München – The SBK is expanding the quality reporting in its eighth transparency report to include additional comparison variables and key figures. She wants to further advance the quality initiative within the GKV.
Germany’s largest company health insurance company and a pioneer in quality transparency, the SBK Siemens company health insurance company, has published its 2022 transparency report. In the 27-page report, the health insurance company evaluates the most important quality indicators for insured persons – for the eighth time in a row. In 2016, SBK was the first health insurance company to make public figures on complaints and objections received. Since this year there has been an official recommendation of 45 quality criteria from the National Association of Statutory Health Insurance Funds. As a representative of the BKK community, the SBK played a key role in developing the key figures and is also based on them in the current report. The legislature has now also become active and will establish a publication requirement. This is another important milestone for the SBK initiative, the aim of which is to make the quality comparison for insured persons as easy as the price/performance comparison.
The SBK Siemens company health insurance company processed almost 1.3 million applications in 2022 in the six designated categories – from rehabilitation and preventive care to sick pay, dentures, aids and care to home nursing. The majority approved it: in 2022, the approval rate in areas such as sick pay, dentures or aids was 99 percent and higher. The median processing time for designated service areas was between one and almost three working days. An important innovation this year is the publication of the reference figure “100,000 insured people”. It is the prerequisite for making comparisons with other health insurance companies possible.
A good decision-making and objection process requires good communication
Last year, 2,958 objections were received from health insurance and 2,529 from nursing care insurance. In both areas the number has fallen compared to the previous year: from 2.9 objections per 1,000 insured persons to 2.7 and 2.3. From the perspective of the insured, the success rate in this area was 43 percent and 45 percent. The number of objections to health or nursing care insurance depends on various factors. “Sometimes it is due to legal regulations that are difficult to understand, sometimes they are due to formal procedures that are too lengthy for those affected, such as nursing assessments,” explains Dr. Gertrud Demmler, board member of the SBK, on the objection procedure. “A good decision-making and objection process in a health insurance company succeeds when decisions are communicated quickly, understandably and in a way that is comprehensible for the insured. This is also why it is important to us to make the process and the experiences of our insured persons transparent and to learn from them.”
Two sides of the same coin: There is no quality assessment without patient feedback
“As a pioneer when it comes to quality transparency, we are particularly pleased that the legislature has now put this important issue on the agenda and is currently working on a bill for more mandatory quality transparency. Because we continue to be convinced that transparency about the willingness to perform and the actual actions of a health insurance fund are mandatory prerequisites for improving the quality in the statutory health insurance system,” says Demmler, commenting on the current plans in the Ministry of Health. “But metrics alone are only one side of the coin. Full transparency is only possible when we collect feedback from the insured. Without the judgment of patients, there can be no quality assessment,” continued Demmler.
SBK obtains feedback from its insured persons through, among other things, the annual representative insured person survey. As in previous years, the results will also be published in the transparency report. This year’s survey received 5,600 responses and gives SBK a good rating: 80 percent are “completely satisfied” or “very satisfied” with SBK’s services. 86 percent of insured people would recommend SBK.
From quantity to people orientation
Demmler sums up: “I am firmly convinced that transparency can be a central lever for fundamentally changing our healthcare system. We are facing major challenges – we must succeed in the transformation towards a sustainable and people-oriented healthcare system. Transparency exposes our current, misguided orientation towards quantity – a lot helps a lot and gets a lot of money. Transparency is therefore a driver for more quality orientation and a real focus on people. I think it’s worth the effort.”
You can find the current transparency report 2022 here: SBK Transparency Report 2022
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 over 100 years, SBK has been personally and committedly committed to the interests of the insured. It positions itself as a pioneer for real quality competition in statutory health insurance. From the SBK’s point of view, the prerequisite for this is more transparency for the insured – about relevant financial 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 worlds and actively promotes digitalization in the healthcare system.