Johor the Dark Horse of Medical Tourism in Southeast Asia

Johor is emerging as a medical tourism gateway in Malaysia, thanks to a longstanding relationship with Singapore, but does it have what it takes to position itself as regional medical hub?

More developing nations seem to be gearing up to become medical tourism destinations. In Southeast Asia, Thailand is the largest medical tourism market with around 2.86 million international patients in 2023 generating approximately US$850 million in revenue. In 2024, Thailand welcomed an estimated 3.07 million visitors, an increase of 7.3% year on year.

In addition to its strategic location, established international flight routes, as well as a robust tourism sector, Thailand’s rapid growth in medical tourism has been driven by the availability of high quality medical care encompassing a broad range of treatments, at a fraction of the cost in Western countries. For example, a coronary angioplasty in a hospital in Bangkok costs between US$4,500 and US$10,600, a fraction of what it would cost in the United States, at approximately US$55,000.

Many Thai healthcare facilities, located predominantly in Bangkok, are also accredited by international bodies, such as the Joint Commission International (JCI), assuring patients of its adherence to international medical standards. Thailand has over 60 JCI-accredited facilities in the country, the highest number in ASEAN.

Bali is also making a bid to become a regional medical hub through the newly opened Bali International Hospital, part of the Sanur Health Special Economic Zone. The hospital houses the Icon Cancer Centre, Indonesia’s first foreign-operated oncology facility, launched in 2025. Offering radiation therapy, chemotherapy, immunotherapy, targeted treatments, and PET-CT diagnostics, the centre integrates global oncology expertise with local capacity-building. Its addition to Indonesia’s healthcare landscape brings world-class cancer treatment closer to home for Indonesian patients, while establishing Bali as part of Southeast Asia's growing medical tourism market.

Malaysia as a medical tourism hub

Malaysia has been actively positioning itself as a premier medical tourism destination in the ASEAN region. The Malaysian Healthcare Travel Council (MHTC), an agency under the Ministry of Health (MOH), reported that Malaysia as a whole recorded about 1 million medical tourist arrivals in 2023, generating approximately US$526 million in revenue. By 2033, the market is forecast to hit US$2.7 billion, exhibiting a growth rate (CAGR) of 20.29% between 2025 to 2033.

Unlike Thailand, whose medical tourism is largely confined to Bangkok, Malaysia’s medical tourism spans across many states, most notably Kuala Lumpur and Selangor in the central region, and Penang in the north. Malacca is also a force to be reckoned with, due to its close proximity to Riau and Sumatera, as well as its globally-recognised UNESCO Heritage status. By state, Kuala Lumpur contributes to nearly 45% of international patient volume and about 42% of national medical tourism income, followed closely by Penang, which contributes about 40.5% of the revenue.

Allan Fernandez, Executive Director at ACG Healthcare Group, Johor Bahru

“Malaysia’s government has played an active part in shaping the medical tourism industry through initiatives such as the Malaysian Healthcare Travel Industry Blueprint 2021 to 2025, which aims to enhance the end-to-end patient journey, from travel logistics to post-treatment care,” comments Allan Fernandez, Executive Director at ACG Healthcare Group in Johor Bahru, a premier healthcare provider offering healthcare management and medical services in Malaysia and Singapore.

“Many hospitals in the urban epicentres in Malaysia are JCI-accredited and staffed with English-speaking professionals, making them globally competitive. We offer a wide range of advanced procedures in cardiology, orthopaedics, fertility, cosmetic surgery, gastroenterology and women’s health. Medical travellers visit us because we can offer high-quality treatments at much more affordable costs than the West, about 30% to 70% cheaper in some instances,” says Fernandez.

Indonesians make up the largest share of Malaysia’s medical tourists, comprising about 70% to 80% of total numbers. There are also large numbers of patients from China, India, the United Kingdom, Japan, and increasingly, from the Middle East and Europe.

Johor, the dark horse

The state of Johor is emerging as a strong contender for the country’s medical tourism industry, following the availability of private hospitals with state-of-the-art facilities in the Iskandar Malaysia region.

The Regency Specialist Hospital is rapidly expanding with an additional 10-storey block, and Thomson Medical Hub, a multidisciplinary tertiary facility with training and research capabilities, has recently opened in Iskandar Puteri.

Johor’s edge lies in its close proximity and long-standing relationship with Singapore. “About 300,000 to 400,000 Malaysians commute daily to Singapore for work, and about 350,000 Singaporeans visit Johor every week for trips, errands and longer stays,” Fernandez says.

“The availability of Singaporean-owned healthcare facilities here ensures that patients get high quality and standard of care, at about 60% of the cost in Singapore. Johor is in a unique position to attract not only permanent residents in Singapore but also Singaporean citizens, who can utilise MediSave under their Central Provident Fund (CPF) to subsidise treatment costs,” explains Fernandez.

The state government has recently signed a landmark cross-border agreement to develop the Johor-Singapore Special Economic Zone (JS-SEZ). The zone offers tax incentives and encourages investment in health facilities ranging from hospitals to pharmacies, making medical tourism a key economic pillar for the state.

Direct ferry links from Puteri Harbour and land checkpoints have enabled Johor to become a gateway for medical tourists from Singapore and Batam, with health tourists making up 36% of all visitors who enter via Puteri Harbour between 2019 to 2022. The state government also promotes medical tourism through networking sessions targeting Batam and Singapore, and has extended outreach efforts to markets like Vietnam, India, Japan and South Korea.

“Elective procedures such as health screening, physiotherapy, acupuncture, Traditional Chinese Medicine (TCM), aesthetics, weight loss and diabetes management, are potential growth areas for Johor’s health and medical tourism. There is also a growing interest in wellness tourism, elderly care and preventive health, reflecting current population trends,” he adds.

Challenges and growth opportunities

Among the pressing challenges that must be addressed to propel Johor forward as a medical tourism hub in this region include:

Workforce shortages

Johor faces a critical shortage of nurses, with a shortfall of between 15,000 and 18,000 “We face a dual-brain-drain; we lose our talents not only to Singapore but also to Kuala Lumpur, and to counter this we may need to establish more nursing training programmes, or colleges, sponsored education with bonded service periods, and bringing in foreign nurses from Indonesia, China or India,” says Fernandez.

Capacity constraints

Private hospitals in JB are already experiencing high occupancy, leaving little room for international patients. As part of the government’s initiatives to meet rising demand, the 304-bed Pasir Gudang Hospital is expected to be operational in 2025, while the Hospital Sultanah Aminah 2 (HSA 2), a 1500-bed tertiary hospital under public-private partnership, is slated to break ground in 2026.

Logistical issues

Fernandez remarks, “If we really want to be a health and wellness hub we also need to look into improving accessibility for less ambulatory patients across one of the busiest land crossings in the world.” While the Rapid Transit System (RTS) Link between JB and Woodlands (Singapore), will significantly improve access and streamline travel logistics for medical tourists, features that help the mobility-impaired get around will need to be considered and implemented.

Tourism and hospitality offerings

Medical tourism extends beyond hospital admission. As well as step-up and step-down care of the patient, we also need to consider the tourism and hospitality element to cater to the extended family. Says Fernandez, "For example, hotels located next to hospitals or clinics may be more suitable accommodation for patients who no longer require the full suite of services that can only be provided by a hospital, but are not stable enough to travel home. These can also provide short-term supportive care where the patient does not need to be hospitalised."

Integrated platforms and data sharing

The standardisation of care between Johor and Singapore healthcare practitioners and facilities is another issue, highlights Fernandez. “Will treatments in Johor be recognised by Singapore doctors and vice versa? Technology and AI may potentially be able to streamline these issues through standardised clinic management apps that trace and record appointments, treatments and medications prescribed to and taken by the patient, etc., in both countries.”

While Johor's unique proximity to Singapore, cross-border economic collaborations, and growing portfolio of modern healthcare facilities position Johor as the obvious choice to value-seeking patients from Singapore, Batam and the Riau islands, much still needs to be done before Johor can be considered on par with established medical tourism hubs like Bangkok.

With the right investments in talent, infrastructure, and seamless patient experiences, Johor has the potential to secure its place as a key driver of Malaysia’s ambition to be a leading medical tourism destination in Southeast Asia.