The base rate (from the English: Base Rate ) is a term from the healthcare and is the amount of the calculation of the DRG prices ( Diagnosis Related Groups is set) for hospital treatment is based. The base case value forms the basis for the remuneration for hospital services.
To calculate the price for hospital treatment, the cost ratio of the DRG is multiplied by the base case value.
DRG F60B Circulatory diseases with acute myocardial infarction, without invasive cardiological diagnostics, without extremely serious comorbidities. The valuation ratio of this DRG is 1.08. For a hospital with a base case value of, for example, € 2,500, the treatment price would be 1.08 × € 2,500 = € 2,700.
Situation in Germany
In 2003 and 2004, the base case value was calculated individually for each hospital. A budget for the hospital (total amount) and a performance plan (list of the planned DRGs) were agreed in negotiations between the hospital and the payers. The (hospital-specific) base case value is then calculated (simplified) from the total amount (total budget) divided by the sum of the valuation ratios of the agreed services.
State base rate (LBFW)
Since 2005, a uniform state base rate (LBFW) has been agreed for each federal state. The individual hospital then only agrees the service planning with the payers. The individual base rate of the hospital was gradually adjusted to the nationwide base rate between 2005 and 2009 (convergence phase). From 2010 to 2014, the LBFW will gradually be adjusted to a uniform base rate corridor in accordance with Section 10 (8) Hospital Remuneration Act (KHEntgG) , the limits of which are +2.5 percent (maximum) and −1.25 percent (minimum) around a uniform federal base rate (BBFW) lie. In the state base rate negotiations, an adjustment amount is determined by which the negotiated state base rate is to be increased or decreased. From 2016, an adjustment of the lower corridor limit for the federal base rate to −1.02 percent is planned. Section 10 (4) sentence 1 of the KHEntgG stipulates that the agreed state base rate may not exceed the state base rate of the previous year including the change in value pursuant to Section 9 (1) sentence 1 no. 5a KHEntgG.
There are other regulations at individual special clinics, which, for example, have a special case severity (e.g. special accident hospitals). These clinics can make separate remuneration agreements with professional associations , accident insurance companies , health insurance companies and the German pension insurance .
Federal base rate (BBFW)
The previous different state base rates (LBFW) in the individual federal states will be adjusted from 2010 to 2014 in five identical convergence steps to the base rate corridor to the federal base rate. The LBFW that are within the limits of the value corridor are also not subject to any convergence process. If the state base rate in individual federal states is above the upper corridor limit of the federal base rate, only a maximum reduction of 0.3 percent is provided. The calculations for this are carried out by the Institute for the Hospital Remuneration System (InEK). In 2019, the federal base rate is 3,544.97, taking into account the corridor limits, a maximum of 3,633.60 euros or a minimum of 3,508.81 euros.
Development of the base case values
|State / year||LBFW 2005||LBFW 2006||LBFW 2007||LBFW 2008||LBFW 2009||LBFW 2010||LBFW 2011||LBFW 2012||LBFW 2013||LBFW 2014||LBFW 2015||LBFW 2016||LBFW 2017||LBFW 2018||LBFW 2019|
|Average of all LBFW||2,802.83||2,804.09||2,807.00||2,812.90||2,894.25||2,940.49||2,951.52||3,010.50||3,065.69||3,155.35||3,221.17||3,298.06||3,365.33||3,456.93||3,544.67|
|Federal base rate (BBFW)||2,935.78||2,963.82||2,991.53||3,068.37||3,156.82||3,231.20||3,311.98||3,376.11||3,467.30||3,544.97|
|Upper corridor limit of the BBFW||3,009.17||3,037.91||3,066.32||3,145.08||3,235.74||3,311.98||3,394.77||3,460.51||3,553.98||3,633.60|
|Lower corridor limit of the BBFW||2,889.08||2,926.77||2,954.14||3,030.02||3,117.36||3,190.81||3,278.19||3,341.67||3,431.93||3,508.81|
The Case Mix Index describes the average severity of patient cases in a medical facility.
Calculation option according to DRG (e.g. € 2400 - gynecology):