Abstract
In Germany health policy-makers of all parties believe in competition as an incentive for creating innovation and to keep costs down. Sickness funds cover about 90% of the population=regulated market/10% are covered by health insurance plans=private market. The sickness funds in the regulated market have the same premium (this goes to a national agency and is distributed to the funds after a risk adjusted scheme that uses morbidity trees to develop a fair payment to the funds) but vary whether they have to ask for a separately paid surplus premium.
Sickness funds compete about surplus premiums, services and offers to the patients and about selection (healthy vs. sick). They have to ask:
What are the strongest interventions in increasing health status and keeping costs down?
Who is offering a comprehensive and sustainable solution serving my population?
With what kind of reimbursement scheme do I attract the right spirit … not too much interventions, but not too few as well …. tackling the right people … using the newest technology, but with as few costs as possible?
For more information on integrated care in Germany, please follow the link to the power point presentation below.
Keywords: Germany, population based integrated care
PowerPoint presentation available from: http://www.integratedcare.org/Portals/0/congresses/Hildebrandt_Virtual%20Study%20Tour%20Germany_GK_Odense_20110330.pdf