There hardly is a country in the world that does not debate on which services the public healthcare system should provide and what these services should cost. What a relief when solutions can be found to improve treatment for patients - solutions that do not strain the healthcare system but reduce its costs.

Fresenius Medical Care has found one such solution and has adopted a comprehensive therapy approach in Portugal. For years the country’s healthcare system lagged behind in the way it paid for dialysis treatment. As of January 1, 2009, Portugal introduced new reimbursement rules - a real paradigm shift. “It was a win-win situation,” says Andrea Stopper, Head of Dialysis Services Coordination (for Europe, Middle East and Africa) at Fresenius Medical Care, “but not everybody realized that from the outset.” Today, Fresenius Medical Care provides the state-run insurer with a vastly improved service that costs less.

How is that possible? “The key was to expand the scope of our services. Today, we are responsible for the entire treatment process instead of just individual steps, as it used to be,” says Dr. Stopper. “We have managed to persuade our partners that we could offer a better overall quality if we were in charge of the entire process, including all dialysis services and products. That’s why we are currently discussing the inclusion of Vascular Access Management (VAM) into our offering.” As a part of dialysis medicine VAM allows a direct access to the dialysis system on the patient’s body. “Until now, VAM was often performed somewhere else, for example in general hospitals. There, a catheter was simply inserted instead of a surgical vessel access being performed. Catheters, however, often cause infections and therefore add to costs. When we carry out the VAM ourselves we avoid such follow-up costs. We are thus able to provide a more cost-effective treatment, while still improving quality.”

This was made possible only because Fresenius Medical Care had been operating its own VAM center in Portugal for years. At the center Fresenius Medical Care physicians acquired the necessary expertise. “We ventured into this direction without receiving a single euro of public funds in return - we simply realized that this was the right way to improve quality,” says Dr. Stopper. The achieved success proves this strategy right: not only do the new standards increase patients’ longevity, patients also return to the hospital less often - what an obvious progress towards quality of life!

Regular gatherings:
marketing executives at Fresenius Medical Care’s
headquarters in Bad Homburg, Germany.

Finding out about the latest developments at
Fresenius Medical Care: Dr. Andrea Stopper chats
with marketing executives from all over the world.

Personal meetings enable experts from
all parts of the world to get together and talk – all for the patient’s benefit.

Quality improvements can also be the result
of cost pressure. The reimbursement model in Portugal
is a role model for healthcare markets worldwide.

– our contribution –

PATIENTS IN CARE
IN PORTUGAL
4,200

PATIENTS IN PORTUGAL
TREATED WITH ONLINE-HDF
65 %

DIALYSIS CLINICS
IN PORTUGAL
34

Further information on this topic can be found here.