Germans are not only reputed to be the world’s champion travelers; they are also well known for being fond of consulting their family doctor frequently and for switching physicians often. Since the chip card was introduced for health insurance in 1995 the number of switchers has increased, and with the cost of healthcare. The federal government was forced to react, and in 2008 it enacted legislation to anchor the family doctor-centered healthcare model in Section 73b of the Social Insurance Code (SGB V).
The aim of this is to reinforce the family doctor’s role. Family doctors know their patients and are to accompany them like ships’ pilots, treating the sick and only referring patients to hospitals or to medical specialists when they need to do so. They will thereby prevent, inter alia, unnecessary multiple medical checks and negative interactions with other medicinal products.
Three million people already insured on the basis of the family doctor-centered healthcare model
Collaboration in family doctor-centered healthcare is voluntary for both doctors and patients. Physicians sign contracts with health insurers and participating patients undertake for at least one year to consult their family doctor first if they have health problems. Exceptions apply in the case of emergencies, appointments with gynecologists, ophthalmologists and pediatricians or if the insured person falls ill outside his general practice’s catchment area.
In Baden-Württemberg a model project that now involves around 3,600 doctors and 935,000 insured persons has been under way since 2009. Across German it involves around 13,000 doctors and three million insured persons in eight of Germany’s federal states. From January 1, 2013 family doctor-centered contracts will also apply in the North Rhine and Westphalia-Lippe regions and in Hesse, with others to follow.
New specialist in IT-assisted service billing
The associations of statutory health insurance physicians have agreed standard healthcare provisions with the health insurers in collective agreements, but services such as family doctor-centered healthcare are subject to so-called selective contracts. That is why these new healthcare contracts require a corresponding amount of service billing.
To deal adequately with this volume of billing and to ease the family doctor’s workload a subsidiary of the German Family Doctors’ Association, the Hausärztliche Vertragsgemeinschaft AG (HÄVG), and Telekom as the majority shareholder have set up a data center to support family doctor-centered healthcare as an IT service provider. From the first quarter of 2013, interested family doctors can register with the scheme, with the first bills to be sent out in the second quarter. This will involve no additional expenditure by family doctors. For them there will be no change in the electronic billing for their services; only their IT service provider will change.