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Abstracts by key term: Morbi RSA; New compensation mechanisms

Disease Management 2.0 & Morbi-RSA 1.0 – Medical Management for health insurance companies under the conditions of Morbi-RSA

Disease management programs are an important part of healthcare in Germany and the Netherlands. In Germany, the results are partially satisfactory. Some relevant disease parameters (surrogate parameters) were improved, but the medical outcomes were only slightly affected. Even the savings promised with the introduction of the DMPs have not yet been realized. In the Netherlands, special software support was used to make DMPs really effective across sectoral supply boundaries. The software-based DMP introduction was accompanied by the parallel deployment of nurses, doctor's assistants and other medical professionals in order to effectively relieve the doctors' workload. This dual approach was key to the programs' success. In addition, multi-disease programs that focus on individual indications will replace DMPs in the future; because they more accurately reflect the given multimorbidity of larger sections of the population. Under the conditions of the new Morbi-RSA in Germany, the new and “old” DMPs will be aimed at the diseases depicted here. Providers and developers of DMPs are called upon to develop solutions for these new indications and to integrate innovative technologies available today. Funds and private health insurance companies should catalyze these developments through accompanying new compensation mechanisms such as quality-oriented compensation (pay for performance) or risk sharing.

01.06.2008

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