AOK Baden-Württemberg's general practitioner and specialist contracts will continue to increase participation numbers and physician fees at a high level in 2023
24.04.2024 13:09
At the end of 2023, AOK Baden-Württemberg recorded an increase in the number of HZV insured persons to 1.83 million (plus 2.9 percent) and 872,000 participants in the joint specialist program with Bosch BKK (plus 4.4 percent). Total fees amounted to €758 million, up 4.6 percent from the previous year.
Of this, €565 million (up 3.4 percent) is attributable to the HZV contract and €193 million (up 8.4 percent) to the nine specialist contracts. A total of 8,779 physicians, including their employees, participate in the care (up 2.3 percent). Of these, 5,523 are general practitioners and pediatricians, and 3,256 are specialists and psychotherapists. The contracting partners, AOK, Bosch BKK, the General Practitioners' Association, and MEDI Baden-Württemberg, are satisfied with the development. In times of health policy challenges, they are committed to demonstrably better and more cost-effective care and plan to continuously develop the contracts.
One focus of patient care is on measures to address the diverse impacts of climate change, which pose a particular health risk for older and chronically ill people. These groups account for over 60 percent of HZV participants. Johannes Bauernfeind, CEO of AOK Baden-Württemberg, explains: "We remain satisfied with the development of the selective contracts. Despite the increasing instability of health insurance fund finances, we continue to invest in high-quality patient care. More than 80 percent of family doctors who meet the requirements for participation are enrolled and make a significant contribution to ensuring this. They enable our HZV insured members to receive comprehensive care and advice that strengthens health and climate awareness, especially among at-risk groups."
A current development topic is the HÄPPI (General Practitioner Primary Care Center – Interprofessional Patient Care) care concept. In July, a six-month pilot project will launch in Baden-Württemberg, the first nationwide project in which HZV practices can participate to test the implementation of HÄPPI. Dr. Susanne Bublitz and Prof. Dr. Nicola Buhlinger-Göpfarth, Chairwoman of the Baden-Württemberg General Practitioners' Association, emphasizes: "For years, we have been experiencing a growing need for care in our general practices and the current shortage of approximately 1,000 general practitioners in the state. With optimized work processes and new forms of teamwork, HÄPPI offers real prospects for ensuring that care remains affordable for practices. The prerequisites for this exist in the HZV, which has stood for innovation for 16 years. By testing HÄPPI, the contracting parties to the HZV contract with AOK Baden-Württemberg are now taking another important step toward sustainable care."
Together with the HZV, the specialist contracts offer a unique, structured, comprehensive care service outside the statutory health insurance system. These include more coordinated collaboration, more consultation time, adequate remuneration without budgeting, and an expanded range of services. For example, cardiologists have been able to perform outpatient defibrillator implantation since 2017. In 2023, the portfolio was completed with the new implantation of three-chamber systems and subcutaneous ICDs (S-ICDs). Since the beginning of the year, the free messenger app garrioCOM has been available to participating general practitioners and specialists for communication with patients.
Dr. Norbert Smetak, CEO of MEDI Baden-Württemberg, commented on the development of selective contracts: "The full-coverage contracts of AOK Baden-Württemberg continue to set qualitative standards – not least because they allow significantly more freedom for independent regional care planning. We have functioning patient management, significantly less bureaucracy, and appropriate remuneration without budgeting. All of these things have been urgently demanded in standard care for years but never implemented."
Frieder Spieth, CEO of Bosch BKK, emphasizes: "We are pleased that our insured patients also benefit from the joint specialist contracts. For example, a major advantage of the PNP contract is immediate online enrollment without extensive bureaucracy. The patient only needs a referral and can be enrolled in the program online directly in the practice. There is also no lengthy approval process or review by an external expert, as is normally required for long-term therapies. For patients, rapid appointment scheduling is also important when needed, so that they don't have to wait several months for a psychotherapy appointment, which can be very stressful."