breaking news
The tough struggle is over: the federal and state governments have agreed on the cornerstones for hospital reform. Federal Minister of Health Lauterbach spoke of a “revolution”.
After months of wrangling, the federal and state governments have agreed on the key points for hospital reform. Federal Health Minister Karl Lauterbach (SPD) spoke of a “revolution” after a meeting with his colleagues from the federal states in Berlin. According to Lauterbach, 14 of the 16 countries voted for it. Bavaria voted against, Schleswig-Holstein abstained.
A joint federal-state group will work out a concrete draft law over the summer. According to Lauterbach, Hamburg, Baden-Württemberg, Mecklenburg-Western Pomerania and North Rhine-Westphalia will also be involved in this. The law is scheduled to come into force on January 1st.
Abandonment of case flat rates
The previous flat rates for hospitals are to be replaced by upfront flat rates for services. Clinics should receive 60 percent of the remuneration for offering certain services, regardless of whether they are actually accessed. That takes the economic pressure off the clinics and allows a reduction in bureaucracy, said Lauterbach.
Small hospitals would no longer be forced to provide so many services, for example cancer treatments would be carried out in special centers. With the flat fee, you would have “a kind of guarantee of existence” beyond the number of cases. Lauterbach emphasized that the provision flat rates could only be received by clinics that also met the corresponding quality criteria. Small clinics could thus concentrate on what they could do well.
Well defined performance groups
The basis of the financing by the health insurance companies should be more precisely defined performance groups of the clinics – for example “cardiology” instead of rough terms like “internal medicine”. The performance groups are intended to ensure uniform quality specifications, for example in terms of equipment, staff and treatment experience.
Lauterbach wants to make the distribution of the service groups in the houses and a division into levels of care transparent. There was no agreement on a more controlling function of the levels. What is meant by levels are classifications of the clinic network in stages – from basic care close to home to a second level with further offers up to maximum care providers such as university hospitals.
Demands from the federal states for a financial injection from the federal government for the clinics before the reform were not implemented. Lauterbach also said with a view to the budget situation that it would be checked, but added: “I can’t hope for that.” Unfortunately, clinics would still go bankrupt before the reform takes effect – but that’s because the reform wasn’t made earlier.