PKV service expenses continue to rise

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Written By Rivera Claudia

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Cologne. The increase in expenditure on private health insurance (PKV) services continues unabated. According to preliminary data from the PKV Association, the industry recorded significant increases in all major service areas in the first half of 2024. Performance expenditure had already increased sharply in 2023.

In outpatient care, spending on services increased by 5.74 percent to €8.62 billion. There was an increase in doctors’ fees of 5.36 percent to €4.37 billion, and spending on pharmaceuticals increased by 7.31 percent to €2.41 billion.

From January to June this year, private health insurers spent a total of €5.06 billion on inpatient care for their policyholders, an increase of 6.66 percent. Of this amount, €3.44 billion went to general hospital services, 8.65 percent more than a year earlier.

GKV and PKV feel the same effects, especially in the stationary sector

In the dental sector, expenditure on services increased by 6.33 percent to €2.75 billion. The increase in dental treatment was stronger, by 9.04 percent to €965 million, than in dental prosthetics (up 5.36 percent to €1.1 billion).

“Like statutory health insurance companies, we are also seeing a sharp increase in service expenditure in private health insurance companies this year,” PKV Association spokesman Stefan Reker told Ärzte Zeitung. Particularly with regard to inpatient care, the industry is feeling the same effects as statutory health insurance companies, as the remuneration for general hospital services is identical for those with private and statutory health insurance.

According to him, the evolution of costs could lead to significant adjustments in the premiums of many private health insurance tariffs from January 1, 2025. The PKV Association had already drawn attention to this a few weeks ago.

For most private insured people it will be more expensive

The prerequisite for this is that the legally prescribed limits for contribution adjustments are exceeded. Private health insurers will have to adjust contributions if so-called triggering factors occur. The development of performance expenses plays a central role: if it is 10% or more above the calculated values, an adjustment is necessary. For some companies, 5% is the limit.

Since the development of each individual tariff must be checked according to the legally prescribed procedures and then recalculated if necessary, the association can only estimate the extent of the contribution adjustments more precisely in the fourth quarter, explains Reker. “But the initial signals from the industry raise concerns that a large proportion of people with private insurance will be affected.” (eat)

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