Integrated care and Fresenius
We’ve revised our views on the Fresenius Rhoen deal. We think Fresenius is deadly serious about integrated care.
The offer document from Fresenius for Rhoen Klinikum sets out its vision for integrated care in some detail. It even explains why it thinks the German state would welcome the move (a painless pilot which means it doesn’t have to anger medical professionals in the wider public sector).
Our interview with Clalit, the Israeli not-for-profit health maintenance organisation, shows what is achievable by a large operator which has head to tail ownership of everything through from family doctors to labs, imaging and hospitals. This ownership allows the operator to really imprint an integrated health culture thoughout an organisation and to surmount the normal resistance from doctors and nurses. And the result is impressive. Clalit claims to have cut the cost of diabetes by 40% (yes, 40%) in 5-6 years. The interview explains how and why. We see no reason to doubt the claims.
It is only when a private operator gets this head to tail ownership that it is really capable of demonstrating real efficiencies. We also think it should be considerably easier for a private employer to enforce this than a state run bureaucracy.
On reflection, it is also clear that Fresenius is uniquely placed to build an integrated care structure. Why? Because:
– It has the financial resources to do so.
– It understands medicalised homecare through its ownership of Fresenius Kabi.
– In Helios and elsewhere it has demonstrated an impressive management track record. For instance, the Swiss state has adapted its KPI measures which lead to real information transparency on how each doctor is performing.
We had thought that Fresenius might simply be using Rhoen founder Eugen Muench’s dream of integrated care to justify a deal it needed to make in order to continue short-term growth. But it is clear that there is much more than that to this deal.
As the private sector continues to consolidate, so we will see the emergence of more such opportunities. General de Sante has for years been trying to persuade the French state to allow it to look after and meet French citizen’s healthcare needs on a per capita basis. Fresenius is likely to be able to make this dream a reality in Germany.
We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.
