Hospital financing: outpatient treatment yes, mere relocation no

16.03.2022 16:46

The outpatient treatment of previously inpatient services, which is being discussed as part of the hospital financing reform, must not simply result in a shift of cases to the statutory health insurance reimbursement system. Furthermore, the federal states must finally fulfill their obligations to finance hospital investment costs. The Professional Association of German Surgeons (BDC) is addressing these demands to those responsible in politics and self-government at the DRG Forum on March 17-18, 2022, in Berlin.

"We fundamentally support the current efforts of the legislature to fundamentally reform the financing structures of German hospitals. We also support, in principle, the outpatientization of services that hospitals have previously provided on an inpatient basis, as provided for in the traffic light coalition agreement. However, it cannot be the case that inpatient cases previously reimbursed via DRG flat-rate fees are now simply shifted to the outpatient sector under the terms of the uniform assessment standard for medical services (EBM)," says Dr. Jörg-A. Rüggeberg, Vice President of the BDC.

Fortunately, the coalition is planning sector-wide reimbursement for suitable services through so-called hybrid DRGs, Rüggeberg said. To this end, a mixed price for surgical procedures would be calculated from the DRGs and the EBM, which should financially cover not only the necessary pre-operative costs but also a short inpatient stay. A commitment to outpatient care is limited by the specific patient situation, which may require short-term overnight care even for minor procedures.

Furthermore, the BDC urgently calls on the federal states to finally fulfill their legal obligation, resulting from the principle of dual financing, to cover necessary investment costs for hospitals. The total volume invested by the states has been declining for a long time. Investments in hospitals' digital and technical infrastructure, in particular, have recently been inadequate. Rüggeberg is certain: "We can no longer postpone this. If we want to provide the usual high level of quality care for patients in the inpatient sector, we must act now. I urgently appeal to the states to finally equip our hospitals with modern equipment."