AOK contract in the southwest noticeably improves the quality of treatment

14.06.2010 15:00

The AOK Baden-Württemberg is now critical of the fire letter from individual health insurance companies, including DAK, Barmer-GEK and KKH, to Federal Health Minister Philipp Rösler. "It appears from the letter that the signatories only partially understood the opportunities offered by the contracts. Our contract for family doctor-centered care will now run for two years. We can therefore say plausibly and based on experience that the contract is not a cost driver," said the CEO the AOK Baden-Württemberg, Dr. Rolf Hoberg, on Friday (June 11, 2010) in Stuttgart.

According to Hoberg, the additional expenditure of up to 1.5 billion euros mentioned in the cash letter to Rösler was completely out of thin air and had no basis. Finally, to put it simply, the adjustment mechanism also ensures that a cash register does not pay twice or three times. Hoberg: “What we pay directly to the doctor for the treatment of the patients enrolled in the contract, we of course do not need to transfer it again to the Association of Statutory Health Insurance Physicians (KV).”

In addition, for Hoberg, it is particularly the savings through prescribing the right medication and aids that ensure the success of family doctor contracts in terms of quality and cost-effectiveness.

For the AOK boss from Baden-Württemberg, the advantages of family doctor-centered care are obvious: “We are approaching 1 million registered patients and 4,000 doctors. Patient surveys confirm that 97 percent of the participating insured persons are satisfied or very satisfied - 94 percent would recommend participation. This is sensible spending because behind these numbers is real quality of care.”

The family doctor's pilot function must be completed by networking with specialists. Hoberg: “This networking expands the security of care and enables outpatient care to be given priority over hospital treatment.”

That is why the AOK Baden-Württemberg has also concluded contracts with specialist groups, such as cardiologists. Further specialist contracts such as those with gastroenterologists would follow. “Overall, with this contract policy we are promoting stability in statutory health insurance. The criticism now expressed about this approach is incomprehensible if the opportunities for contractual activities offered by the law were properly used. In any case, AOK Baden-Württemberg has taken the right path,” continued Hoberg.

You can read more about the topic in the focus issue of discount contracts (MVF issue 03/2010) and selective contracts, especially family doctor contracts (MVF issue 04/2010).

Excerpt from the contents of the upcoming issue (04/2010) – available from August 2, 2010:

Oberender / Götz
Direct contracts in outpatient care - effects and the question of "safety" - an analysis from a competition perspective

Ehlers / Bitter
Change in care through direct contracts in conjunction with the interconnection of service sectors

Klusen
Supply management in health insurance: On the way to a learning system

Flour/White
Experience from contract negotiations and arbitration proceedings on the HZV

Elger / Happy / Fox
Experience from contract negotiations and arbitration proceedings on the HZV

Stadler / Urnauer
Two years of HZV in Baden-Württemberg from the perspective of an IT provider

Weatherly
The unknown quantity of healthcare: doctor networks

Eberhard
Quality indicators for medical networks

June 14, 2010