The hospital reform in Germany is becoming more concrete. A draft bill envisages, among other things, a reduction in flat rates per case. In addition, medical treatment should be a maximum of 40 minutes away by car.
The Federal Ministry of Health has completed a draft bill for a comprehensive hospital reform. Accordingly, this should, among other things, introduce a new remuneration system that will relieve clinics of the economic pressure to treat more and more patients. “Bild” first reported. The design also suits that ARD capital studio before.
Today, clinics receive a flat rate of euros per treatment case or patient. These per-case flat rates should be reduced. In return, there should be fixed amounts for the provision of staff, an emergency room or necessary medical technology. In the future, the clinics should receive 60 percent of the remuneration simply for providing services.
Clinics should be in Performance groups to be grouped
The basis for financing by the health insurance companies should be more precisely defined service groups. The aim is to ensure the quality of treatment through the same standards nationwide. According to the draft, the initial performance groups and their quality criteria are to be worked out by the federal and state governments in a four-stage process. Medical specialist societies and self-governing partners in the healthcare system should also be involved. The groups in this process should also be further developed.
Additional money is earmarked for clinics every year from 2027, for example to provide pediatric medicine wards (288 million euros), obstetric wards (120 million euros), stroke wards (35 million euros) and intensive care units (30 million euros). University hospitals should also receive more money.
Rural hospitals should also be retained. “The annual funding amounts for rural hospitals in need will be increased” to up to one million euros per year per hospital, according to the draft bill. This should save clinics in the area that provide basic medical care. Existing clinics can therefore also be converted into a “cross-sector care facility”. There should no longer be any complicated procedures carried out close to home, but rather care and minor operations, among other things.
Maximum 40 minutes travel time to treatment
The draft also stipulates that internal medicine and general surgery wards should be reachable by car in a maximum of 30 minutes. For the other performance groups, the travel time should be a maximum of 40 minutes. The planning should also take into account the number of residents who would be affected by longer travel times if there are no corresponding services in their local area.
In addition, a transformation fund is to be set up for the reform, with which a financial volume of up to 50 billion euros will be made available by 2035. According to the draft, half of the money will come from health insurance companies; The federal states should take over the other half.
Lauterbach: Hospital landscape is changed significantly
Most recently it was said that the draft law would be passed in the cabinet on April 24th. According to Federal Health Minister Karl Lauterbach (SPD), “major quality deficits” should be reduced through more specialization. Today, a third of cancer treatments are carried out in those two thirds of German clinics that do not understand this well due to a lack of experience. The result is serious complications such as sepsis (blood poisoning), said Lauterbach at the end of January. The reform will significantly change the hospital landscape. So far there are over-supplied cities and under-supplied areas in rural regions.
“There is a lack of insight into the practice and the patient”
The board of the German Foundation for Patient Protection, Eugen Brysch, accused Lauterbach of carrying out his reform “on the drawing board and with a slide rule.” “There is a lack of insight into the practice and the patient,” he said. Everyday life in the hospital continues to resemble a jungle. There is no coordination between patients, relatives and employees. This “misery” is characterized by a lack of contact persons, postponements of medical examinations, long waiting times and canceled appointments. Those who suffer are patients and relatives, said Brysch.
With regard to the reform plans, Brysch called it questionable “whether quality can be measured solely by the number of employees in relation to the number of treatment cases, their frequency and the complication and mortality rate.” He criticized the draft law as lacking a binding requirement to provide each patient with a case manager.