Hybrid DRG: Opportunity for investment and expansion in the contract medical sector
16.11.2022 11:33
Health Minister Lauterbach has now decided to seriously advance patient-friendly outpatient surgery. This emerges from a draft of the Hospital Care Relief Act (KHPflEG), which was discussed in the Health Committee of the Bundestag on November 9, 22. The Federal Association of Ambulatory Surgery (BAO) expressly welcomes the fact that the hybrid DRG project, as agreed in the coalition agreement, is now finally being implemented.
“Hybrid means: better remuneration for outpatient operations than before, but less remuneration than for inpatient operations,” explains BAO Executive Board member Dr. Jörg Hennefründ, who runs a large gynecological day clinic in Oldenburg. “This remuneration should go equally to all sectors involved, i.e. both the hospitals and the contracted doctors.”
The BAO sees the legislative initiative as a serious effort to ensure the population's supply in the future. Ultimately, around four million operations are carried out annually on an outpatient basis in contracted medical facilities, and 1.8 million in the hospital sector. But in an international comparison, Germany is still at the bottom when it comes to the frequency of outpatient operations. “This is because the previous low remuneration in the outpatient surgical facilities hardly allowed any investments and the hospitals wrote deficits due to the lack of remuneration and preferred to arrange inpatient stays,” explains Dr. Hennefründ.
The BAO does not accept the concerns of hospitals that they cannot operate economically with the remuneration of the hybrid DRG. “It would be counterproductive to exclude the contract medical sector from better remuneration and at the same time to grant the clinics the full remuneration for outpatient operations as for inpatient treatment,” emphasizes Dr. Hennefründ. After all, the main costs in healthcare are personnel costs. “This suggests that hospital staff are deployed less efficiently and can provide fewer services to patients than is the case in contract medical facilities,” argues the BAO representative.
According to the BAO, a rejection of the hybrid DRG solely to support economically less efficient hospitals endangers the supply of the population. “If the hospitals fear for their existence and there is a political desire to support them, then there must be other options than preventing the contracted doctors from providing care to the population!” warns Dr. Hennefründ and adds that appropriate remuneration would enable statutory medical institutions to expand their capacities through investments and thus ensure care for the population.