Slovak spas are part of the public healthcare system. This system is under pressure due to the demographic trend of an ageing population and increasing healthcare costs, including costs expended by health insurance companies on spa care. The aim of this research note is to describe the relationship between medical and non-medical forms of spa tourism. By means of a case study, it describes the importance of public health insurance to the occupancy rate of accommodation capacity, the manner of payment for spa care and its medical or wellness character. In addition, it analyses the current financial situation of these operations. The traditional exploitation of natural healing springs for treatment, its connection to the public health insurance system and the level of spa treatments result in the prevalence of medical stays.

This paper gives an account of the experience of Slovakia, the Czech Republic and Poland with the implementation of destination management and formation of destination management organisations. It focuses on the most controversial topics such as building trust, tasks, and initiative in the formation of destination management organisations, legislative aspects, membership, funding and the decision-making process of destination management organisations (DMOs). The analysis itself is based on the legislation (currently valid and drafted) and on the statutes of the regional DMOs operating in the territory of Poland (16 organisations), the Czech Republic (33 organisations), and district/regional organisations kept in the registry of the Ministry of Transport, Construction and Regional Development of the Slovak Republic (32 organisations).

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The article deals with the financing of spa undertakings through the health insurance system. The analysis is based on the financial statements of 28 spa undertakings operating in the Slovak Republic, their contracts with the individual health insurance companies and secondary data sources (accommodation statistics of these undertakings, the number of medical stays paid by clients themselves and of those covered by public health insurance, the spa treatment expenditure of the health insurance companies, the percentage of this expenditure out of the total expenditure spent by the health insurance companies on health care). The still significant percentage of revenues from the health insurance companies out of the total revenues of spa undertakings shows the prevalence of the medical nature of spa care. At the same time, it reflects the current tax measures related to the spa industry and shows that the introduction of a recreation allowance might influence the future development of spa care.