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Portugal introduces new haemodialysis treatment scheme

The Portuguese Ministry of Health and Anadial, the national association of privately run dialysis centres, have agreed on a new reimbursement model for ambulatory care to haemodialysis patients.

The new model Comprehensive Price Payment model bundles a variety of dialysis-related services and products with the aim of improving quality and rationalising the system.

The Comprehensive Price Payment model will include all necessary dialysis services; the deployment of dialysis-related products; laboratory services and other complementary medical tests; and the administration of renal drugs for anaemia management, bone management, blood pressure and cardiovascular control; as well as vitamins.

The new reimbursement structure will provide for payment of a national reimbursement rate per week per patient. The main characteristic is that the amount of this reimbursement will directly depend on the fulfillment of certain treatment results and quality control parameters with the dialysis services provided.

The therapeutic goals include, among others: the adequacy of dialysis; targets for haemoglobin levels; bone metabolism status; water quality as well as outcome measures such as mortality rate and hospitalisation days.

These goals mirror the good practices guidelines, both national and international, for dialysis care to patients, which will serve as support for contractual monitoring.

The establishment of auditing, information, monitoring, attendance and evaluation mechanisms is a pre-requisite for a participating dialysis provider.

Furthermore, the Portuguese Ministry of Health and Anadial agreed to continuously develop studies that will examine the inclusion of other modalities and treatment components such as the construction and maintenance of vascular access, hospitalisation and patient transport into the comprehensive price payment.

German firm Fresenius Medical Care Portugal, the largest private dialysis provider in Portugal, welcomed this development.

Ben Lipps, Chief Executive Officer of Fresenius Medical Care, said: “Portugal is the first European country opting for a bundled reimbursement model in dialysis.

“The introduction of a bundled rate for the treatment of haemodialysis patients in Portugal equally benefits all those involved: the quality of life of dialysis patients can be significantly improved, health care spending for social systems and insurers remains controllable and dialysis companies gain the freedom to manage their cost structure while maximising patient services.”

Including the new additional services in this reimbursement model, Fresenius expects the reimbursement rate to increase by about 50%.

The company aims to fully adapt its dialysis care model to the new reimbursement structure for haemodialysis patients within its own network as of March 1, 2008.

Portuguese Ministry of Health

Fresenius Medical Care