Progress on reform is commendable, but a sense of urgency is needed for continued advancement
Germany Pursues De-bureaucratization and Digital Transformation in Hospital Reforms
In a bid to address the concerns of the German Hospital Association (DKG) regarding the upfront financing model in the Hospital Reforms Adaptation Act (KHAG), there is a call for measures that promote de-bureaucratization and deregulation.
Professor Dr. Henriette Neumeyer, deputy chairwoman of the DKG, has expressed hope for a parliamentary procedure involving federal states and self-government. The DKG's concerns revolve around the potential cash-flow constraints that hospitals may face due to the upfront financing approach. To address this, regulatory adjustments are necessary to enable more responsive and less rigid funding allocations.
The de-bureaucratization strategy for both KHAG and the Federal Clinic Atlas should leverage digital tools and automation. For instance, implementing intelligent digital systems similar to Kaiser Permanente’s advanced patient portal, which uses AI and natural language processing to improve care navigation and reduce administrative barriers, can inspire similar digital optimization in German hospital data systems.
Specifically, for the Federal Clinic Atlas, necessary steps include introducing standardized and automated data submission formats, integrating real-time electronic health record (EHR) data feeds, minimizing duplication by linking various reporting requirements into a unified digital framework, and establishing clear data governance protocols to protect patient privacy while allowing efficient data processing.
While no direct documents address KHAG reform or the Federal Clinic Atlas de-bureaucratization, these recommendations align with current healthcare digital transformation trends and expert calls for reducing administrative workload in hospitals. Implementing such reforms would ensure more efficient resource use and better data quality in hospital reporting systems.
The DKG also insists on genuine steps towards de-bureaucratization and deregulation after the transformation costs are covered. The foundation of upfront financing is flawed, as it remains dependent on the number of cases, sets the wrong incentives, and is associated with excessive bureaucratic effort. The original reform law by Minister Lauterbach was essentially a bureaucratic expansion program, requiring 5,000 additional positions to cope with the new bureaucracy for implementing the KHVVG.
The legislator has made some adjustments to simplify the administrative process. For instance, they have relieved the states of the obligation to conduct a complex insolvency check of hospitals before they can receive transformation funds. However, the DKG is disappointed that necessary adjustments to the implementation of hybrid DRGs are not being addressed.
The DKG urges the federal and state governments to fundamentally overhaul the upfront financing instrument, not just postpone it. Time limits or agreements with health insurance companies in these decisions should be critically examined. The immediate transformation costs are not included in the Hospital Reforms Adaptation Act, but a planned four billion euros will be anchored in the Budget Accompanying Law by early September and paid out promptly to hospitals. The planned revenue surcharge is suitable for providing hospitals with the needed liquidity quickly.
The DKG will analyze the bill in detail to check whether it contains concrete measures for deregulation and bureaucratic reduction. The German Hospital Association (DKG) supports the hospital reform, but finds the retention of upfront financing problematic. The DKG encourages decisions on exceptions to be made independently by clinics.
In summary, Germany should focus on simplifying funding flows and adopting advanced digital infrastructure to address the German Hospital Association's concerns about KHAG and to advance the de-bureaucratization of the Federal Clinic Atlas. A determined de-bureaucratization would act as an investment impetus for hospitals and would be an effective instrument in the fight against the shortage of skilled workers. A legally secure and promptly implementable distribution mechanism for the transformation funds is crucial for hospitals.
- The need for deregulation and de-bureaucratization in German healthcare, as advocated by the German Hospital Association (DKG), extends to policy and legislation concerning medical-conditions, health-and-wellness, and general-news, not just hospital reforms.
- To advance the de-bureaucratization of the Federal Clinic Atlas, the use of digital tools such as intelligent digital systems and advanced patient portals could be beneficial in streamlining data collection, reducing administrative barriers, and improving care navigation.
- In the push for de-bureaucratization, it's essential to consider science and technology as means to modernize hospital systems, ensuring more efficient healthcare service delivery, and attracting a larger workforce to the sector, especially in light of the ongoing skilled worker shortage.
