With the new reimbursement system, the Minister of Health wants to ensure that patients are more often treated on an outpatient basis or go home at night. After heavy criticism, he now wants to pay midwives better.
Fewer overnight stays in the hospital, more outpatient surgeries. Federal Health Minister Karl Lauterbach (SPD) wants to use a new pay system to make hospital stays less attractive and thus save money. “We want to save patients a hospital stay and at the same time relieve the staff there,” Lauterbach said. Rheinische Post:. “We are transforming the system so that unnecessary hospital admissions for simple procedures will no longer be worth it in the future.”
Lauterbach’s complaint was a long time ago. “The proportion of inpatient treatments here is still too high by international standards.” That’s why he wants many treatments that used to be in-clinic to be done on an outpatient basis in the future. “Even for inpatients, overnight stay is not mandatory, if the patient wants it, and there is nothing medically wrong with it,” the minister said. Therefore, in the future, patients should be able to choose whether they prefer to spend the night at home or stay in the clinic, and decide this together with the doctor. “An overnight stay in the hospital is not necessarily part of good medicine,” says Dr. Lauterbach.
In October, he already discussed it with his colleagues from the countries. Germany has 50 percent more inpatient admissions than neighboring countries without improving the quality of care, he said at the time. “That’s a big reserve.”
After the criticism, Lauterbach backed off on paying the midwife
For treatment, clinics receive so-called flat rates from health insurance companies, that is, fixed payments per patient, depending on the diagnosis. Critics have long complained that the system is an incentive for hospitals to increase the number of profitable surgeries and cut back on departments that tend to cause harm, such as pediatric and adolescent medicine or obstetrics. Lauterbach wants to take countermeasures in these areas with his reform of the compensation system; “Obstetrics and pediatrics should not be subject to the austerity dictates of the old hospital system.” In the first step, they should receive premiums in addition to the case-based flat rates.
Lauterbach also touches on a point that has received much criticism recently. midwives must stay within the so-called care budget. “And we will remove midwives from the fixed system and pay for their services separately,” he said. Rheinische Post: – The SPD also demanded this in the 2021 Bundestag election campaign. “Economic pressure is not compatible with the job description. In the future, hospitals should no longer be able to skimp on midwives,” Lauterbach said. His initial plans met with fierce opposition. The German Association of Midwives stated that they had a “disastrous effect on clinical midwifery”. Lauterbach has now responded to this.