With the changes in dietary structure and living habits in China, secondary chronic kidney disease is increasing. Chronic kidney disease, including diabetes and high blood pressure, may develop into end-stage renal disease (ESRD), which is often referred to as "uremia." According to Mei Changlin, vice president of the China Association of Non-Public Medical Institutions, the treatment of uremia is mainly divided into three types: hemodialysis, peritoneal dialysis, and kidney transplantation, and the proportion of domestic hemodialysis treatment is as high as 85%. The industry estimates that the domestic hemodialysis market is over 10 billion yuan.
But in the face of such a huge market, there are still more than 600 counties in China without a hemodialysis center. Before the third-party independent hemorrhagic center was fully released, except for more than 2,300 public hospitals with more than two levels, only Sansheng Pharmaceutical, Bethune Foundation and Weigao were awarded pilot qualifications. Until the end of 2016, the Health and Family Commission issued the standard specifications of the independent Hemodialysis Center, and this market has sprung up many companies.
When the "squatting" is opened, capital is poured in, and the industry will inevitably have some players who want to make quick money. However, Mao Jiafan believes that companies that can't make quick money and want to make quick money will soon be eliminated in the next shuffle process. On July 16th, Yiou Dahe went to Zhuhai to raise the headquarters of the kidney, and interviewed Mao Jiafan, the director of the president of the company.
“Rural encircling the city†is a strategy and concept
According to the business registration information, Yangkang was established in June 2016 to provide hemodialysis and related health management services for patients with kidney disease. However, according to Mao Jiafan, before the establishment of the kidney-analysis, the company's core team has already entered the hemodialysis industry.
“When the team was in 2012, there were some hospitals in Shandong and Fujian. But after all, the management of the staff and departments was decided by the hospital, and we couldn’t let it go. After the 2016 policy was opened, the team felt that the time was ripe. Only decided to set up the company to be a hemodialysis center." Mao Jiafan said.
As one of the first batch of independent hemodialysis centers in Guangdong Province, Yangkang has now obtained more than 30 medical institution licenses and 8 business outlets. On a strategic layout erected on the wall of the office, Mao Jiafan showed the situation of raising the kidneys to the health of the billion-dollar health. Mao Jiafan said that the plan for raising kidneys is to "based on Guangdong, deepen the three provinces, and radiate the country." Up to now, more than 30 hemodialysis centers have been established in Guangdong, and it is expected to increase to 50 this year.
“It’s the development path of 'urban encircling the city’,†Mao Jiafan said. “After research, we found that the resources of the first-tier cities are concentrated. On the contrary, the third- and fourth-tier regions are very scarce. Especially in Guangdong, the remote areas are in the hemodialysis market. There is still a lot of room for development, and the layout of these cities is also in line with the concept of national grading diagnosis and treatment and resource sinking."
In 2017, the kidney analysis began to lay out the Sichuan market, and this year also launched the exploration of the Fujian Hemodialysis Center. Mao Jiafan believes that when selecting the geographical layout, first look at the population base, "Sichuan is a large population province in this respect", the survival rate of the Hemodialysis Center will be higher; and Fujian is introducing Taiwan resources and technology because of its proximity to Taiwan. There are also good advantages in terms of aspects.
"In the future, Yangke will also move closer to the first-tier cities from the 3rd and 4th tiers, but this process will take a long time. You can hope to lay a solid foundation, but not blindly expand for the sake of quickness." Mao Jiafan Health said.
"Three divisions" are co-management to create "ecology"
Previously, in the inventory article of the third-party independent medical institutions, the executive director of a domestic chain of hemodialysis companies said that the hemodialysis center can be set according to national standards, and there is no differentiated competition. If each family wants to form its own industry advantage, it is necessary to return to the "playing style" thinking.
Mao Jiafan said that there is almost no technical barrier in the Hemodialysis Center, so the formation of the brand depends on word of mouth, and the word of mouth comes from the quality of service. "The reproducibility of this kind of thinking is very high. What we can do is to quickly accumulate word of mouth by relying on the quality of management and service. When the peers are fighting for word of mouth, they will be the first to brand a chain." Mao Jiafan further said.
The core technology and management experience of recuperating kidneys comes from Taiwan. "Taiwan is ahead of the mainland in terms of standardization and community development of hemodialysis." Mao Jiafan said that at present, Yangkang has established its own standard operating procedure (SOP) for nurses, through standardized training to achieve care workers. "Self-hematopoietic."
"We are still promoting the 'Three Divisions' co-management, that is, taking the teachers as the main line, and then cooperating with the help of doctors and supervisors to achieve the full care of patients with kidney disease." Mao Jiafan contrasts, through the hemodialysis service, mainland ESRD patients On average, it can last for 2.4 years, while Taiwan can be extended to 12 years, and Japan can reach 20 years. Therefore, kidney disease, as a chronic disease, requires more labor costs.
Mao Jiafan revealed to the health of Yiou Great Health that the operating cost of raising kidney in the Hemodialysis Center is about 20 million yuan per month, of which the cost associated with personnel accounts for 30%, which is higher than the industry average. "Because he is not a profiteering industry, the payback period generally takes two years, but the users in this industry are very sticky. Once the kidney friends have identified you, the follow-up dialysis services will gradually bring returns." Mao Jiafan said.
In terms of input, the “human†is the standard for the cultivation of kidneys. On the one hand, it is the training of nursing staff, and on the other hand, the management of kidney friends. In the future, the company will also build itself into an ecological chain. By cooperating with big data, wearable devices and telemedicine related companies, it will strengthen the home management and monitoring of patients with kidney disease, thus achieving a win-win situation for life and profit.
The best times? The worst era?
Of the eight operating hemodialysis centers that can raise kidneys, only two have achieved profitability. Asked about the reasons, Mao Jiafan said with some helplessness, "If you have medical insurance, you can make a profit. If you don't have medical insurance, you can only continue to increase your investment." However, as early as the “Guidelines for the Six Sectors on the Work of Urban and Rural Residents' Major Disease Insurance†issued in 2012, hemodialysis was included in the policy scope of major illness insurance compensation. In recent years, the reimbursement rate of Hemodialysis has gradually increased from 50%. For the poor people who meet the relevant conditions, the total reimbursement rate for policy requirements is not less than 90%.
“The policy is indeed good,†Mao Jiafan responded. “But when it was implemented, the medical insurance was still a major factor restricting the development of the Hemodialysis Center due to the inconsistent connection.†Mao Jiafan also said that some places Access to medical insurance has a one-year pre-condition for business hours, and it is not possible to apply if the time requirement is not met.
The health of the billion-dollar health has noted that non-public medical care, including independent hemodialysis centers, has been promoted by many policies in recent years. For example, the "Notice on Further Reforming and Perfecting Medical Institutions and Physician Approval Work" issued on June 19 mentioned that for the setting up of medical institutions at the secondary level and below, the health and health administrative department will no longer issue the "Approval of Medical Institutions". The Medical Institution License is issued only at the time of practice registration. This also means that it is easier for social capital to enter the non-public medical field such as the Hemodia Center, but Mao Jiafan believes that the “two-in-one†of approval and practice registration may not be as good as imagined.
"In the past, an independent hemodialysis center had to obtain an approval letter. The result was that the approval was cancelled, but the relevant requirements for approval were not cancelled. It was equivalent to moving backwards. Once the final acceptance was unsatisfactory, the tens of millions dropped. It’s drifting.†Mao Jiafan said that this can, to a certain extent, persuade a group of companies that want to make quick money.
According to Tianyue data, more than 300 Hemodialysis Center companies have been established in the past year. As the policy is released, it is conceivable that there will be more influees in the future. Mao Jiafan believes that the domestic hemodialysis market is still in its infancy, and competition and supervision are subject to further development. "It is expected that by the end of 2019, the hemodialysis market will have a reshuffle and eliminate a group of companies that are in troubled waters. Only then will the industry norms and alliances be gradually established and eventually feed back the whole hemodialysis field." Mao Jiafan Say.
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