Making health care future proof

The Act to Strengthen Care Provision in the Statutory Health Insurance System (Care Provision Strengthening Act) took its last parliamentary hurdle on 10 July 2015 in the Bundesrat and an integral part of it entered into force on 23 July 2015.

The purpose of the Act is to continue to guarantee a high level of easily accessible medical care for patients in the future.

In future, good medical care may not depend on where a person lives. Precisely in the rural areas, a greater effort needs to be made so as to maintain good health care provision. Financial incentives are one component; it is important, however, to improve working conditions in such a way that more physicians once again choose rural practice. At the same time, it is necessary to take an intelligent approach to developing care further. The innovation fund is intended to provide targeted funding for projects that are forging new paths in the provision of care.

Federal Minister of Health Hermann Gröhe

The provisions contained in the Care Provision Strengthening Act in detail:

  • The Act allows the persons responsible on the ground to grant greater incentives to encourage doctors to settle in underserved or structurally weak regions. To this end, the setting up of a structural fund to promote the establishment of medical professionals will be facilitated and the funding options expanded.

  • Furthermore, the possibilities for opening medical service centres will be further developed. By setting up a medical service centre, local authorities, particularly those in rural regions, can take an active role in shaping health care provision.

  • Doctors should be working in those locations where they are needed to secure the provision of good care. In the future, a practice in an over-served area will be allowed to remain open after the doctor retires, only if this makes sense in order to care for patients. This case-by-case decision will be taken by physicians and the health insurance funds within the local licensing committees.

  • In order to strengthen family doctor care in the long term, the minimum number of further training places eligible for funding will increase from 5,000 to 7,500. Doctors doing further training in outpatient care are to receive the same remuneration as an assistant physician in a hospital.

  • With respect to doctors' remuneration, the focus is to be directed more towards the provision of care, for example, by ensuring that the standard schedule of fees for doctors' services is adjusted as soon as possible and by eliminating unjustified disadvantages in overall remuneration, as well as by increasing transparency in the principles and service objectives of fee distribution. Furthermore, services provided by university outpatient clinics are to be adequately remunerated.

  • The panel doctors' associations are to be required to set up appointment service centres. The task of these centres is to secure an appointment with a specialist, within four weeks, for insured persons who have a referral. In order to improve psychotherapeutic care, the Federal Joint Committee is being entrusted with the task of drawing up psychotherapy guidelines.

  • The process of transferring patients from hospitals to outpatient care (so-called discharge management) is to be improved and Disease Management Programmes are to be expanded.

  • Medical treatment centres can be set up for adults with mental disabilities or serious multiple disabilities.

  • In the case of specific, elective interventions that are susceptible to over-provision, insured persons will have a right to seek a second, independent medical opinion.

  • With regard to medical rehabilitation benefits, insured persons will have more right of choice.

  • Persons in need of long-term care, persons with disabilities and persons with restricted competence in day-to-day living, will be given the right to additional benefits in the area of dental prevention.

  • Insured persons will be entitled to receive a sickness benefit, from the very first day on which a doctor determines their incapacity for work.

  • In order to promote innovation in care provision and health services research, an innovation fund will be set up at the Federal Joint Committee, endowed with €300 million per annum – initially from 2016 to 2019.

  • In the future, health insurance and long-term care funds are to waive compensation claims against independent midwives. In the long term, this could help to stabilise the midwives' insurance premiums and stimulate the insurance market, while helping to ensure the nationwide provision of midwife services in the long term.

  • In the area of medical devices, a systematic procedure for method evaluation, to be conducted by the Federal Joint Committee, is being envisaged for new methods which involve the use of medical devices that fall into one of the high risk categories. Hospitals wishing to introduce such a new method will be required to participate in the trial studies.

  • In the area of medicinal products and remedies, the provisions governing efficacy studies will be further developed and regionalised. The size of the pharmacy discount will be specified by law. In addition, the regulations will be adapted so as to avoid incorrect prescriptions and reduce reassessments.