Outpatient care from AOK-Baden-Württemberg: 725 million euros will flow into family doctor and specialist contracts in 2022
24.04.2023 15:43
In 2022, doctor's fees and the number of participants in the general practitioner and specialist program will continue to grow at a high level. At 725 million euros, the total fee paid to doctors is 2.4 percent higher than the previous year. Of this, around 547 million euros (plus 1.9 percent) relate to the HZV contract with 1.78 million AOK insured people. 178 million euros (plus 2.5 percent) will flow into the joint specialist contracts between AOK and Bosch BKK with 835,000 participating insured persons. 8,577 doctors including employees take part in the care (plus 0.8 percent). Of these, 5,416 are general practitioners and pediatricians and 3,161 are specialists and psychotherapists. The contractual partners will continue to rely on better and more economical care in the selective contracts in the future. On the occasion of the 15th anniversary of the HZV, they are eagerly awaiting the long-term results of a scientific evaluation comparing HZV with standard care, which will be presented to the public in Berlin on May 15th.
The CEO of AOK Baden-Württemberg, Johannes Bauernfeind, comments: “The family doctor and specialist contracts as a closely networked care unit still stand for long-term, high-quality and coordinated care for our insured persons with performance-related remuneration for the doctors. This only works with full supply contracts, as the supply structures can be tailored precisely to regional conditions. We want to continue on this path to success in the future.” A path that is also well received by AOK policyholders. Regular surveys of participants in the family doctor and specialist program show satisfaction levels between 90 and 95 percent. And for 9 out of 10 HZV insured people, the expectation of coordinated care from their family doctor is the most important reason for participation. However, the prerequisite for successful care structures like the HZV is stable cash finances, says Bauerfeind. “This can only be achieved if the efficiency advantages of selective contracts remain where they are achieved. It is not expedient if regions like Baden-Württemberg with high quality and efficiency in health care are financially penalized for this.”
The HZV is indispensable for many practices
For the first time in 2022, there will be a decline in the number of participating family doctors in the HZV contract due to age (minus 21). Compared to 2021, 47 employed doctors in the HZV are taking more part in the care, which confirms the growth trend in the area of employees. Prof. Dr. Nicola Buhlinger-Göpfarth, chairwoman of the Baden-Württemberg General Practitioners Association, says: “The HZV is indispensable for many practices, and it is much easier to find a successor for a successful HZV practice. But the HZV also has to face the challenges of demographic developments. In addition to the increase in the burden of disease, there is also a steadily decreasing number of doctors practicing as family physicians. An important strategic direction that we can actively influence ourselves is the systematic expansion of delegation, the strengthening of interprofessional care and the development of care centered on family practice. In the future, many HZV practices will be able to cover a wider range of services, be more attractive to employees and thus look after significantly more patients.”
Explicitly promote quality-oriented primary care and specialist medical full care contracts
On the development of selective contracts, Dr. Werner Baumgärtner, CEO of MEDI Baden-Württemberg and MEDI GENO Germany: “The HZV contract was designed to be expandable from the start because better outpatient care and control requires a more structured interaction between general practitioners and specialists. The growth rates of participating insured persons and doctors last year are still satisfactory given the financial situation. There are now 8 specialist contracts for 13 specialist groups and the evaluation data shows that the positive HZV effects are further strengthened as a result. That's why we have been tirelessly calling on federal politicians for years to ensure reliable framework conditions and to explicitly promote quality-oriented primary care and specialist full-service contracts, so that significantly more patients nationwide than before can benefit from the proven advantages.