Skip to main content
Fachgebiete
Automobil + Motoren Bauwesen + Immobilien Business IT + Informatik Elektrotechnik + Elektronik Energie + Nachhaltigkeit Finance + Banking Management + Führung Marketing + Vertrieb Maschinenbau + Werkstoffe Versicherung + Risiko
DE
EN
Themenseiten
Organisationspsychologie Projektmanagement Marketing Smart Manufacturing
Bücher
Zeitschriften
Weitere Formate
Podcasts Webinare Technik Webinare Wirtschaft Kongresse Veranstaltungskalender Awards
Jetzt Einzelzugang starten
Zugang für Unternehmen
Referenzkunden
ATZ-Fachkongress

Chassis.tech plus 2024


4 Kongresse in einer Veranstaltung

Treffen Sie in München die Fachleute von Chassis, Lenkung, Bremsen sowie Reifen/Räder.
Erweiterte Suche
Anmelden
nach oben

2012 | Buch

Introduction Kapitel lesen Erstes Kapitel lesen

Redefining German Health Care

Moving to a Value-Based System

verfasst von: Michael E. Porter, Clemens Guth

Verlag: Springer Berlin Heidelberg

Enthalten in: Springer Professional "Wirtschaft+Technik" , Springer Professional "Wirtschaft"

Einloggen, um Zugang zu erhalten
insite
SUCHEN

Über dieses Buch

The German health care system is on a collision course with budget realities. Costs are high and rising, and quality problems are becoming ever more apparent. Decades of reforms have produced little change to these troubling trends.

Why has Germany failed to solve these cost and quality problems? The reason is that Germany has not set value for patients as the overarching goal, defined as the patient health outcomes achieved per euro expended.

This book lays out an action agenda to move Germany to a high value system: care must be reorganized around patients and their medical conditions, providers must compete around the outcomes they achieve, health plans must take an active role in improving subscriber health, and payment must shift to models that reward excellent providers. Also, private insurance must be integrated in the risk-pooling system.

These steps are practical and achievable, as numerous examples in the book demonstrate. Moving to a value-based health care system is the only way for Germany to continue to ensure access to excellent health care for everyone.

Inhaltsverzeichnis

Frontmatter
Chapter 1. Introduction
Abstract
The German health care system has achieved a great deal. Universal coverage and a wide range of covered services are taken for granted, and many patients are cared for by compassionate and dedicated doctors and nurses. There is a dense network of providers, some of which are internationally renowned centers that attract patients from around the world.
Michael E. Porter, Clemens Guth
Chapter 2. Defining the Problem
Abstract
Health care is a daunting field to understand, with rapidly advancing medical sciences, a complex array of institutions, heavy government regulation, and numerous highly engaged stakeholders. The sheer complexity of the field has led to widely different opinions about the problems in health care and the many ill-advised “solutions” to these issues. Despite the many voices speaking about the German health care system, the challenge is clear: the system is in need of reform. While Germany has achieved much over the course of the last 65 years in providing health care to citizens, the nation is on an unsustainable path. There is a toxic combination of rising costs, unsustainable financing, divergent quality of care, shortages of skilled personnel, and a confrontational atmosphere among entrenched stakeholders.
Michael E. Porter, Clemens Guth
Chapter 3. Guiding Principles of a Value-Based Health Care System
Abstract
National health system reform in Germany, as well as in many other countries, has historically been approached on an issue-byissue basis. Each reform has focused on solving individual problems such as rising costs, risk selection by insurance plans, or skewed reimbursement incentives. While many of these efforts involve desirable steps, an overall strategic framework has been lacking.
Michael E. Porter, Clemens Guth
Chapter 4. The German Health Care System: Overview and Historical Development
Abstract
The German health care system is one of the most comprehensive and extensively developed systems in the world. In this chapter, we provide an overview of the system as it exists today and trace its historic development, which can be divided into a period of rapid expansion after World War II, followed by one increasingly centering on cost containment starting in the mid 1970s, and continuing up to the present. As we will see, many of Germany’s current problems are rooted in past choices.
Michael E. Porter, Clemens Guth
Chapter 5. Health Insurance in Germany
Abstract
In this chapter, we discuss the current German health insurance system, in which statutory health plans coexist with a smaller private system. Germany’s insurance system has produced nearly universal coverage and has many strengths compared to other countries, including one of the most comprehensive risk-adjustment systems to mitigate zero-sum cost shifting among plans. However, insurance competition is still not fully aligned with value for patients, and ermany faces important choices such as the number and viability of health plans and the appropriate relationship between the statutory and private insurance systems. In this chapter, we address insurance access and competition, the focus of most discussions on health care reform in Germany and other countries. In Chapter 8, we will explore the role of health insurance plans in health care delivery. While historically German health plans have assumed a passive role with respect to involvement in the delivery of care, there is an opportunity to transform the role of plans in improving patient value.
Michael E. Porter, Clemens Guth
Chapter 6. Health Care Providers
Abstract
Germany has an extensive provider system with expertise in every medical field and with a density of providers among the highest of any country. Unlike many other countries, there is a strict separation among inpatient care provided by hospitals, outpatient care provided in physician’s offices, and rehabilitative care provided by separate institutions. Significant structural reform will be needed to transform German providers into a value-based delivery system.
Michael E. Porter, Clemens Guth
Chapter 7. Overall Assessment of German Health Care Providers
Abstract
The German health care delivery system has achieved improved life expectancy, minimal wait times by international standards, free choice, and acceptable patient satisfaction. Many patients are cared for by dedicated and compassionate doctors, nurses, and other health care professionals.
Michael E. Porter, Clemens Guth
Chapter 8. The Role of Health Plans, Employers, and Patients in Health Care Delivery
Abstract
While the core of value creation in health care delivery takes place at the provider level, other stakeholders have crucial roles to play as well. Health plans, employers, and patients can all make a significant contribution to improving value. However, this opportunity is largely lost in Germany. Health plans have focused on insurance instead of helping subscribers navigate through the health care system or working with providers to improve the value of care. Employers have taken a passive role, despite paying for a major share of health care costs through employer contributions to health insurance and by covering the first six weeks of sick leave. Patients themselves have often not lived up to their responsibilities to improve their health and their care, and they have failed to demand that health care delivery be more patient-centered, focused, and outcome-oriented.
Michael E. Porter, Clemens Guth
Chapter 9. Measuring the Results of Care
Abstract
Universal measurement of patient health outcomes and costs is essential in a high-value health care system to inform and motivate improvements. Historically, however, neither providers nor health plans have measured outcomes or per-patient costs in Germany. Instead, physicians have assumed that their care was excellent and concentrated on growing patient referrals and visits based on convenience, academic publications, and personal relationships.
Michael E. Porter, Clemens Guth
Chapter 10. Creating a High-Value German Health Care System: Overall Assessment and Recommendations
Abstract
The German health care system has achieved a great deal: universal health insurance for 84 million people, substantial choice of health plans regardless of financial means, a broad range of services covered, and free choice of providers. However, the system is clearly not achieving its full potential. No other part of Germany’s social security system has undergone as many changes, with 15 major health care reforms since 1975. However, there is a consensus that the system still has major weaknesses. Clearly, a robust strategy for fundamental reform has been lacking.
Michael E. Porter, Clemens Guth
Backmatter
Metadaten
Titel
Redefining German Health Care
verfasst von
Michael E. Porter
Clemens Guth
Copyright-Jahr
2012
Verlag
Springer Berlin Heidelberg
Electronic ISBN
978-3-642-10826-6
Print ISBN
978-3-642-10825-9
DOI
https://doi.org/10.1007/978-3-642-10826-6

Premium Partner

    Bildnachweise