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Fresenius Medical Care Research Paper Roberta Page

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Introduction There are approximately 26 million Americans that have chronic kidney disease and another 20 million are at increased risk. This list is growing every day and the need for dialysis grows with it. The list for a transplant grows every day and only a lucky few are able to receive a transplant each year, but many die before that important call is received by them. There are only a few companies that offer the wide varieties of services to dialysis patients. The Fresenius Medical Care company is the worlds largest integrated provider of products and services for individuals with renal failure that are undergoing either peritoneal dialysis or hemodialysis. This condition affects more than 2.1 million individuals worldwide with more being diagnosed every day. Located in several countries with over 2,800 clinics, Fresenius Medical Care is able to provide dialysis treatment to 233,156 patients around the globe. There are over 7,500 companies that provide dialysis in the world, but the leading provider is Fresenius Medical Care in the United States. Some countries even today only allow dialysis treatments to be done in hospitals because of the fraud by bigger companies. Four big companies that also provide dialysis in other nations along with the United States include: Gambro Healthcare, Baxter, DaVita, and Fresenius. The treatment of renal failure is big business in the United States and is growing to outside nations. Fresenius Medical Care provides both hemodialysis and peritoneal dialysis for patients of renal failure. Hemodialysis is available for both at a

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clinic and at home. Peritoneal dialysis is done at your home, but you still need to go to the office at least twice a month, once for a blood draw and then for a clinic. Fresenius and Dialysis The Fresenius Medical Care Company is committed to delivering excellent patient care. The company has innovative programs, the latest technology, continuous quality improvement and a focus on patient satisfaction. The staff is highly trained, dedicated to the treatment of renal patients, and attends routine trainings. There are six elements included in their facilities for patient care: superior customer service, patient-centered care, the clinical leadership, team approach to care, continuous quality improvement, and innovative technology. They are the market leaders in dialysis products providing both hemodialysis and peritoneal dialysis supplies to their renal patients. The Fresenius Medical Care Company does not just provide patients with products as they also provide the patients with services. The idea behind the clinic is to have the patient come to one location and be taken care of. Fresenius Medical Care dialysis products and equipment are available all over the world. The company has the largest provider of dialysis products and services in the United States. Fresenius has partnered with hospitals to deliver dialysis treatment is over 1,000 hospitals and through the network of over more than 1,800 dialysis facilities. They are able to deliver to their partner hospitals patient clinical programs, help with cost control efforts, and work with staff

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and physicians. Fresenius Medical Cares Spectra Laboratories provides all laboratory products and services and is the leading provider in the renal industry. At Fresenius Medical Care, they also provide renal pharmaceuticals delivered to the patients home. This service allows patients to focus on their care by providing them with the products they need for their chronic kidney failure. The company DaVita is located in California and has 64% of the total market for dialysis patients. The patients are looked at as profit, and for them the more Epogen the patients need equals more profits for the company. Epogen is used to keep hemoglobin in good range. There are problems with too much Epogen that can lead to heart problems, blood clots or even premature deaths (Pollack, 2007). Average cost per vial of Epogen provided by Fresenius Medical Care is $400 billed to Medicare. Price of bottle of Epogen
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The chart shows and example with the cost of a bottle of Epogen where the supply and demand curve would

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The Baxter Company has been part of the dialysis treatment since 1956 when they improved the original construction of Dr. Willem Kolffs design and

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introduced the first commercially built artificial kidney (Baxter, 2012). The company offers both hemodialysis (home or clinic) and peritoneal dialysis. Baxter defines the company on sustainability as a long-term approach to include social, economic, and environmental responsibilities among business priorities. Their efforts in this area align with and support their mission of saving and sustaining lives (Baxter, 2012). The Gambro in brief is a global medical company and leader in developing, manufacturing and supplying producing and therapies for kidney and liver dialysis. Gambro was founded in 1964 and today has over 8,000 employees, production facilities in nine countries, and sales in more than 100 countries (Gambro, 2012). The Gambro purpose is through innovation and partnership with their customers so they are able to provide extracorporeal therapies that save, sustain and improve the lives of patients worldwide (Gambro, 2012). The above competitors in the dialysis market have been working with patients for 40 to 50 years. There are no new companies entering into this market at this time. The companies working with dialysis patients need to be able to bill Medicare and Medicaid, along with private insurance companies. The Medicare and Medicaid may not pay all of the charges and will involve taking cuts in their normal charges, but with the well-established company it is expected. The need for dialysis treatment will continue until there is a cure for all causes of kidney failures. Kidney failure may not always be caused by a

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disease but can also be from an injury. The patients are from all walks of life and all over the world Because of this, the need is growing for medical care to reach out to these patients. The medical care organizations and companies that provide dialysis need to continue providing dialysis for patients. The need is to expand their treatment and seek out new ways to help reduce costs to their patients. Their outlook should not be on the profits that they make, but on their patients and what they provide. Their focus should be on the care that they are giving and not the profit that the organization or company is going to make. There are different ways that dialysis treatment facilities help their patients with their treatment. If the patient goes to a clinic, then there probably is a bigger company name behind that clinic. That clinic will use certain items that the organization or company gets breaks or produces for the patients. This is one way that the organization or company can maximize their profits. The organization or company will also invest in dialysis equipment makers, drug suppliers, and other items that the patient will use to boost their profit margins. All of this is used to increase profits and look better to investors. The clinic locations require registered nurses, technicians, and other staff to handle patients with hemodialysis. There are teams that come to meet with home dialysis patients for monthly visits such as nurses, financial, social workers, doctor, and any other staff necessary. The wage and benefits are decided according to the location of the clinic. Each of the clinics must follow

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the federal and local regulations regarding any health care laws. They also have to dispose of their waste according to the rules in their state. Fresenius Medical Care works with more than 200 nephrology Principal investigators working with end stage renal failure disease to help best treat their disease. The Clinical Studies Group is the leader in bringing a wide range of studies and research to patients for the best possible care. Their model fosters compliance with state and federal guidelines, as well as protocol adherence and timely completion of data collection (FMC, 2012). The key areas of research include: anemia management, associates of mortality and hospitalization, atherosclerotic cardiovascular disease, blood pressure and dry weight, diabetes and diabetic complications, dialysis adequacy, dineral metabolism, nutrition and inflammation, peritoneal dialysis, quality of ESRD care, quality of ESRD care, quality of life on dialysis, and vascular access. The ability to provide the high quality care allows Fresenius Medical Care to be the worlds leading provider of dialysis services and products. They use a team approach with their treatment of patients and encourage all nephrologists to explore the service that Fresenius has to offer. The patients of Fresenius work with a support team that includes: nurse supervisor, nurse, technicians, dietician, social worker, financial support, and doctors receptionist. The nurse supervisor was in charge of the clinics, and in the small clinics is the same as the nurse. The patients nurse take care of everything at the clinic and technicians help hemodialysis patients working with the nurse. Once a month a patient meets with the support team and they

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go over the numbers from the blood work. The dietician will talk about how to improve their diet, and give them some menu ideas. The nurse will go over the patients numbers from the blood work, give them some new tips on treatment, and check their vitals. The patients doctor will check them out, talk to them about their blood work, make sure they have no questions, and schedule any tests if necessary. The social worker will come in and talk about any problems that the patient is have regarding depression, help with living arrangements, feeling scared, and whatever else. The financial support person comes in and asked if there is any financial concern that the patient has. They will offer suggestions and get numbers for the patient. The clinic last approximately one to two hours. Conclusion The rising cost of treating dialysis patients in this economy needs to be addressed at the patients end. Most of the dialysis patients are on Social Security disability and Medicare, which means limited resources for the patient to get to treatments and clinic appointments. The dialysis organization or companies need to address these problems with that patient and not just ask them and then leave. Supplies for home dialysis patients are delivered to their home. The location of the blood draw and clinic should be as close as possible for the patient that is doing home dialysis. The organization or company should not add to the hardship of the patient by requiring special trips to other clinics. All the organizations or companies clinics should be certified to take

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care of all patients for all dialysis treatments. The hemodialysis and peritoneal patients still have renal failure and should not be required to travel right by a clinic because of this. This causes patients not to want to be on peritoneal, they are not able to make the drive to the clinic twice a month and have no other way to get there. The peritoneal patients may have to drive right by one of those clinics to get to their monthly clinic or just for a blood draw. The company is in the business of dialysis and should be in the business of taking care of the patient. Writing letters to our representatives of the state and letting them know that if a dialysis patient needs to have blood drawn from Baldwin, they have to drive an extra 110 miles (round trip). The clinic in Baldwin is not certified to treat peritoneal patients and they are required to have blood drawn at their sites. With all the clinics able to take care of patients, it would save on longer trips. The financial savings for the patients would be great. It would also save the patient time, and keep them off the roads in bad weather. It could encourage more patients to try peritoneal because they would not need to leave their home. The cost of peritoneal dialysis would save Medicare and Medicaid money. It would be a win-win situation for the patients.

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Reference Baxter Company, (2012), Corporate address: One Baxter Parkway, Deerfield, IL, 21 Mar 2012, URL: http://www.baxter.com/about_baxter/contact_us/index.html Fresenius Medical Care North America (2012), Fresenius Medical Care Holding Incorporated, 14 Mar 2012, URL: http://www.fmcna.com/fmcna/DialysisCompany/dialysis-company.html Gambro, USA, (2012), Global Medical Technology Company, 21 Mar 2012, URL: http://www.gambro.com/en/usa/ Pollack, Andrew (2007), The New York Times Business, The Dialysis Business: Fair Treatment?, 21 Mar 2012, URL: http://www.nytimes.com/2007/09/16/business/16dial.html? pagewanted=1&_r=1