Staying the Health Course: Germany's Proposed Structural Reforms for Health and Long-Term Care Insurance
Klingbeil pledges to inject funds into the health insurance sector
The current German government has rolled out a series of bold structural reforms, tackling the financial not-so-healthy state of the health and long-term care sectors. Here's a lowdown on the key reforms:
Saying Auf Wiedersehen to the DRG System
It's time to say goodbye to the Diagnosis-Related Group (DRG) flat rate fee system for hospitals. In its place, a system based on Vorhaltepauschalen will take charge. This new system pays for maintaining certain services, and hospitals will be grouped according to their service offerings[1]. The full implementation of this reform is set for 2027, following a transition period.
Transparency, Baby!
Investor-owned medical care centers (iMVZ) will fall under increased scrutiny and regulation, with efforts focusing on enhancing transparency regarding ownership and the appropriate use of funds. Previous discussions have hinted at stricter regulations, but the current plans are less drastic[1].
Synergy in the Pharmaceutical Sector
The government remains committed to the pharma dialogue, further developing the AMNOG process, and emphasizing personalized medicine. The reshoring of critical drug and medical product manufacturing aims to boost supply security[2].
Shoring Up the Health Insurance System
The focus is on stabilizing the health insurance system's finances by addressing the structural gap between revenues and expenditures. Contribution rates keep climbing due to financial pressure, impacting pharmaceutical reimbursement conditions[2].
Going Digital in Healthcare
The government plans to boost the adoption of telemedicine and digital triage, with a focus on improving early assessment and smoother access coordination[2].
The Federal Wallet to the Rescue
Federal funding is crucial for addressing health and long-term care sector difficulties. The government is aiming to:
- Closing the Financing Gap: Solidifying financing for the statutory health insurance system by filling the revenue-expenditure gap[2].
- Investing in Digital Infrastructure: Supporting the development of digital platforms for telemedicine and digital triage[2].
- Reshoring Production: Encouraging the return of critical drug and medical product manufacturing to Germany and Europe to improve supply security[2].
However, the budget's financial constraints limit the scope for substantial federal funding increases, potentially leading to stricter pharmaceutical reimbursement conditions[2].
- In the proposed reforms for health and long-term care insurance in Germany, the focus is on shoring up the health insurance system's finances, going digital in healthcare, and investing in digital infrastructure to improve early assessment and smooth access coordination.
- The government has plans to close the financing gap in the statutory health insurance system by solidifying financing, resorting to reshoring critical drug and medical product manufacturing to Germany and Europe to boost supply security.
- In a bid to address the health and long-term care sector difficulties, the government aims to enhance transparency regarding ownership and the appropriate use of funds in investor-owned medical care centers, as part of a series of structural reforms, also including a shift from the DRG system to a new system based on Vorhaltepauschalen. The reforms also involve further developing the AMNOG process, emphasizing personalized medicine, and boosting the adoption of telemedicine.
