Insurance

Health insurance companies want to cut doctors’ money

Summary

The statutory health insurances (GKV) have dug up the hatchet: They want to reduce the fees of the 130,000 resident doctors in this country – and clearly. The statutory health insurance doctors, on the other hand, have announced that there […]

Health insurance companies want to cut doctors' money.  Statutory health insurance doctors should earn less according to the will of the GKV (source: Thinkstock by Getty-Images)

The statutory health insurances (GKV) have dug up the hatchet: They want to reduce the fees of the 130,000 resident doctors in this country – and clearly. The statutory health insurance doctors, on the other hand, have announced that there is a need to catch up and warn against the closure of country doctor practices.

The National Association of Statutory Health Insurance Funds considers a reduction in total remuneration by 2.2 billion euros to be appropriate. The doctors had previously asked for 3.5 billion euros more money. Both sides are already negotiating the re-setting of the medical remuneration.

Study: Doctors’ surpluses increased significantly

According to a study by the management consultancy Prognos for the statutory health insurance, doctors’ incomes have risen faster than the financial outlay for operating their practices. The average surplus generated per doctor from the care of the statutory insured rose accordingly by 29 percent from 105,000 euros in 2007 to 134,000 euros last year.

If income from the care of private patients is also included, the result is even a net income of 165,000 euros. This meant that the resident doctors were among the top earners in Germany, said the deputy chairman of the National Association of Statutory Health Insurance Funds, Johann-Magnus von Stackelberg.

In the Prognos analysis, a reduction in the so-called orientation value from currently 3.50 to 3.25 cents is proposed for 2013. The value essentially determines how much money is allocated to the statutory health insurance physicians. The proposed reduction would mean an average minus of 19,000 euros per practice per year.

GKV: Fee claims “completely excessive”

“If the doctors only want to finance the actual cost increases and the additional services, the price for the medical service must be corrected,” explained the project manager of the Prognos study, Ronny Wölbing.

The chairman of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Köhler, on the other hand, had called for the orientation value to be raised by eleven percent. Von Stackelberg called this demand “completely exaggerated”. In the future, the remuneration of the contract physicians will have to be adjusted to their expenses.

KBV: austerity measures endanger practices in rural areas

The KBV, however, spoke of an irresponsible austerity course by the health insurance funds at the expense of the patients, especially in rural areas. There, more and more individual practices are already struggling to survive.

Committee meets in late August

“Falling costs per service, better utilization of practices and other economic reserves in statutory health care are just as much on the negotiating table as price and quantities,” added Stackelberg. The National Association of Statutory Health Insurance Funds wants to submit its application next week. At the end of August, the GKV and KBV representatives meet for their negotiations in the evaluation committee.

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