Treatment and prophylaxis using mineral water have a long history dating back to the Roman Empire in the cross-border regions (CBR). The objective of the study is to evaluate the potential of CBR Bulgaria-Serbia for the development of medical spa and wellness tourism using hydrogeological, medico-biological and medico-social assessments of tourism resources. More than 30 mineral springs and 21 touristic objects have been studied. There are good hydrogeological conditions for the development of intensive medical spa, wellness and spa tourism in the area of investigation. The combination of free-flowing springs and specific climate conditions is a great advantage for the development of highly
specialized tourism such as medical spas.

The main wellness principles for creating holistic effects of treatment are described, and on the basis of an assessment of the medical spa and spa network and the market for these services in the CBR, a new management concept is presented. The core of the model is finding a good balance between the unique environment, highly qualified personnel, quality of services and innovative products such as Geomedical tourism, which will contribute to wellness and spa tourism and become a successful business. The necessity for certifying medical spa and spa services and introducing a quality management system (QMS) and a health risk assessment system (HSE) is outlined with the view to promoting a specialized tourism product on the international market.