[Medical centers--from a Statutory Health Insurance Company's perspective].
In the course of recent activities involving the bundling of healthcare institutions into so-called "Centers", many kinds of Healthcare Centers, Breast Centers, Comprehensive Cancer Centers etc. have been established. The term "Center" suggests expertise and superiority, and, without doubt, centers take medical care closer to higher quality and cost efficiency at the same time. However, there are preconditions which need to be fulfilled, such as the compliance with certain structural and process-oriented criteria in patient care. From the perspective of the compulsory health insurance funds, this raises questions regarding the type of centers that should be supported, the requirements that must be met, and the role that centers are assigned within the complex of our healthcare system. For health insurance purposes, Medical Centers provide innovative structural conditions for group-balanced concepts. Since the Statutory Health Insurance System Modernization Act (GKV-Modernisierungsgesetz and 140 a ff. SGB V) has provided individual contract options and inpatient oriented institutions have opened up to offer highly specialized ambulatory treatment (and 116b SGB V), centers have become attractive contractual partners for health insurance companies. The present article describes expectations and requirements in relation to the formation of Medical Centers from the perspective of a compulsory health insurance company, focusing on oncological centers.
Straub
Christoph
C
Techniker Krankenkasse (TK), Hamburg.
Müller
Hardy
H
D000046:Academic Medical Centers / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D005858:Germany; D006757:Hospital Units / Q000592:standards; D006801:Humans; D007348:Insurance, Health / Q000592:standards*; D011785:Quality Assurance, Health Care