München – At the end of June 2023, the central association of nursing care funds and the manufacturer associations negotiated a framework agreement for digital nursing applications (DiPA). These should make everyday life easier for those in need of care and counteract a worsening of the impairment. For example, applications for fall prevention or memory training are conceivable. Above all, however, the DiPA pricing guidelines will presumably prevent extensive use.
The costs for a digital care application (DiPA) are limited to 50 euros per patient per month. Long-term care insurance companies are not allowed to take over more. This maximum amount also includes remuneration for additional support services. As part of these support services, care services can support those in need of care in using the DiPA. However, if the costs for the digital aid plus the support service exceed the specified fixed amount, the insured must bear the additional costs themselves.
Different pricing for DiGA and DiPA is not understandable
With digital health applications (DiGA), on the other hand, health insurance companies even have to bear costs of several hundred euros per quarter in the first year. This clear difference between digital applications for health and care is difficult for DiPA manufacturers to understand, reports Franziska Beckebans, Head of Customer Management and Supply at SBK: “I expect that this approach will result in very few applications for the care are brought to market. Numerous potential providers of DiPA reflect to us that the market is not attractive enough. Therefore, they will try to market their applications as DiGA instead. That would be an unfortunate development. Because good digital care applications that are tailored to the needs of those in need of care and their relatives could provide positive impetus for the entire care system”. In fact, no DiPA has been officially registered to date.
Another difference between DiPA and DiGA: With DiPA, proof of effectiveness must already be available when applying for approval. In the case of a provisionally listed DiGA, this is only necessary at a later point in time. For the time being, they can also be approved without proof of effectiveness. “In principle, however, we as SBK support the submission of proof of effectiveness, since insured persons can thus use a good and effective application,” says Beckebans.
How much is care worth to us?
In order for all insured persons to have access to sensible digital applications, the same rules must apply to health insurance companies (DiGA) and long-term care insurance companies (DiPA). The main aim should be to create offers with added value that are geared to the needs of the insured. For the DiPA, these would primarily be proven positive effects on one’s own abilities and the preservation of independence. In addition, the pricing must also be based on the regular use of the application. Only when the digital applications are actually used can improvements that can be attributed to the application occur. “We will also have to reassess the question of how much caring for people and thus DiPA is worth to us. Why do we differentiate between applications for people not in need of care and for people who are dependent on care when designing them? The latter in particular could benefit from digital offerings if there were actually a good selection of relevant applications,” says Beckebans.
The SBK Siemens company health insurance company is the largest company health insurance company in Germany and is one of the 20 largest statutory health insurance companies. As an open, nationwide health insurance company, it insures more than a million people and looks after over 100,000 corporate customers in Germany – with more than 1,800 employees in 86 branches.
For more than 100 years, SBK has been personally and committed to the interests of the insured. It positions itself as a pioneer for real quality competition in statutory health insurance. From SBK’s point of view, the prerequisite for this is more transparency for the insured – about relevant financial key figures, but also about the willingness to perform, advice and service quality of health insurance companies. In the interests of the customer, SBK also combines the best of the personal and digital world and actively promotes digitization in the healthcare sector.