Union for significant changes in hospital reform

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Written By Kampretz Bianca

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Berlin – The Union parliamentary group in the Bundestag intends to “constructively accompany” the parliamentary process for hospital reform and propose changes to “high-quality, comprehensive and needs-based hospital care”.

The parliamentary group announced this in a current circular to members of the CDU/CSU parliamentary group. The paper is there German medical journal before. The Union reiterated that hospital reform is urgently needed. However, the “how” must be intensely debated.

Hospital reform will soon be discussed in the parliamentary process. On May 15, the Federal Cabinet approved the draft Hospital Care Improvement Act (KHVVG), although the Federal Ministry of Justice (BMJ) has not yet completed its legal analysis.

However, the way is clear for discussions in the Bundesrat and Bundestag. A first reading in the Bundestag is scheduled to take place before the summer holidays.

The CDU/CSU faction wants to present its criticisms of the KHVVG accordingly, because the law is currently another “law to improve hospital care”, write the Union’s health policy spokesman, Tino Sorge (CDU) and the health politician Stephan Pilsinger (CSU).

The Union criticizes that the many criticisms from “almost all relevant players in the healthcare system” show that the Federal Minister of Health, Karl Lauterbach (SPD), single-handedly rejected constructive suggestions for improvement.

“This is particularly fatal in this fundamentally important legislative process, which involves a hospital reform that will last many, many years with the aim of guaranteeing safe care for patients, especially for hospital care, including in rural areas.”

The amendment provides for performance groups and reserve funding

The hospital reform foresees the introduction of 65 groups of services. The objective is to improve the quality of care through national material and personnel criteria. Clinics must meet criteria to be able to provide and bill for services within a specific service group.

Additionally, there must be reserve funding that replaces 60 percent of the diagnosis-related fixed fees (DRG). Funding and performance groups must be interdependent. The third planned change is cross-sector care facilities (formerly Level 1i clinics), which, like small hospitals, are intended to provide an interface between outpatient care and inpatient care.

Transformation Fund Reviews

The Union specifically criticizes the planned financing of the transformation fund, which is intended to support the restructuring of the hospital sector. Currently, it is planned that half of the financing will come from the health fund, i.e. contributions from those insured under the statutory health insurance (GKV). This is “a unilateral and enormous burden on legal health insurance contributors”, emphasizes the Union.

The Union also criticizes the KHVVG approval plan in the Federal Council as a law without approval. Deputies complained that states had constitutionally standardized competence in hospital planning.

The federal government is on “constitutionally thin ice” here. There is also a lack of effective and flexible instruments to take regional characteristics into account in hospital planning, criticized the deputies.

They also doubt the planned financial relief for clinics through the announced reserve funding of 60 percent of operating costs. The Union announced that it would develop further points that would ensure that care-relevant hospitals would still experience reform, taking into account the economically difficult situation of many clinics.

In September 2023, the parliamentary group submitted a request to the Bundestag calling for a preliminary law to guarantee the safety of hospitals in the short term due to the high inflation rate at the time.

This means that the federal states are receiving some tailwinds, at least from the Union faction. The Minister of Health of Schleswig-Holstein and President of the Conference of Ministers of Health (GMK), Kerstin von der Decken (CDU), explained the day before yesterday that she rely on changes in parliamentary procedure.

Otherwise, the federal states in the Bundesrat would block the hospital reform law and convene the mediation committee so that the state demands could be heard.

The SPD parliamentary group has already rejected consideration of one of the states’ main demands. These require more flexible exception options for the 65 planned performance groups. © cmk/aerzteblatt.de

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