Berlin – Today, no cornerstones of the hospital financing reform have been passed by the federal-state working group. The German Evangelical Hospital Association (DEKV) assesses the proposals for the provision budgets and for redistribution between the hospitals as disadvantageous both for the care of the patients and for the structural further development of the hospital landscape. “It is disappointing that the federal states and the federal government did not have the strength today to make courageous and forward-looking decisions together. The clarification of the central points of contention is thus postponed to the future. As a result, there is a lack of a reliable framework for redesigning the hospital structures, as well as planning security for the funds required for this,” says Christoph Radbruch, Chairman of the DEKV. At the moment there is little confidence that the federal states and the federal government will jointly decide on reliable and concrete cornerstones on July 10, 2023.
“Realigning hospital structures is a Herculean task from a social, societal, entrepreneurial and financial perspective. This is an enormous feat that demands a lot from the employees and the management in the hospitals, from politicians and from the citizens. Those responsible at federal and state level must ensure security in the face of change so that the majority does not see the change as a threat,” warns Radbruch.
In particular, the planned shortage of capacities due to the performance corridor in the reserve budget raises a serious problem. “It’s a planned economy. The fatal effects on health care must now be evaluated together with hospital practice. This is more than overdue,” comments Radbruch.
Financing of coordination and control tasks requires additional money
The blanket assignment of coordination and control tasks to university hospitals or maximum care providers does not correspond to reality in practice. The associated unilateral redistribution of funds is unjustified and should be rejected. Should these new tasks be regularly introduced in the future system, the individual services must be adequately remunerated.
Advance financing with a performance corridor reduces supply
The introduction of upfront funding with a performance corridor seems attractive. At first glance, this promises adequate funding for hospitals and comprehensive medical care for everyone. In reality, however, this leads to bottlenecks and insufficient supply. If it is determined in advance how much money is available to a hospital, regardless of its actual performance, there are no financial incentives to perform above average or to work efficiently. Since the budget has already been determined, there is no direct connection between the actual total number of all in-patient and day-patient medical services performed in a hospital and their refinancing.
Planned economy mechanisms are implemented in hospital financing
The central problem of the reserve financing is the introduction of the health policy planned economy, since the reserve is capped in the future. The hospital does not have the flexibility to make decisions about how many beds, medical staff and equipment to provide based on the actual needs of the population. This shortage of capacities leads to longer waiting times for medical treatments and interventions.
The German Evangelical Hospital Association (DEKV) represents every ninth German hospital with 199 evangelical clinics at 273 locations. The Protestant hospitals treat more than 2 million inpatients and more than 3.5 million outpatients every year. That is more than every 10th inpatient nationwide. With more than 123,000 employees and a turnover of more than €10 billion, they are an important economic factor. The DEKV is the industry association of Protestant hospitals and a member of the Evangelical Work for Diaconia and Development eV as well as a member of the board and the executive committee of the German Hospital Society. The DEKV is particularly committed to a future-oriented and innovative hospital policy with a variety of providers and quality competition, reliable framework conditions for hospital financing, modernization of the health professions and consistent patient orientation in care.
Chairman: Chairman Christoph Radbruch, Magdeburg, deputy Chair: Andrea Trenner, Berlin, Treasurer: Dr. Holger Stiller, Düsseldorf, Association Director: Melanie Kanzler, Berlin.