BMC calls for more courage in reform plans for selective contracts.
12.11.2020 14:47
With the Healthcare and Nursing Improvement Act (GPVG), the German Federal Government plans, among other things, to expand the possibilities for selective contracts. In the run-up to the public hearing in the German Bundestag next Monday (November 16, 2020), BMC Chairman Prof. Dr. Volker Amelung is calling for bolder steps to help integrated care achieve a breakthrough.
The German Association of Statutory Health Insurance Physicians (BMC) generally views the measures proposed in the draft of the German Act on the Reform of the Provision of Care (GPVG) for the reform of special care pursuant to Section 140a of the German Social Code, Book V (SGB V), positively. In particular, the new possibility for cross-insurance care models involving various social security providers is considered an important step. "This offers the opportunity for integrated care models beyond the scope of the SGB V, for example, between health insurance funds, rehabilitation facilities, and municipal institutions such as social and youth welfare services, which play a crucial role in providing care," explains Amelung. The planned regulation in the law regarding regionally limited care innovations is also very helpful in addressing specific local care needs.
Despite many positive individual measures, the BMC criticizes the lack of an overall strategy for integrated care. "It remains unclear how the legislature actually intends to achieve widespread adoption of selective contracts and integrated care models," criticizes Amelung. There is still a lack of incentives for potential contracting partners to participate in such agreements. For health insurers, these agreements are at best a tool to differentiate themselves from the competition with additional services, while healthcare providers face a high level of bureaucracy when dealing with numerous contracts.
Therefore, the BMC CEO calls for concrete political targets: „A deadline by which a selective contract must be offered to a minimum percentage of insured individuals could provide new momentum and translate the opportunities created by the GPVG (German Healthcare Strengthening Act) into practical healthcare provision. I would like to see more courage from policymakers in formulating goals and pursuing them consistently.“ The current example of how a political vision can foster the commitment of all stakeholders can be seen in the area of digital health. A similar commitment from policymakers to integrated care would therefore be desirable.
Beyond the targets, selective contracts should also be regularly evaluated and, if the results are positive, scaled nationwide and across all health insurance funds. This also requires harmonizing the auditing practices of the Federal Office for Social Security (BAS) with those of the state supervisory authorities responsible for the AOKs, Amelung concluded.
The full BMC statement on the GPVG is available for download at www.bmcev.de/publikationen/stellungnahmen/.