Despite initial resistance and protests, the ruling coalition insists on the need for clinic specialization and increasing medical service standards. The new adjustments are intended to make the transition period more flexible, providing hospitals with time for restructuring.
The bill, initiated by Health Minister Nina Warken, received majority support from the black-red coalition. The main task of the adopted changes is to ensure a structured process for transforming hospital infrastructure without losing the quality of care. Warken rejected concerns that such concessions could weaken the reform’s goals, emphasizing that the changes are necessary for the system’s functioning.
Distribution of services and temporary exceptions for clinics
One of the innovations is providing regions and medical institutions with greater freedom in distributing service groups. These groups determine the list of specialized procedures that a specific clinic branch is authorized to perform. According to the new rules, until the end of the current year, such distribution can be carried out without mandatory coordination with health insurance funds, which simplifies administrative processes.
Furthermore, the Bundestag agreed to maintain exceptions for a longer period for those hospitals that do not yet fully meet quality criteria. This will allow medical institutions in the regions to avoid closing departments and provide an opportunity to gradually bring standards up to the required level without leaving patients without necessary support during the transition period.
Change in payment system: moving away from the race for case numbers
A fundamental part of the updated reform is the change in the financing system. To relieve doctors of economic pressure and the need to inflate the number of operations for profit, a new payment model is being introduced, the implementation of which has now been pushed back by one year. In the future, payment for each individual insurance case (DRG) will constitute only a smaller part of a hospital’s income.
The main part of the budget will consist of fixed payments for service readiness. This category includes expenses for:
- Maintaining medical personnel;
- Ensuring the operation of the emergency department;
- Maintaining necessary medical equipment in working order.
It is planned that by 2030, this remuneration system will become fully effective, ensuring the financial stability of clinics regardless of the number of patients admitted.
Position of professional communities and the risk of queues
Professional associations express concerns regarding the adopted amendments. The German Medical Association and the Catholic Hospital Association consider the proposed remuneration system insufficiently developed. In their view, the concentration of specialized services in large centers and the reduction of structures in the regions could lead to the emergence of waiting-list medicine.
Association representatives warn that the pursuit of savings and optimization risks resulting in increased waiting times for elective surgeries for the population. Nevertheless, the law has already been passed by the Bundestag and will soon be submitted to the Bundesrat. Since the approval of the upper house of parliament is not required in this case, the reform is considered approved at the legislative level.Source: dpa
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