[Integrated supply models--do we need it at all?].

Abstract

Much has been written about so-called Integrated Healthcare for a number of years and this healthcare model is regarded by many as the solution to our problems in the German healthcare system. Although the legal framework conditions for integrated healthcare models have existed since 2000, no operating model has yet been realised in the German statutory healthcare system (Gesetzliche Krankenversicherung, GKV). Given past experiences, the question therefore arises as to whether we need integrated healthcare models at all. The German health system provides healthcare at a very high level. It suffers nevertheless from constantly growing problems concerning decreasing quality at increasing costs. One of the reasons for this is the fact that past reforms set in the GKV did not remove structural deficits but were essentially symptom-oriented on a short-term basis. The financial relief of the past reforms therefore held only for a short time until the unresolved deficits then re-emerged as a growing problem--in terms of quality and costs. Structurally new forms of healthcare supply--so called Integrated Healthcare models--should integrate four areas: Contracts, supply, reimbursement and responsibility. The aim should be to achieve a high-quality healthcare supply at acceptable costs by appropriate selection of suitable healthcare providers and installation of efficient processes. International experience shows that a qualitatively better supply at reduced costs might be possible with Integrated Healthcare models.