxing Recovery - Traveling for medical treatment offers the added benefit of a
relaxing vacation while in recovery.
- Growing Insurance Coverage - An increasing number of insurance providers are
offering coverage for foreign medical alternatives provided that it isn't an elective procedure.
- Bring Friends and Family - Because of the significant cost savings on treatment abroad,
it is often possible to bring others along and still spend less.
- World Class Facilities and Equipment - With medical tourism growing rapidly,
hospitals are making big investments in equipment and technology to help them draw more patients.
- Package Deals – Several companies specialize in providing patients with not only their
treatment, but vacations afterwards, travel to and from the airport and all of the accommodations needed.
- Surgical Options - While the most popular options with medical tourists are cosmetic
and dental surgeries, there is a growing market for a wide variety of procedures including heart surgery and orthopedic hip and knee replacements.
- Luxury Accommodations - Many hospitals that cater to medical tourists are corporately
owned and therefore are in staunch competition with other hospitals to draw you in to their facilities.
- Service - Patients can usually expect a high level of personal care and attention from
hospitals and clinics that are popular with medical tourists.
- Travel is Affordable - While fuel costs have risen in the past few years, air travel is still
an affordable and relatively convenient way to travel.
Facts and Figures
In the United States, an estimated 49 MM people are without health insurance and 120 MM are without dental coverage - numbers that are both expected to grow. Countries like Britain and Canada have public health care systems plagued by long waiting lists for most major surgeries. This stimulates the need for foreign health care alternatives.
In addition, the high cost of the U.S. health care system has put many US businesses at a competitive disadvantage with foreign firms. The US automotive industry is the poster child for the dilemma posed by high employee medical costs: GM, Ford, and Chrysler's medical costs amount to $1,000 to $1,500 per sold car, which greatly exceeds the medical costs for Japanese, Korean, and European competitors. Simply put, countries such as India, Thailand, Mexico, and Costa Rica can provide equivalent healthcare treatment at much lower prices than in the United States.
The cost of surgery in India, Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the U.S., for example, can be had for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fourth of what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South Africa.
Faced with surging global popularity, numerous countries are creating options for this lucrative market including: Argentina, Costa Rica, Cuba, Jamaica, South Africa, Jordan, Malaysia, Hungary, Latvia and Estonia.
Future Outlook
Employers make a push for 'medical tourism'
U.S. health care costs have gotten so outrageous that some small employers save money by flying workers to foreign countries for inexpensive medical procedures.
Until recently, medical tourists were mostly individuals seeking low-priced cosmetic and elective surgery not covered by insurance. But more than one million Americans will travel overseas for procedures this year, and a rising proportion are getting insurers or employers to pay part of the cost.
While global medical tourism has yet to make major inroads with U.S. employers, some small employers and benefit providers such as BlueShield and BlueCross are starting to take the idea seriously. Experts predict that the medical tourism industry will grow to $40 B by 2010.
Medical tourism will grow regardless of possible U.S. universal health plan.
While president Obama is calling for a universal healthcare system, experts predict the adoption of a universal health plan will not affect medical tourism. The industry will continue to grow for the same reasons it is growing in countries like UK and Canada.
The demand simply outstrips the supply. Medical tourists will continue to use foreign alternatives to avoid long waiting periods, and save on costly elective procedures that are not covered by any healthcare plan.
Insurance companies are beginning to embrace ‘Medical Tourism.’
According to David Boucher, an assistant vice-president of health-care services at Blue Cross & Blue Shield of South Carolina, Blue Cross and other insurers would like to see more policyholders traveling abroad for medical care. “As healthcare costs continue to rise in the U.S., medical travel is going to be part of the solution.”
Like manufacturing facilities and call centers, health care is moving offshore. According to Jonathan Edelheit, president of the Medical Tourism Assn., “All of the largest U.S. insurers are starting to educate themselves or are putting [offshore] programs in place.”
Insurance companies could waive all deductibles and co-pays, offer to cover travel costs for the patient and family members, even throw in a cash incentive, and still save tens of thousands of dollars.
Blue Cross took the lead in medical “offshoring” when its Companion Global Healthcare subsidiary formed its first partnership, with Bumrungrad Hospital (Bangkok, Thailand), in February 2008. Since then, Companion Global Healthcare has signed similar pacts with the Parkway Group Healthcare, owner of three hospitals in Singapore, and with hospitals in Turkey, Ireland, and Costa Rica. Three members of India's Apollo Hospitals Group are also joining the network. And another large Indian chain, Wockhardt Hospitals, is working with U.S. insurers as well.
Charles Cutler of Aetna notes that the savings for his firm are not as great as they may be for some others, since it gets volume discounts from American hospitals thanks to its size. Travel abroad for Aetna’s clients makes sense only for procedures costing $20,000 or more, which might include heart and orthopedic surgeries. He remains bullish, observing that quality at the best foreign facilities can be much better than at the average American hospital, thanks to greater transparency and better information technology. He thinks this is inspired by the Asian hospitals’ need to market to a skeptical foreign audience.
The Booming Cruise Ship Industry
The Cruise Industry is the fastest growing sector of the Travel Industry. Its economic benefit to the US economy was estimated at $35.7 B in 2006. An estimated 12.5 MM people took a cruise in 2007; up nearly half a million from 2006.
The number of new ships continues to grow, reflecting optimism about the future. Nearly 40 ships were built in the 1980s; nearly 80 in the 1990s, and roughly 100 new ships will have been introduced since 2000. Additionally, there are an increasing number of small niche operations, catering to more specific markets. Overall, the market is by no means exhausted; only about 17 percent of US adults have taken a cruise.
The average cruiser is now 49 years of age, down from the stereotype "older" market of the past. Average household income of cruisers is $104,000. Florida, California, and Texas are the big three states for cruise patrons.
Cruise Vacation as an Ideal Solution for Recuperation
Increasingly, medical tourism operators are emphasizing the vacation aspect of the medical tourism excursion to lure patients to their facilities. By way of example, some destinations in Africa offer safaris, a few in Thailand offer jungle excursions, and several in India provide daytrips to the Taj Mahal.
In recent years the cruise experience has become increasingly luxurious. Major cruise lines now offer larger rooms, bigger beds, and marble lined bathrooms. In addition, many staterooms now include butler services.
The newest addition in cruise line luxury is the spa-focused retreat. Carnival Cruises is introducing the line's first spa staterooms, with private access to a luxurious 6,400-square-meter spa. Cruises have become the ideal recuperation experience; with therapeutic spas, world-class entertainment, and 5-star dining, surrounded by the calm of the sea.
Cruising is considered to be one of the most comfortable holiday options. Compared with other types of vacations, cruising has the highest percentage of extremely satisfied customers (45%), outpacing all-inclusive resorts (42%) and visiting friends and relatives (40%). 82% of cruisers gave the industry high marks and ratings fell in the ‘very’ satisfied and ‘extremely’ satisfied categories. Moreover, the comfort level associated with cruising is also high as compared with other vacation alternatives. About 57% of respondents in a survey stated that cruises are superior to other types of vacations in terms of overall pampering, and about 52% of people rated it as the most luxurious vacation option.
Economics
Product
Customers
Competition
Niche
Strategy
Promotion
Promotional Budget
Pricing
(lease valuation procedure)
Proposed Location
Sales Forecast
Operational Plan
Legal Environment
Management and Organization
Professional and Advisory Support
- Management advisory board
- Legal counsel
- Financial strategist
- Insurance agencies
- Banker
- Consultants
- Mentors and key advisors
Financial Model
Start up costs and capital projection
Break even
Cash flow
Return on investment
Unit economics
Franchisor economics
Projected rate of growth for the franchise system
Projected rate of growth for company-owned system
“Cost out" of each material operational, training, legal and marketing obligation included in legal documents
Define what needs to be measured and reported
Assess and determine exit strategies
Threshold Analysis
Gap Analysis
Competitive Analysis
Assessment of each available route to market
Fees
- Franchise fee (minimal: cost of materials and services provided times two)
- Royalty (regressive payment structure)
- A la carte charges (components available for purchase)
- Fee structure per unit
- Multi-unit fee structure( for master franchisee?)
- Advertising (appropriate venues and costs per venue)
- Etc.
Description of the financial risks and advantages of the expansion models selected
Short term
- Orthoscopic -> Heart valve replacement, &c
- On-board Health store/ Pharmacy
- Lease -> purchase of cabins/zone of ship -> ships
Long term
- Charter -> purchase of vessel -> vessels
- Acquisition of cruise line -> lines
- Participation in construction of fixed ClubStead and/or MedStead on SeaLand
- Biotech research facility
Financing Programs
Unit Financial Plan Format
Personal Financial Statement
Startup Expenses and Capitalization
12-Month Profit and Loss Projection
Four-Year Profit Projection
Projected Cash Flow
Opening Day Balance Sheet
Break-Even Analysis
Exhibits
Brochures and advertising materials
Industry studies
Blueprints of vessels
Stock
Renovated
Wave maps of location
Magazine or other articles
Detailed lists of equipment owned or to be purchased
Copies of leases and contracts
Letters of support from future customers
Any other materials needed to support the assumptions in this plan
Market research studies
List of assets available as collateral for a loan
See also
- Las Portadas
- ClubStead Master Lease
- Restitution Transfer and Recoupment
- Constitution of the Autonomous Freezone of Aquia
Guiding principles
- Instead of Politics (Civilization 101) by John Frederic Kosanke