AOK Baden-Württemberg
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Berlin (ots)
The family doctor-centered care (HZV) of the AOK Baden-Württemberg has clear advantages for patients compared to standard care (RV). This is the conclusion reached by scientists from the Goethe University in Frankfurt (Main) and the University Hospital in Heidelberg. For the years 2011 to 2020, projections show that in 119,000 diabetics, over 11,000 serious complications could be avoided. Among other things, around 350 new cases of blindness and around 2,250 strokes were avoided. The 1.78 million AOK-insured persons cared for by 5,400 doctors in the HZV receive demonstrably more intensive and better coordinated care. In 2020 alone, there were two million more general practitioner contacts and 1.9 million fewer uncoordinated specialist contacts without a referral. The better quality of care has been achieved for years at lower costs. As part of the evaluation results presented today (May 15) in Berlin, the contractual partners emphasize that the HZV and the associated specialist contracts should be consistently further developed.
The signing of the contract on May 8, 2008 for the first nationwide HZV contract was the blueprint for many other contracts. And in outpatient care, it stands for the competitive departure into a world of selective contracts without the participation of the Associations of Statutory Health Insurance Physicians (KV). The full supply contract of the AOK Baden-Württemberg still sets qualitative standards today – not least because the HZV allows significantly more degrees of freedom for independent regional supply planning. Dr. Werner BaumgartnerCEO of MEDI Baden-Württemberg and MEDI GENO Germany explains: “Our family doctor and specialist contracts were, are and will remain the better alternative to standard KV care and call center medicine. The magic formula is controlling patient care. That is only possible with selective contracts The HZV contract was designed to be expandable right from the start, both for general practitioner treatment and for better outpatient care through a more structured interaction between general practitioners and specialists.”
For many funds, however, the collective agreement is still too convenient. According to the experiences of the contractual partners, the statutory HZV obligation to pay the health insurance fund, which prescribes offering a HZV, is not sufficient. So that significantly more patients nationwide can benefit from the proven advantages, they therefore demand that full care contracts must be explicitly promoted by federal politics through start-up financing and bonuses.
According to the CEO of AOK Baden-Württemberg, many enrolled insured persons are convinced of the advantages of HZV. John Bauerfeind: “Overall, we are very satisfied with the development of the HZV. It is well received by our participating insured persons. The coordinated care by the family doctor is the most important reason for participation for 9 out of 10 insured persons.” Regular surveys show that around 90 percent of participants would recommend HZV and more than 90 percent are very satisfied with the range of services. “The annual costs per patient are around 40 euros lower than for a comparable insured person in standard care,” continued Bauernfeind. However, a prerequisite for successful supply structures such as the HZV are stable cash register finances. This could only be achieved if the efficiency gains from selective contracts remain where they are achieved.
“Especially people with chronic diseases benefit from the HZV”, arranges Prof. Dr. Ferdinand M. Gerlach, Director of the Institute for General Medicine at the Goethe University in Frankfurt/Main, commented on the current evaluation results: “For example, we see significantly fewer serious complications and even a longer life expectancy in diabetics.” Partly responsible for this is probably the approximately 20 percent higher participation in disease management programs (DMP), which are specifically encouraged in the HZV. Care is becoming more structured and continuous, which is particularly important in the case of chronic diseases. In addition, there are mutually reinforcing control measures, such as the quality circles established in HZV for guideline-based pharmacotherapy or the increased role of general practitioners in HZV as guides through the healthcare landscape. “It is also remarkable that the quality gap between HZV and standard care is opening up more in favor of HZV from year to year. And this also applies under the difficult conditions of the pandemic,” adds Gerlach. In the current evaluation, impressive results were achieved with 422,000 older insured persons (from 65 years) in the HZV group compared to the RV: The projections in the first pandemic year 2020 resulted in over 35,000 more influenza vaccinations, around 6,500 fewer prescriptions of potentially inadequate medication and approximately 195 avoided hospitalizations for hip fractures.
Prof. Dr. Joachim SzecsenyiSenior Professor and longtime Medical Director of the Department of General Medicine and Health Services Research at Heidelberg University Hospital emphasizes:
“HZV patients demonstrably receive more intensive and better coordinated care with a permanently higher continuity of care. HZV practices with a supply assistant in the family doctor’s practice (VERAH) perform even better.” Right from the start, HZV has focused on including the whole team in the care. In the HZV contract of the AOK Baden-Württemberg, the further qualification of MFA to VERAH in the practice team was therefore supported and remunerated from the beginning. In the meantime, more than 2,300 VERAH relieve the doctors. Another point that was examined is the care provided by more and more employed doctors. At the start of the HZV in 2008, there were around 12,500 employed doctors in the outpatient area, and the number has now quadrupled. “That’s why we looked into the question of whether and how the quality of care differs between HZV practices with and without employees,” says Szecsenyi. “The analysis of important indicators such as avoidable hospital admissions showed that patients in HZV practices with employed doctors are treated just as well as in HZV practices without.”
These results are of great importance for the contractual partners, as they underpin central strategic development strands. Prof. Dr. Nicola Buhlinger-Göpfarth, Chairwoman of the General Practitioners’ Association of Baden-Württemberg, emphasizes: “The general practitioner’s practice must remain the central place of care. With the HZV innovation engine, we are focusing intensively on the expansion of delegation and the development of general practitioner practice-centric care.” In addition to general practitioners, MFA and VERAH, other academic non-medical healthcare professions should then be represented in the core team of a team practice. These include above all the academic VERAH and Physician Assistants. From July, the contractual partners will support their training with 300 scholarships of 5,000 euros each and, after completion, also the payment of these specialists. An important and up-to-date step towards family doctor practice-centric care should also be taken by registering the patient’s HZV in practices instead of with individual doctors. “Such expanded HZV practices are more efficient, more flexible and more attractive for employees. And they can look after significantly more patients. This is an extremely important contribution to being able to offer high-quality primary care nationwide in the future,” says Buhlinger-Göpfarth.
One focus of further development is measures in HZV practices to deal with the diverse effects of climate change on health. Heat waves that will occur more frequently in the future pose a particular health risk, especially for older and chronically ill people. These groups make up over 60 percent of HZV participants.
The contractual partners aim to strengthen the health and climate competence of risk groups in a structured way through the respective treatment practice. “Received in the case of corresponding offers, for example in the form of climate-resilient advice or employee training
HZV practices will receive a fee surcharge for the first time this year,” emphasizes Johannes Bauernfeind.
Investments:
- Infographic 10-year results in diabetics
- Press photo at the press conference on May 15 in Berlin (Photographer: Jens Schicke)
(from left to right: Dr. Werner Baumgärtner, CEO of MEDI Baden-Württemberg and MEDI GENO Germany; Johannes Bauernfeind, CEO of AOK Baden-Württemberg; Prof. Dr. Nicola Buhlinger-Göpfarth, Chair of the General Practitioners Association of Baden-Württemberg; Prof. Dr. Ferdinand M. Gerlach, Director of the Institute for General Medicine at the Goethe University in Frankfurt/Main, Prof. Dr. Joachim Szecsenyi, Senior Professor and long-standing Medical Director of the Department of General Medicine and Health Services Research at the University Hospital in Heidelberg
Press contact:
Contact (Press office):
AOK Baden-Württemberg, telephone: 0711 2593-229, [email protected]
Baden-Württemberg Association of General Practitioners, Telephone: 0172 201 0390
MEDI Baden-Württemberg, telephone: 0711 806079-223
Further information at: www.neueversorgung.de
Original content from: AOK Baden-Württemberg, transmitted by news aktuell