The German Central Health Fund—Recent developments in health care financing in Germany

Göpffarth, Dirk; Henke, Klaus-Dirk

doi:10.1016/j.healthpol.2012.11.001

Cited by 27 publications

(20 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to Ikegami et al [2], the median contribution rate of the society-managed health insurance plans is 7.40%, although the contribution rates are substantially different between the health insurance plans in Japan and the contribution is equally shared between employer and employee. In Germany, the contribution rate is 15.5%, and employees and employers pay 8.2% and 7.3%, respectively [38]. The difference in contribution rate between Japan and Germany might partly explain the differences in co-payments estimated in our study; however, we should consider various other factors such as structure of diseases and socioeconomic characteristics of the citizens.…”

Section: Discussionmentioning

confidence: 81%

Cross-National Comparison of Medical Costs Shared by Payers and Patients: A Study of Postmenopausal Women with Early-Stage Breast Cancer Based on Assumption Case Scenarios and Reimbursement Fees

Hamada

Hinotsu

Ishiguro³

et al. 2013

Breast Care

View full text Add to dashboard Cite

Background: The objectives of this study were to estimate and cross-nationally compare the medical costs shared by payers and patients and the distributions of medical costs by cost category. Material and Methods: We estimated the medical costs covered from definitive diagnosis to completion of treatments of early-stage breast cancer and follow-up, assuming almost identical medical care provided in Japan, the UK, and Germany. The analysis was performed from the payer's perspective. Medical costs were calculated by multiplying the unit costs by the number of units consumed, based on assumption case scenarios. The medical costs incurred by payers or patients were estimated according to the cost-sharing and the cost-bearing systems in each country. Results: The total medical costs in Japan were much lower than those in the UK and Germany, and these differences were mainly caused by the low costs of surgery and radiotherapy in Japan. For the base-case scenario, the co-payment in Japan (€ 3,486) was found to be 6.4-fold higher than that in Germany (€ 548). The payers in the European countries paid 2.9-fold more than those in Japan (€ ∼25,000 vs. € 8,627). Conclusion: Our results will be useful for policy makers in considering how to share medical costs and how to allocate limited resources.

show abstract

Section: Discussionmentioning

confidence: 81%

Cross-National Comparison of Medical Costs Shared by Payers and Patients: A Study of Postmenopausal Women with Early-Stage Breast Cancer Based on Assumption Case Scenarios and Reimbursement Fees

Hamada

Hinotsu

Ishiguro³

et al. 2013

Breast Care

View full text Add to dashboard Cite

show abstract

“…This national legislation replaced the sickness-fund-based funding of health care (a model in place since 1883 in which contribution rates were set by each The impact of slow economic growth 17 available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S1744133117000445 individual fund), with a new, nationally structured pool that collected a fixed national contribution rate paid by all covered citizens (Göpffartha and Henke, 2013). Moreover, this new structure also broke with the traditional 50% employer-50% employee premium assessment model.…”

Section: Germanymentioning

confidence: 99%

The impact of slow economic growth on health sector reform: a cross-national perspective

Saltman

2018

HEPL

View full text Add to dashboard Cite

This paper assesses recent health sector reform strategies across Europe adopted since the onset of the 2008 financial crisis. It begins with a brief overview of the continued economic pressure on public funding for health care services, particularly in tax-funded Northern European health care systems. While economic growth rates across Europe have risen a bit in the last year, they remain below the level necessary to provide the needed expansion of public health sector revenues. This continued public revenue shortage has become the central challenge that policymakers in these health systems confront, and increasingly constrains their potential range of policy options. The paper then examines the types of targeted reforms that various European governments have introduced in response to this increased fiscal stringency. Particularly in tax-funded health systems, these efforts have been focused on two types of changes on the production side of their health systems: consolidating and/or centralizing administrative authority over public hospitals, and revamping secondary and primary health services as well as social services to reduce the volume, cost and less-than-optimal outcomes of existing public elderly care programs. While revamping elderly care services also was pursued in the social health insurance (SHI) system in the Netherlands, both the Dutch and the German health systems also made important changes on the financing side of their health systems. Both types of targeted reforms are illustrated through short country case studies. Each of these country assessments flags up new mechanisms that have been introduced and which potentially could be reshaped and applied in other national health sector contexts. Reflecting the tax-funded structure of the Canadian health system, the preponderance of cases discussed focus on tax-funded countries (Norway, Denmark, Sweden, Finland, England, Ireland), with additional brief assessments of recent changes in the SHI-funded health systems in the Netherlands and Germany. The paper concludes that post-2008 European reforms have helped stretch existing public funds more effectively, but ☆

show abstract

“…The pension and unemployment insurance incur the employers' share for pensioners and unemployed members. The payroll tax and a subsidy from the federal budget are pooled in the Central Health Fund, which in turn pays risk-adjusted capitation payments to plans (Göpffarth and Henke, 2013). Plans are not allowed to make profits: they must cover expenditure gaps by raising supplemental contributions (Zusatzbeitrag) from their members, and return 1 For additional details on the SHI see, e.g., Busse and Blümel (2014 Although SHI plans are not allowed to make profits, they are nonetheless economic actors that are attentive to financial incentives and their financial position.…”

Section: The Statutory Health Insurancementioning

confidence: 99%

Plan responses to diagnosis-based payment: Evidence from Germany’s morbidity-based risk adjustment

Bauhoff

Fischer²,

Göpffarth

et al. 2017

Journal of Health Economics

Self Cite

View full text Add to dashboard Cite

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Many competitive health insurance markets adjust payments to participating health plans according to their enrollees' risk -including based on diagnostic information. We investigate responses of German health plans to the introduction of morbidity-based risk adjustment in the Statutory Health Insurance in 2009, which triggers payments based on "validated" diagnoses by providers. Using the regulator's data from office-based physicians, we estimate a difference-indifference analysis of the change in the share and number of validated diagnoses for ICD codes that are inside or outside the risk adjustment but are otherwise similar. We find a differential increase in the share of validated diagnoses of 2.6 and 3.6 percentage points (3-4%) between 2008 and 2013. This increase appears to originate from both a shift from not-validated toward validated diagnoses and an increase in the number of such diagnoses. Overall, our results indicate that plans were successful in influencing physicians' coding practices in a way that could lead to higher payments. Terms of use: Documents inJEL-Codes: H510, I100, I130, I180.

show abstract

The German Central Health Fund—Recent developments in health care financing in Germany

Cited by 27 publications

References 11 publications

Cross-National Comparison of Medical Costs Shared by Payers and Patients: A Study of Postmenopausal Women with Early-Stage Breast Cancer Based on Assumption Case Scenarios and Reimbursement Fees

Cross-National Comparison of Medical Costs Shared by Payers and Patients: A Study of Postmenopausal Women with Early-Stage Breast Cancer Based on Assumption Case Scenarios and Reimbursement Fees

The impact of slow economic growth on health sector reform: a cross-national perspective

Plan responses to diagnosis-based payment: Evidence from Germany’s morbidity-based risk adjustment

Contact Info

Product

Resources

About