;Resize=(1200,627)&impolicy=perceptual&quality=mediumHigh&hash=5d9ced734ed9be260eab15b1a77e2468e4c42b1f68c74a1ddb18ded6d64dc679 "Place in the nursing home more and more expensive: Co-payments have increased massively")
Home care is getting more and more expensive. The proportions to be paid by those in need of care and their families increased significantly again, according to an evaluation presented on Tuesday by the Association of Substitute Health Insurance Funds as of July 1st. In the first year in the home, the nationwide average was 2548 euros per month – 348 euros more than in mid-2022. Higher wages for urgently needed nursing staff are having an impact. But accommodation, food and drink costs also went up. And the burdens continue to grow despite the relief surcharges that have since been introduced. Demands for deeper financial reform are growing louder.
On the one hand, the out-of-pocket payments include a personal contribution for pure care and support. Unlike health insurance, long-term care insurance only pays part of the costs. For residents of the home, there are also costs for accommodation, meals and investments in the facilities. Without the relief surcharges, it would now be an average of 2610 euros per month as a total co-payment for everyone. Below this, the personal contribution for pure care alone increased by 281 euros to an average of 1245 euros per month within twelve months. And it can be assumed that it will continue to rise until the end of the year, the substitute health insurance association warned.
The load dampers
As a cost brake, there has been a surcharge in addition to the payment of the nursing care fund since 2022, which increases with the length of stay. The personal contribution only for care is reduced by 5 percent in the first year in the home, by 25 percent in the second, by 45 percent in the third, and by 70 percent from the fourth year. Even with the highest surcharge, the co-payments rose to an average of 1738 euros per month – that was 165 euros more than on July 1, 2022.
Remuneration agreements between the long-term care insurance funds and homes in all federal states were evaluated. The data relates to residents with care grades 2 to 5. Overall, the care insurance funds are likely to spend more than four billion euros on relief grants this year, the association of replacement funds expects.
The cost drivers
The background to the jump in costs is primarily higher personnel expenses, as the association explained. Because since September 2022, all facilities have had to pay nursing staff according to a collective agreement or something similar in order to be able to settle accounts with the nursing care insurance companies. The requirement had been set in motion by the previous black and red government – also to keep and attract nurses in the profession.
But the costs for accommodation and food also went up: on average to 888 euros per month now, after 814 euros in mid-2022. There are regional differences. All in all, the most expensive care was in the first year in the home in Baden-Württemberg with an average of 2913 euros per month. The lowest was the burden in Saxony-Anhalt with 1994 euros.
The cost dilemma
“We support the measures for fair payment of the nursing staff,” said Jörg Meyers-Middendorf, representative of the board at the substitute health insurance association. However, it cannot be the case that the steadily increasing costs have to be borne largely by those in need of care. “If more and more people can no longer pay for the stay in the nursing home, something goes terribly wrong.” The left-wing expert Ates Gürpinar warned: “The employees and those to be cared for must not be played off against each other.” Rising costs in nursing homes must not fall back solely on the residents.”
The first countermeasures
The Bundestag has just passed a reform by Health Minister Karl Lauterbach (SPD), which includes higher care contributions. On January 1, 2024, however, the relief surcharges will also be increased. The personal contribution for pure care should be reduced in the first year in the home by 15 instead of 5 percent, in the second year by 30 instead of 25 percent, in the third by 50 instead of 45 percent, from the fourth year by 75 instead of 70 percent.
This should only moderate the trend in the short term, said Meyers-Middendorf from the substitute health insurance association. The board of directors of the German Foundation for Patient Protection, Eugen Brysch, complained that the cost wave for the government was foreseeable. “But the tsunami was not stopped.” Instead, “a mini relief” will soon come.
The other demands
A sustainable solution is not needed solely on the backs of the contributors, demanded the substitute health insurance association. The federal states would have to bear the investment costs of the homes. That would immediately relieve the burden – currently an average of 477 euros per month. The Association of Private Health Insurance promoted supplementary long-term care insurance. Without more provision, contributors and the federal budget would be totally overwhelmed in an aging society. Patient advocate Brysch demanded an increase in all benefits by 350 euros. And the long-term care insurance must bear the full costs of pure care.
The goal of full insurance
The calls for such an end to all co-payments for pure care are becoming more urgent. “Only a bold step forward for sustainable financing can ensure decent care for everyone,” said DGB board member Anja Piel. There must be full insurance that covers all nursing costs and is financed by everyone.
The left and the VdK also demand full insurance. VdK President Verena Bentele said that in consultations one sees that many are afraid of having to claim social assistance. And: “A care place in the home must not make you poor.”