The nation’s AOK health insurance providers are signaling continued concerns regarding the financing structure for hospitals, urging a fundamental shift away from current models. Recent adjustments to the proposed hospital reform, approved by the Bundesrat, have prompted the AOK to reiterate its call for a more scientifically robust and patient-centric approach to funding.
Carola Reimann, Chairwoman of the AOK Federal Association, emphasized that the postponement of the “advance funding” (Vorhaltefinanzierung) by a year presents a crucial opportunity. She advocates for the development of a scientifically validated instrument to determine hospital need, moving beyond the current reliance on actual patient cases (Ist-Fallzahlen). Reimann stressed the necessity of transitioning, after an initial implementation period, towards advance funding based on planned caseloads (Planfallzahlen) – a system designed to ensure the economic viability of hospitals deemed essential for regional care.
This position isn’t isolated. Reimann pointed to the German Hospital Federation (Deutsche Krankenhausgesellschaft) as a fellow proponent of a case-number independent funding model. The AOK’s worry is stark: maintaining a system driven by actual patient numbers risks creating perverse incentives. Such a structure, according to Reimann, could lead to economically motivated treatment decisions, potentially compromising the quality of care and ultimately harming patients.
The debate underscores a deeper political fault line concerning the control and direction of the German healthcare system. While politicians grapple with maintaining budgetary constraints and streamlining processes, the AOK’s critique highlights the potential for well-intentioned reforms to inadvertently create unintended consequences, incentivizing cost-cutting measures at the expense of patient well-being and potentially undermining the long-term stability of regional hospital networks. The shift to a scientifically driven, planfallzahl-based system, though potentially complex to implement, represents a significant challenge to existing political and bureaucratic inertia and carries the weight of protecting the integrity of Germany’s healthcare provision.