The medical tourism industry takes off, albeit restricted to large cities

At 1.4 million patients in FY23, having doubled since the pre-Covid year of 2019, medical tourism is fast emerging as a major revenue earner for the hospitals and diagnostic centers in the large Indian cities.

India is now the second-largest medical tourism hub in Asia, with world-class medical facilities and advanced infrastructure, skilled medical professionals, affordable treatments, and a plethora of cultural attractions. A widely English-speaking population too has helped.

India is ranked 10th out of the top-46 nations, with a score of 69.80 on the Medical Tourism Index, twelfth out of the top-20 wellness tourism markets, and fifth out of the top-10 wellness tourism destinations in the Asia-Pacific by the Medical Tourism Association.

The medical travel industry in India is estimated at USD 10 billion in FY23, expected to reach USD 25 billion by 2025. This is 13.9 percent of the global medical tourism industry, estimated to be USD 72 billion, poised to rise sharply to USD 192 billion in 2026.

In 2020, at the peak of the Covid outbreak, when India was in lockdown and travel was restricted, 180,000 tourists came for medical treatment. This was a decline from 700,000 in 2019. The number went up to 370,000 in 2021, a 66-percent increase. This increased by 23 percent in 2022, and 2023 seems poised to close at 1,400,000.

In 2021, 68.4 percent of visitors were from South Asia. This was closely followed by West Asia with 61.1 percent and Africa with 40 percent of arrivals falling under the medical category. Out of the total arrivals from Bangladesh, 77.6 percent were seeking medical treatment. Similarly, for Afghanistan, 53.6 percent of the total arrivals were for medical purposes. The trend continues with arrivals from Maldives, where an overwhelming 85.8 percent were seeking medical treatment. And a remarkable 94.7 percent of arrivals from Iraq were specifically for medical purposes. Visitors from the Asia-Pacific region and the US, the UK, and Australia are attracted to India for hair transplant and cosmetic surgeries. Niche treatment areas as bariatric treatment and dental services are also popular.

The popular destinations the Indian industry is competing with are Japan, South Korea, Thailand, Indonesia, and Malaysia.

Patients from around the world are looking at India for treatment, related to severe ailment and complicated surgeries, particularly in cardiology, oncology, fertility, orthopaedics, and neurology. International-level services are provided at a compelling cost advantage. Procedures, ranging from cardiac surgeries, organ transplants, orthopedic treatments, and cosmetic surgeries to fertility treatments and advanced cancer therapies are available at 60–80 percent lower costs without compromising on quality. For instance, savings for angioplasty and knee replacement are to the tune of 80 percent and 88 percent, compared to USA.

The affordability of high-quality treatment is undeniably the differentiating factor in medical tourism. Skilled surgeons come a close second. Huge difference in cost, less waiting time, Indian hospitality, and good nursing care are other deciding factors.

The vast network of globally and nationally accredited hospitals, equipped with world-class equipment, doctors, and nurses, ensure patients the highest standard of care and treatment. The country has 1600 hospitals accredited by NABH, 45 hospitals accredited by the Joint Commission International, and 184 Ayush hospitals accredited by NABH. Apart from the four metros, Bengaluru, Hyderabad, Gurugram, Ahmedabad, Kochi, Chandigarh-Mohali, Pune, and Jaipur are the frontline cities.

Leading hospital chains of India like Apollo and Fortis have established international patient assistance centers in several countries, partnering with local medical professionals, travel agencies, diplomatic missions, and wellness tourism agencies to create a seamless experience for medical tourists.

There is a severe shortage of medical doctors in the country. The government has nearly doubled the number of undergraduate medical seats in private and public colleges to 101,043 as of March 2023 from 51,348 before 2014.

There are more than 3000 doctor vacancies at 31 large federal government hospitals, including more than a dozen specialized institutes. Vacancies of nurses and support staff were more than 21,000.

Outside the big cities, the lack of specialized care is especially acute. There are only 4485 specialists in position at these small hospitals against a requirement of 21,920. Specialist doctors tend to go overseas or join the private sector in metropolitan and other large cities.

India has a total of 612 medical colleges, 321 government-run and 291 private, as of July 2022. Tamil Nadu has 70, Uttar Pradesh 67, Karnataka 63, Maharashtra 62, and Telangana 34, constituting 48.37 percent. The balance 316 are distributed across India.

Fifty new medical colleges have been approved this year, adding 8195 more undergraduate seats and taking the total number of such seats in the country past 107,658, taking the total tally to 702. The 50 medical colleges have been approved in Telangana, Rajasthan, Tamil Nadu, Odisha, Nagaland, Maharashtra, Assam, Karnataka, Gujarat, Haryana, Jammu and Kashmir, West Bengal, Uttar Pradesh, and Madhya Pradesh.

India has 1000 recognized nurses-training centers with 10,000 nurses graduating annually. India also has Ayurveda, yoga, and naturopathy and other traditional systems of medicine for the treatment of various ailments, promoting wellness tourism.

The government has made medical tourism a high priority. 100 percent foreign direct investment in medical infrastructure and fiscal incentives for businesses involved in the medical service export sector are a few of the critical interventions by the government.

The recently held G-20 co-branded mega events on Advantage Healthcare India-2023 in Delhi in April, followed by Gandhinagar in August. It brought together health industry, government, and international players and stakeholder consultations have been held. A new category of Ayush (AY) visa for foreign nationals, seeking treatment under Ayush systems of medicine, has been created.

Advantage Healthcare India portal has been launched. It is a window of information and interaction for use by the prospective medical tourists to India. It is designed to be a comprehensive, user-friendly, and multilingual interface that caters to the needs of patients from all corners of the globe. It offers a comprehensive platform for information dissemination, seamless patient journeys, transparent pricing, and grievance redressal.

The portal empowers patients to explore healthcare options, based on city, hospital, doctor, medical procedure and MVT facilitator, for identifying the most suitable services. The end-to-end patient journey tracking ensures a frictionless experience for all stakeholders, including patients, facilitators, and hospitals. It helps in navigating treatment options, scheduling appointments, visa facilitation, and follow up. A teleconsultation module is also linked. Additionally, the portal efficiently captures patient testimonials.

With the Heal in India initiative, the government is targeting global demand for holistic healing for lifestyle diseases, such as diabetes, and is pitching Ayurveda, Yoga, and Naturopathy – falling under the ambit of the Ayurveda, Yoga, and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) Ministry – as an alternative to modern medicine.

The Ministry of Tourism is pursuing a focused mission to harness medical tourism’s potential fully. Through strategic initiatives and collaborations, it has aimed to position India as a premier destination for high-quality healthcare services, catering to international travellers seeking medical treatments. Along with the Ministry of Health and Family Welfare, it has created a medical tourism board, simplification of visa procedures, and the establishment of medical tourism facilitation centers in major cities. E-visas are available for visitors from 156 nations.

The ministry also supports Wellness Tourism and Medical Tourism Service Providers (WSTPs and MTSPs) through the marketing development assistance scheme (MDA). Traditional medicine and techniques via the Ministry of AYUSH are being promoted. Additionally, a Wellness and Medical Tourism Promotion Committee (WMTPC) has been established to make India a holistic tourism destination with detailed guidelines for a year.

NITI Aayog also emphasizes the potential of medical tourism in India. It recommends closer coordination between the Ministry of Tourism and the Ministry of External Affairs. Additionally, the think tank has suggested that a ₹500 crore fund be invested in easily retractable Government Bonds or securities by the ministry of tourism, with ₹100 crore investment every year for next 20-30 years, which grows over a period of time and helps sustain the industry in case of another unprecedented crisis. It would offer loans without collateral with a 10-year payback term, a two- year moratorium, and a low interest rate.

Medical travel companies, providing seamless and secure experience for international patients, facilitate international patients to the appropriate hospitals as per their specific needs. These companies are accredited under the National Accreditation Board of Hospitals and Healthcare Providers (NABH).

The rising demand for wellness resorts among travelers, and an increasing interest in luxury senior living projects offering state-of-the-art medical facilities, serves as a positive affirmation for opportunities in medical tourism sector. People are constantly looking for places that offer the best of both the worlds – health and hospitality. Experiential and immersive travel experiences, such as yoga, workouts, meditation coupled with carefully curated food menu and local community practices, also giving fillip to the local economy, are going to be a newer area of wellness resort development in the coming years.

According to India Hospitality Industry Overview 2022 report by HVS Anarock, developing dedicated hospital-hotel mixed-use projects and patient hotels designed to meet the needs of medical travelers, as is common in Scandinavian countries, and even in Asian countries, like Japan, South Korea, Singapore, and Thailand could be a profitable business model.

Telehealth that received a major impetus at the time of the pandemic promises to bridge geographical distances, offering personalized services and enhancing the efficiency of the healthcare system. To boost medical tourism further, an efficient online payment system, including international modes, is essential. Some companies have started connecting patients worldwide with desired doctors through teleconsultations, expanding healthcare access on a global scale.

The Ministry of Health and Family Welfare’s collaboration with the Center for the Development of Advanced Computing (CDAC) has resulted in the eSanjeev OPD portal, serving over 100 million patients, making it the world’s most comprehensive public telemedicine system.

The success in medical tourism in India over the past two decades has established the country’s healthcare brand globally. It is expected to encourage further investment in cutting-edge medical equipment, robotic surgery, and AI-enabled technologies, making India even more attractive to international patients.

For India, a robust public-private partnership has played an important role in pushing forward the government’s national strategy and roadmap for medical value travel. The private sector with its capital and experience must support the progressive policy framework to achieve India’s medical prowess. We still need to work toward building our credibility through best global medical accreditations, provide transparent and effective communication, reduce huge price anomalies for similar treatments across hospitals, and most importantly implement a robust medical tourism policy at the center and state levels.

The most significant challenge is facilitating coordination among various agencies responsible for the patient’s care. There are significant hygienic and patient safety problems in the Indian healthcare sector. With one of the highest percentages of post-operative infections, Indian hospitals are infamous for their lax infection control standards.

Challenges as increasing dollar prices and fuel costs may play spoilsport, despite the majority of patients representing the affluent class in their respective countries.

India’s G20 Presidency theme of One Earth, One Family, One Future signifies the need for unity of purpose and action and has categorically stated that the country is striving to converge ongoing initiatives toward building resilient healthcare delivery systems, supplemented with equitable access to vaccines, diagnostics and therapeutics to ensure that no one is left behind. The medical tourism industry is a relevant cog in this wheel.