Hospital.Help

Berlin – The Federal Council’s Health Committee wants to deal with the hospital reform (KHVVG) next Wednesday. The National Association of Statutory Health Insurance Physicians (KBV) today drew attention to the emerging negative consequences for outpatient care in a letter to the committee chairman.

On the whole, it must be stated that the outpatient sector will be “further weakened and undermined” by the Bundestag’s proposed legislative resolution, write KBV boss Andreas Gassen, KBV vice-president Stephan Hofmeister and KBV board member Sibylle Steiner.

If the KHVVG provides for hospital activities in the outpatient sector, “a consistently better position compared to established contract doctors can be observed”. This is neither understandable nor acceptable and worsens the supply, especially in rural regions.

The KBV is particularly critical of the planned authorization of hospitals to provide primary care and specialist medical care with so-called security hospitals. From the KBV’s point of view, this neither makes medical sense nor will it improve care.

From the KBV’s point of view, the financing of the transformation fund and thus infrastructure measures with funds from the GKV health fund “fundamentally” contradicts the legal framework of hospital financing, which does not provide for the statutory health insurance (GKV) to contribute to the costs of structural costs.

The KBV described it as “completely incomprehensible” why hospitals are provided with funding for activities in the outpatient sector, which is denied to contract doctors as the actual providers of outpatient care.

“From the KBV’s point of view, the planned state aid for hospitals is unlawful because it increases the competitive disadvantages for the outpatient sector. Unilateral funding violates EU law. On June 10, 2024, the KBV submitted a complaint to the European Commission about this,” the board members explain in the letter.

They also criticize the plans for authorizing pediatric institute outpatient clinics. Where there is a shortage of pediatricians, there are simply no hospitals. Real control/demarcation can only be achieved through a pediatrician referral reservation.

The KBV leadership fears that the regulation – as with the psychiatric outpatient clinics (PIA) – will actually be expanded and that regular contractual medical and psychotherapeutic services will be provided in the institute outpatient clinics.

When it comes to further training in specialist medicine, the KBV complains that the associated additional costs for hospitals should in future be taken into account through surcharges on top of the DRG flat rate per case. However, contracted doctors in the specialist care area do not receive any separate remuneration. “Separate compensation for the additional training costs, including in the specialist medical field, must therefore urgently be provided for the outpatient sector.”

The KBV appeals to the federal states not to continue on the “expensive wrong path characterized by a centralist ideology”. The approximately 100,000 practices account for around 570 million treatment cases annually, while the hospitals account for around 20 million.

Without the resident general practitioners and specialists as well as psychotherapists and their teams, high-quality care close to home would not be possible. They also relieved the burden on hospitals to a considerable extent. The general conditions need to be improved in both sectors. © may/aerzteblatt.de