Whether surgical interventions, physiotherapy, psychotherapeutic treatment or medicines – the health insurance funds cover all medically necessary services. In doing so, the health insurance funds must take into account gender-specific characteristics as well as the special concerns of people with disabilities and chronically ill people. Medical progress is also creating new therapeutic options – and thus better treatment options. All insured persons benefit from this – regardless of the contributions they pay.
Improving medical and psychotherapeutic treatment
In Germany, there is a free choice of doctor. People with statutory health insurance can see any doctor who is registered or authorised to provide statutory health care. This can be a family doctor, a specialist, a medical care centre or another outpatient facility. The same applies to psychotherapists who are authorised to provide psychotherapeutic care.
In order to continue to ensure a high level of needs-oriented, comprehensive and easily accessible medical care for insured persons in the future, various legal provisions have been made in recent years that serve to improve medical and psychotherapeutic care, especially in rural and structurally weak areas. In addition, the rights of patients have been strengthened and numerous measures have been taken to integrate digitalisation into the treatment process. In addition, good hospital care was ensured for the future.
Improving care in rural areas
In contrast to cities and conurbations, medical care in many rural and structurally weak regions is a major challenge. In the past, structural funds of the associations of SHI-accredited physicians (KVs) have provided incentives for physicians to settle in underserved areas. It is also possible, for example, to award scholarships that obligate a person to later work as a registered doctor in a certain area. In addition, there is assistance in setting up and taking over a practice as well as supplements to remuneration, for example to promote home and nursing home visits.
With the Appointment Service and Care Act (TSVG), the structural funds of the KVs were increased in 2019 and made more binding: The KVs must now ensure that the funds made available for funding measures are actually used. In addition, the possible uses were expanded. Among other things, investment costs for practice takeovers or the establishment of own facilities and local health centres for primary health care can now be funded.
To ensure that doctors work where they are needed to provide good care, the law already provided in the past that a practice in an over-supplied area can only be reoccupied if this makes sense for the care of patients. The decision on a case-by-case basis is made by representatives of the medical profession and the health insurance funds in the local licensing committees. In rural or structurally weak areas, additional licensing possibilities for doctors or psychotherapists can now be created, insofar as this is determined by the Länder.
In addition, the workload of physicians was further reduced by strengthening the possibilities for qualified non-medical staff to provide services that can be delegated. It was made easier for hospitals to provide outpatient medical care if the need for physicians in private practice cannot be met. In addition, municipalities were also given the opportunity to establish medical care centres (MVZ) and thus actively improve care in the region.
Medical care centres (MVZ)
In MVZs, several doctors – often in different specialities – work under one roof. In contrast to the classic forms of participation (individual practice, joint practice), in which the practice owners usually have to exercise the medical activity personally, MVZs are characterised in particular by an organisational separation of the ownership from the medical treatment activity. Frequently, other health care providers are also active in the same building, such as physiotherapists or occupational therapists. Health professionals work closely together in treatment and jointly agree on the course of the disease, treatment goals and therapy for their patients. Through this structured and coordinated treatment, for example, the simultaneous use of several medicines can be better coordinated and multiple examinations can be avoided.
Telemedicine improves care in rural areas
Telemedical applications, such as video consultation and teleconsultation (the professional exchange between doctors via video), were already introduced into care in 2017 as a result of the E-Health Act and have since been further advanced by the legislation. For example, telemedical applications were declared permissible in SHI-accredited medical care even for cases in which there is no personal doctor-patient contact, but the exchange takes place exclusively via video. But also for patients who are already being treated by the doctor they know, telemedicine can contribute to securing care in rural areas, because it can overcome spatial boundaries for the patient, but also for the doctor.
Telemedicine was further expanded with the Digital Care and Nursing Modernisation Act (DVPMG). Providers of therapeutic products can now also offer telemedical services. For midwives, the contractual partners of the midwifery assistance contract have to determine which services can be provided telemedically. In future, acute psychotherapeutic treatments can also take place within the framework of a video consultation. Telemedical care is also being expanded in emergency services.
Among other things, these digitalisation measures enable timely medical care that can easily overcome distances – for example, the specialist knowledge of experts can be made available immediately regardless of the patient’s place of residence, an emergency situation can be assessed or medical advice can be obtained.