On March 27, 2019, PT Masa Cipta Husada in collaboration with the Yayasan Muslimat NU inaugurated the Hemodialysis Clinic Muslimat NU 3. The clinic is located on Jl. Kh. Zarkasi, Lugosobo, Purworejo City. Purworejo Regent, Mr. Agus Bastian, attended the inauguration ceremony and expressed his happiness at the presence of Hemodialysis Clinic in Purworejo. He hopes that the quality of life of patients with kidney failure in Purworejo can be improved by the presence of this clinic.

Since 2016 PT Masa Cipta Husada and Elisabeth Hospital has established a joint cooperation to run the hemodialysis unit that serves a wide range of patients. On July 31, 2018 BPJS finally approved to welcome this public health service after the Bekasi Health Service Office previously allowed Elisabeth hospital to have some additional hemodialysis equipment.
In her speech, the acting head of the Health Office, Tanti Rohilawati, SKM, m. Kes appreciated Elisabeth hospital that helps the Government to provide health facilities especially hemodialysis, both for regular patients and patients who incidentally need hemodialysis therapy. Head of Bekasi BPJS, dr Siti Farida Hanoum expected that other hospitals could also contribute the same service in accommodating the infectious patients (exposed to hepatitis).
Drg. Tetty Manurung, Deputy Director of Medical Services from Dr. Chasbullah Abdulmadjid hospital who also attended the ceremony, conveyed her gratitude for the opening of this new public facility.

On Friday, April 27, 2018, PT Masa Lestari Husada and PT Fresenius Medical Care Indonesia officially announced a Business Cooperation which had been previously studied and approved by both parties. This important event was held on the 18th of Jakarta Nephrology & Hypertension Course (JNHC) at Borobudur Hotel, Jakarta.
The Letter of Agreement was signed by the President Director of PT Masa Lestari Husada - Ir. Andreas Japar, MBA. and the Managing Director of PTF resenius Medical Care Indonesia - dr. Parulian Simandjuntak MM.
Quoted from the book “Disruption” by Rhenald Kasali, Ph.D.
Change is a must. The era of “Zero to One” is over, and we are even now in the era of the third internet world which moves very fast, exponential and hard to be pursued by the inactive people. They are not doctors. How can they disrupt the health service through some clinics in 40 venues and this will soon reach 400 throughout Indonesia?
We are not talking about the regular clinic. This special clinic is a hemodialysis center for poor people. Hemodialysis treatment is very costly. For one time treatment we have spend around 800.000-1.200.000 Rupiahs. And this does not include the transportation fee if patients have to travel long distance. Many kidney failure patients come from the middle low income who live in the outskirt of big cities.
Andreas Japar, an ITB 1977 graduate, majoring in physics engineering, is a pioneer of this noble health service. After working as a sales for European company for several years, he run his own business as a distributor for health equipment. And he became more skillful and confident after learning the ins and outs of the health business. He then found out that patients do not need to spend their money inefficiently. He also learned and understood about the equipment and the behavior of the patients and their family.
Together with two IT experts, he then established PT Masa Cipta Husada (focusing on the management of hemodialysis equipment in hospitals and clinics) and PT Masa Lestari Husada (focusing on the sales of hemodialysis machines). The first project was built in Kebayoran Baru, This project is a joint cooperation with the Foundation of Nahdlatul Ulama. On my visit in 2016, I found out that the building previously functioned a maternity clinic.
The maternity clinic business at that time faded away. Facing the era of 21st century the financial condition was getting worse and the physical condition of the building was getting poor too.

Rhenald Kasali, Andreas Japar, Agus Hendrosusanto, and team were visiting Cipta Husada Muslimat NU 1 Hemodialysis Clinic
The maternity clinic business at that time faded away. Facing the era of 21st century the financial condition was getting worse and the physical condition of the building was getting poor too.
Meanwhile the latest data shows that the number of hemodialysis patients from the low income society is increasing. Together with YKM-NU, Andreas and his two other partners decided to disrupt the hemodialysis service. They insisted to lower the hemodialysis fee by 50-70 percent.
At the beginning, even with the lower rate which was Rp 550.000,- per visit ( it takes 5 hours to undergo the treatment), only a few patients came for the treatment. Why? It seemed that the poor still could not afford to pay. Then they worked on the new strategies.
Fortunately, in the era of President Joko Widodo, the Government really pay attention to the poor. Formerly there was Jamkesmas ( Social Health Insurance), but they did not work well enough with the hospitals. The cost was unbearable for the hospitals, moreover the settlement was just paid four months later. Luckily the BPJS managed to improve the system so that payment to the hospitals is now settled in fifteen days. But BPJS is still willing to pay the costly fee for hospital grade A and B. There is still inefficiency.
You can see in the table list of the standardized rate for health service in PMK (Regulations issued by the Minister of Health) No. 52/2016 to check the fee for chronic kidney patient undergoing the hemodialysis treatment.
| Hospital Class | Regional 1 Rate |
Regional 2 Rate |
Regional 3 Rate |
Regional 4 Rate |
Regional 5 Rate |
| A Class (G) | 982.400 | 991.200 | 994.200 | 1.008.900 | 1.041.300 |
| A Class (P) | 1.031.500 | 1.040.800 | 1.043.900 | 1.059.900 | 1.093.400 |
| B Class (G) | 879.100 | 887.100 | 889.700 | 902.900 | 931.900 |
| B Class (P) | 923.100 | 931.400 | 934.200 | 948.000 | 978.500 |
| C Class (G) | 786.200 | 793.300 | 795.700 | 807.500 | 833.400 |
| C Class (P) | 825.500 | 833.000 | 935.500 | 847.800 | 875.100 |
| D Class (G) | 702.600 | 708.900 | 711.000 | 721.600 | 744.800 |
| D Class (P) | 737.700 | 744.400 | 746.600 | 757.700 | 782.000 |
| Cipto Mangunkusumo Hospital | 1.118.900 | ||||
| Harapan Kita Hospital | 1.085.600 | ||||
| Dharmais Hospital | 1.085.600 | ||||
| Harapan Kita Hospital | 1.085.600 | ||||
Annotation : G = Government ; P = Private |
|||||
Regional Division |
||||
| Regional 1 | Regional 2 | Regional 3 | Regional 4 | Regional 5 |
| Banten | West Sumatra | Aceh | South Kalimantan | East Nusa Tenggara |
| DKI Jakarta | Riau | North Sumatra | East Kalimantan | Maluku |
| West Java | South Sumatera | Jambi | North Kalimantan | North Maluku |
| Central Java | Lampung | Bengkulu | Central Kalimantan | Papua |
| DI Yogyakarta | Bali | Bangka Belitung | West Papua | |
| East Java | West Nusa Tenggara | Riau Archipelago | ||
| West Kalimantan | ||||
| North Sulawesi | ||||
| Central Sulawesi | ||||
| Southeast Sulawesi | ||||
| West Sulawesi | ||||
| South Sulawesi | ||||
| Gorontalo | ||||
The table shows that fee for hemodialysis in Grade A Hospital is around Rp 982.000,- to Rp 1.031.500,- per treatment. The same treatment in Grade B Hospital is around Rp 800.000,- to Rp 978.000,-.
This is not efficient. Many hospitals in big cities develop their business in hemodialysis unit because it makes money. The fact is most patients come from the outskirt of the cities, so travel costs a lot.
Andreas and his team insisted to continue reducing the treatment fee. He even runs a manufacturing company to produce washing blood liquid.
Lately, the Ministry of Health turns to India that could offer a “super cheap” service which is around Rp 350.000,- to Rp 500.000,- but many doctors doubt about the quality of the service. particularly with recycled equipment like syringe and medical tubes for multiple use and for different patients.
Andreas keeps on fighting for the disruption. With his business partner, he set up e-Medical Center which will pay 400 to 1000 small building size clinics located in the outskirt of big cities. This Smart Hospital would be very efficient.
Now JKN-KIS dialysis patients are made easy in extending referral letters that are due. In this case dialysis patients no longer need to come to the first level health facilities (FKTP) to extend their referral letters, simply by applying the VClaim application from the BPJS Clinic or Hospital where those patients getting dialysis services can immediately extend their referral letters.
In his spotcheck visit to the Tidore Hemodialysis Clinic, BPJS Managing Director Mr. Fachmi Idris said that the ease of this procedure is to cut down the administrative procedures of chronic kidney failure patients who routinely receive dialysis services in the hospital. This is expected to make it easier for JKN-KIS patients to access dialysis services without the hassle of taking care of referral letters from FKTP. Usually JKN-KIS participants who do dialysis take care of referral letters from FKTP such as Puskesmas or clinics which must be renewed every three months.
The following was conveyed by Managing Director of BPJS Fachmi Idris:
"For matters related to improving services that facilitate participants who make it easier for participants to access health services is increasingly improved. One of them, which we agreed on, was the simplification of hemodialysis services."
"So JKN participants affected by kidney failure & nbsp; can access the facility & nbsp; health cooperating, without having to go back and forth to the First Level Health Facility (FKTP). Because the cases of the disease are already clear, which requires continuous service in follow-up service facilities. But there are requirements to record the fingerprint first, the existence of this recording ensures and makes it easy & nbsp; they come here, and truly they are participants."
"So we want to make sure it runs, because this program starts on January 1, then we deliberately choose one of the clinics, we want to make sure also how the service at the clinic is carried out. If in the hospital for hemodialysis services I have often (reviewed), but if in this clinic only the first."
"At present, there are 772 health facilities serving hemodialysis that have implemented the fingerprint program. Among these are 715 hospitals and 47 main clinics."
"For finger print, everything is ready. So indeed we asked for January 1, not only clinics but also hospitals cooperating with collaborating clinics that have already recorded. & Nbsp; The point is that participants are heading for January 1, we already have a commitment. & Nbsp; Everybody prepares a fingerprint device, then every time they come they are immediately recorded so they don't need to go back to the puskesmas, come here without bringing a letter of reference."

Besides that, Mr. Andreas Japar as one of the Directors at the Tidore Hemodialysis Clinic, the cost of dialysis can reach Rp 900,000 to Rp 1 million for one dialysis service, usually the Tidore Hemodialysis Clinic can serve up to 20 patients per day where the capacity reaches 24 patients per day. Most dialysis patients in this clinic are JKN-KIS participants, JKN-KIS patients also usually get this service 2 times a week with 5 hours each time dialysis.
With the increase in BPJS Health contributions per 2020, Andreas also hopes that claim payments by BPJS Health will be faster. However, he guaranteed that they would still maintain the quality of service to participants. "With the increase in fees, we hope we can get paid faster. Secondly, of course from the beginning we prioritized quality, so that our patients could be cared for properly, and could last a long life. So we do not carelessly own this clinic, From the equipment which is quite sophisticated, the human resources are trained and certified, the third sop we run it seriously," continued Andreas.
