Table 2.
BW | BV | BE P | BE N | BB | HB | HH | HE 1f | HE 2 | MV | LS | NR | RP | SL | ST e | SX/ TH | SH | WE | Sum | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Reimbursement scheme publicly available | x | - | x | x | x | - | - | x | x | x | x | x | contract cancelled | - | x | x | - | x | 12 | |
Differentiated care levels | x | Individually negotiated | x | x | x | x | x | x | x | 8 | ||||||||||
Full care | Case fee w/o performance daya | x | x | x | x | x | x | x | Individually negotiated | x | 8 | |||||||||
Case fee w/ performance dayb | x | x | x | 3 | ||||||||||||||||
Weekly rate | x | x | x | 2 | ||||||||||||||||
Daily rate | xc | x | x | x | xc | 5 | ||||||||||||||
Daily rate w/ visit | x | 1 | ||||||||||||||||||
Fee for service | x | x | x | x | x | 5 | ||||||||||||||
Nursing care (§37 SGB V) excluded if SPHC | x | x | x | x | 4 | |||||||||||||||
Partial care | Case fee w/o performance daya | x | x | x | x | x | x | x | x | x | 9 | |||||||||
Case fee w/ performance dayb | x | x | x | x | 4 | |||||||||||||||
Weekly rate | x | x | x | 3 | ||||||||||||||||
Daily rate | xc | x | x | 3 | ||||||||||||||||
Daily rate w/ visit | x | 1 | ||||||||||||||||||
Fee for service | x | x | x | x | x | x | x | xd | x | 9 | ||||||||||
Nursing care (§37 SGB V) excluded if SPHC | x | 1 | ||||||||||||||||||
Coordination | Case fee w/o performance daya | x | x | x | x | x | x | x | x | 8 | ||||||||||
Case fee w/ performance dayb | x | x | x | x | 4 | |||||||||||||||
Weekly rate | x | x | 2 | |||||||||||||||||
Daily rate | x | x | x | 3 | ||||||||||||||||
Daily rate w/ visit | 0 | |||||||||||||||||||
Fee for service | x | x | x | x | x | x | xd | x | 8 | |||||||||||
Consultation | Case fee w/o performance daya | x | x | x | x | x | x | x | 7 | |||||||||||
Case fee w/ performance dayb | x | x | 2 | |||||||||||||||||
Weekly rate | x | x | 2 | |||||||||||||||||
Daily rate | x | x | 2 | |||||||||||||||||
Daily rate w/ visit | 0 | |||||||||||||||||||
Fee for service | x | x | x | x | x | x | x | x | xd | x | 10 | |||||||||
Transportation expenses | x | x | 2 | |||||||||||||||||
Fees for GPs and other physicians | x | x | x | 3 |
BW Baden-Württemberg, BV Bavaria, BE P Berlin, physicians, BE N Berlin, nursing care, BB Brandenburg, HB Bremen, HH Hamburg, HE 1 Hesse (two contracts), HE 2 Hesse AOK health insurance fund, MV Mecklenburg-Western Pomerania, LS Lower Saxony, NR North Rhine, RP Rhineland Palatinate, SL Saarland, ST Saxony Anhalt, SX/T Saxony/Thuringia, SH Schleswig–Holstein, WE Westphalia
a Case-based lump sum is paid for days with and without patient-related contact b Case-based lump sum is only paid for days with patient-related contact
cif any kind of service is provided dnumber of visits with cut-off eonly the regulations for physicians are publicly available fHesse has three model contracts for different groups of health insurance funds. Two of these model contracts share the same reimbursement scheme