KVB representatives' meeting demands: Corona vaccinations should not be hastily transferred to standard care

28.11.2022 12:56

The Federal Ministry of Health's (BMG) plans to make corona vaccinations part of regular care at the turn of the year could cause chaos in practices. Too many questions are still unanswered to ensure a smooth transition. That is why the representative meeting (VV) of the Bavarian Association of Statutory Health Insurance Physicians (KVB), which took place on Saturday under the leadership of the chairwoman Dr. Petra Reis-Berkowicz in Munich called on the BMG to extend the Corona vaccination regulation until April next year as originally planned.

Otherwise, there is a risk of significant problems with the further implementation of the vaccination campaign, especially in the winter months. In addition to the corona pandemic, the KVB VV also dealt with, among other things, the slow digitalization of the healthcare system and the difficult economic situation of practices due to inflation and rising energy prices.

The board of directors of the KVB – Dr. Wolfgang Krombholz, Dr. Pedro Schmelz and Dr. Claudia Ritter-Rupp – looked back over the past few years in this last VV of the current term of office. The on-call service reform has proven to be very successful. The new layout of the on-call areas with transport services and 126 permanent on-call practices has not only reduced the number of hours on duty for doctors by half. In addition, patients can usually get to the nearest on-call practice within 30 minutes. The goal of abolishing recourse for drug prescriptions was also achieved through the active ingredient agreement with the health insurance companies. “Tax instead of checking” is the motto here, which is brought to life through regular trend reports to the practices and references to more economical options in the regulation. The regular updating of the fee distribution scale (HVM), coordinated with the specialist groups, is also one of the achievements reported by the board. While the HVM was often a contentious issue among medical groups in the past, things have now largely calmed down thanks to open communication, good coordination and forward-looking planning. The VV acknowledged the board's balance sheet with much applause and approval.

However, the current situation in outpatient care is certainly challenging, as the KVB board also made clear in its reports. Always in the focus of criticism: Federal politics and in particular the Federal Minister of Health Professor Dr. Karl Lauterbach. He simply doesn't listen to doctors and psychotherapists and creates a "culture of distrust towards the medical profession". Examples of this include the deletion of the GKV new patient regulation, which is important for practices, the further delay in the urgently needed update of the fee schedule for doctors (GOÄ) and the lack of practice support programs in view of galloping inflation and energy costs. It is therefore no wonder that there is now a shortage of outpatient medical care in more and more regions of Bavaria. The family medicine planning areas of Donauwörth Nord, Simbach am Inn, Ansbach Nord and Wassertrüdingen are considered to be undersupplied, subject to the decision of the responsible state committee. In addition, there are the Wunsiedel and Regen districts for dermatologists and the Tirschenreuth district for ENT doctors. From the point of view of the KVB board, this is just the tip of the iceberg, as the situation is expected to worsen further due to more and more regions being threatened by undersupply. It is absolutely counterproductive if the health insurance companies constantly insist on zero rounds for the practices in fee negotiations. In a unanimously passed motion, the VV called on the umbrella association of health insurance companies to end its blockade policy and show willingness for constructive negotiations.

In the area of psychotherapeutic care, the consequences of the corona pandemic and the war in Ukraine mean that more and more children and young people are suffering from mental illnesses that should be treated by specialized medical and psychological psychotherapists as well as child and adolescent psychiatrists. In this context, the board renewed its call for a reform of demand planning and more branch opportunities in this area. The state must also ensure sufficient funding for the new psychotherapy training. The VV also presented an analysis of patients' waiting times for psychotherapy, which is based on the treatment and billing data. Although it is not possible to determine the length of time from contact to the first consultation, from then on the progression of time is easy to understand. The median duration from the first consultation to the first psychotherapy requiring approval in Bavaria is 97 days, although there are of course regional variations. When it comes to data protection, against the background of a European Health Data Space, it was demanded that the state must ensure that patients have the right to informational self-determination when further developing the electronic patient file.