[Disease management programs from a health insurer's point of view].
Disease Management Programmes represent a great challenge to the German statutory health insurance system. According to politicians, disease management programmes are an appropriate tool for increasing the level of care for chronically ill patients significantly, while at the same time they can slow down the cost explosion in health care. The statutory health insurers' point of view yields a more refined picture of the chances and risks involved. The chances are that a medical guideline-based, evidence-based, co-operative care of the chronically ill could be established. But also, there are the risks of misuse of disease management programmes and of misallocation of funds due to the ill-advised linkage with the so-called risk compensation scheme (RSA) balancing the sickness funds' structural deficits through redistribution. The nation-wide introduction of disease management programmes appears to be a gigantic experiment whose aim is to change the care of chronically ill patients and whose outcome is unpredictable.
Szymkowiak
Christof
C
cszymkowiak@tk-online.de
Walkenhorst
Karen
K
Straub
Christoph
C
D019468:Disease Management; D005858:Germany; D006801:Humans; D007348:Insurance, Health; D008329:Managed Care Programs / Q000191:economics / Q000592:standards*; D009313:National Health Programs / Q000592:standards; D011785:Quality Assurance, Health Care