AOK general practitioner and specialist doctor contracts in the southwest will continue to grow at a high level in 2021
11.05.2022 13:54
In 2021, 8,509 doctors took part in the care provided under AOK Baden-Württemberg's family doctor and specialist contracts. This corresponds to a total increase of 2.7 percent compared to 2020 - of which 5,396 are general practitioners and pediatricians and 3,113 are specialists and psychotherapists. They now provide care for 1.76 million HZV insured people from AOK Baden-Württemberg (plus 2.1 percent). The number of insured people in the joint specialist program run by AOK and Bosch BKK grew by 5.2 percent to 814,000. The fee for the services provided also increases accordingly.
At the end of 2021 it is 708 million euros, 4.4 percent above 2020. 537 million euros (plus 3.9 percent) are attributable to the HZV contract and 171 million euros (plus 6.2 percent) to the specialists and Psychotherapists. The contractual partners are satisfied with this development and continue to rely on better and more economical care in the selective contracts. The ninth specialist contract in pulmonology started in 2021.
However, there is still a shadow on the development prospects - due to general financial developments and redistributions in the statutory health insurance system. The AOK Baden-Württemberg has to cope with an outflow of around 260 million euros to other federal states due to the regional component alone. Money that was generated through efficient structures and that the AOK would prefer to invest further in innovations and supply improvements in the country.
The CEO of AOK Baden-Württemberg, Johannes Bauernfeind, comments:
“With family doctor and specialist contracts, we have been showing in Baden-Württemberg for 14 years that better quality and more economical outpatient care is possible in this way. That's why we want to continue on this successful path in the future. The key success factor is that it is based on voluntary agreements, as this is the only way to really promote creativity and innovation.” A current example of the rapid adaptability of selective contracts is the inclusion of a flat rate consultation fee for patients with long- and post-Covid after referral a HZV family doctor. The new service started in April in the fields of cardiology, neurology and pulmonology.
“It should therefore be the task of politicians to maintain and strengthen incentives with stable framework conditions in order to further exploit the potential of full care contracts for participating insured persons. This also means that efficiency gains through successful action are not skimmed off, as is the case with the regional component.” In addition, Bauernfeind sees the federal government as responsible for fundamentally ensuring stable financing of the statutory health insurance, without permanently depriving the health system of the health system through an excessive federal subsidy to make the federal government's cash position dependent.
The number of family doctors and pediatricians participating in the HZV rose to a high level in 2021 due to the increase of over 100 employed doctors. Prof. Dr. Nicola Buhlinger-Göpfarth, chairwoman of the Baden-Württemberg General Practitioners Association, says: “Not least due to the increasing pressure on care, the practice of the future will increasingly become a team practice based on the division of labor. There are now over 1,400 employed doctors working in our HZV practices. In addition, the number of VERAH is also increasing, which represents an increasing relief from the previously often medical functions. In the future, according to plans by the general practitioner association and its training institute, the academic VERAH will also be an important component of the HZV's further development towards family doctor-centered care."
Commenting on the development of selective contracts, Dr. Werner Baumgärtner, CEO of MEDI Baden-Württemberg and MEDI GENO Germany: “The growth rates of participating insured persons and doctors in the two pandemic years are satisfactory, and we still see development potential in the general practitioner and specialist program – also outside of Baden-Württemberg. Politicians should therefore not question the HZV's obligation to pay health insurance, but should finally ensure that health insurance companies, beyond the bureaucratic monster of the Innovation Fund, receive financial incentives to improve medical care through selective contracts and to promote and adequately remunerate freelance outpatient medical care . In addition, family doctor and specialist contracts are the only instrument for meaningful patient management that we have nationwide.”
Dr. Gertrud Prinzing, board member at Bosch BKK, adds: “In recent years, the legislature has increasingly intervened in supply with nationwide regulations. This is counterproductive because only through selective contracts do we have the necessary regional design options. The contracts give the participating doctors time to provide more intensive care for their patients. Through comprehensive advice, their health literacy is sustainably strengthened and the quality of care is improved." The contractual partners in the southwest agree that the solutions to the widely discussed problems in the health care system can only be solved with consistent adherence to the principle of subsidiarity - that means predominantly at the regional level by the actors who bear direct responsibility there.