Demand Management (Healthcare)

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In the health care system, demand management refers to all concepts in which health insurance companies try to influence the demand for health services by patients through the advice and information they provide.

Demand management is intended to help reduce over- and undersupply by advising against unnecessary services (e.g. hospital stays) or recommending early measures (e.g. consulting the family doctor). Essentially, the patient should be directed towards the most suitable measure for a specific problem. The implementation of such a concept usually consists of setting up a telephone hotline, but online portals are also used on the websites of the health insurance companies. Contact by email is almost always questionable in terms of data protection law. The staff of such hotlines (the so-called demand managers) usually consists of medical specialists such as doctors or nurses. Demand management offers are very widespread in the USA and Great Britain, and in some cases they are also incorporated into the tariff structure there. This means that an insured person is entitled to premiums if he consults the demand manager before visiting a doctor.

In Germany, it is forbidden to make diagnoses or give specific therapy recommendations as part of demand management (prohibition of remote consultation). The services here mainly consist of information about service providers or general information on medical topics such as vaccinations. For statutory health insurance , the legal basis for such offers is provided by Section 65a of the Book V of the Social Code , in which the legislature has standardized the possibility of bonus regulations for health-conscious behavior.

Demand management offers are widespread both as an isolated measure and as part of other supply concepts such as integrated supply . On the part of the provider, the demand management should primarily contribute to reducing costs. Although such an effect has not yet been proven, demand management offers can also be used as a mere differentiating feature.

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