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Hospital reform: A closer look at the reimbursement of hospital services.

Policy paper published: result shows potential risks for payers and hospitals

On behalf of the PKV Association, a team from Oberender AG led by Prof. Dr. Andreas Schmid prepared a policy paper. It analyzes the implications of retainer payment for hospital sector reform.

That compensation reform is necessary is indisputable. The same applies to the fact that an advance payment can make a meaningful contribution here. Of fundamental importance, however, is their sensible design.

Prof. Dr. Andreas Schmid, manager at Oberender AG, emphasizes: “Based on the key points communicated so far, there is still a clear need for development. Otherwise, there is a risk of potentially serious misalignment of incentives and a further increase in complexity without coming substantially closer to the goals of the reform.”

Possible misaligned incentives arise, on the one hand, at the level of the payers. Here, for example, there is a risk that prevention efforts by insurers will be less worthwhile and reduced accordingly. At the hospital level, the very high retention rate of 60% entails a high risk that providers will reduce services for economic reasons. At the same time, the retention payment in the form currently outlined does not relieve the burden on departments struggling with high retention costs and low caseloads at the same time.

Jochen Baierlein, CEO of Oberender AG, points to the precarious situation of many hospitals: “The hospitals need effective measures in the short and medium term. In the form currently under discussion, the advance payment does not relieve the clinics, but at the same time increases the administrative burden. Urgent action is needed here.”

You are welcome to download the expert opinion here:

Authors: Andreas Schmid, Katja Heinz, Lennart Klages und Jochen Baierlein
With the collaboration of: Sarah Günther and Philipp Leibinger
Contact: Prof. Dr. Andreas Schmid

The classification of the results of the policy paper by the PKV association can be found here.

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