Outpatient coding policies don't make patient care better, they make it worse
04.02.2011 18:06
The board of the Bavarian Association of Statutory Health Insurance Physicians (KVB) rejects the introduction of the outpatient coding guidelines (AKR) in their current form.
The KVB announced this on February 4th in Munich. “The AKR system in its current form aims to make people sicker than they actually are. Because the focus is not on healthy people, but rather on illnesses that are as severe as possible. In the future, the sicker the more lucrative,” criticizes the KVB CEO, Dr. Wolfgang Krombholz. This would create completely wrong incentives: “The new coding guidelines tend to promote complex, detailed documentation of diagnoses. Approaches to keep patients healthy - such as incentives for prevention - are completely missing. On the contrary: the idea of prevention is counteracted by the AKR.” The guidelines set by the federal level would therefore in no way improve the care of citizens in Bavaria, said Krombholz.
“The bureaucracy associated with the introduction of the AKR is also causing the workload of practicing doctors and psychotherapists to increase massively - and without any financial compensation,” emphasized Board Vice President Dr. Pedro Schmelz. “The enormous coding depth required and the complex recoding of existing diagnoses mean considerable additional bureaucratic effort. In our practices, we lose valuable time that we could otherwise devote to our patients,” says Schmelz. It is also problematic that not all manufacturers of practice management systems have implemented the AKR in a user-friendly manner. “Numerous technical problems currently make it impossible to integrate the new coding regulations into everyday practice.”
The KVB board also criticizes the fact that no significant information is yet available about the impact of the entire project on fee policy. “At the moment it is still completely unclear what significance the coding according to the new coding guidelines will have for the fees of doctors and psychotherapists in the future,” says Dr. Ilka Enger, second deputy chairwoman of the KVB board. She warned against turning Bavaria's doctors and psychotherapists into helpers in implementing federal regulations, the effects of which have not even been clarified yet. The KVB board jointly declared that they were generally in favor of precise coding of diagnoses. In their current form, however, the AKR is unreasonable for both the medical profession and patients. That is why the KVB board supports a petition submitted to the German Bundestag to stop the outpatient coding guidelines.