Basic wage bill

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The basic wage amount (GLS) is understood to be the sum of the wages and salaries subject to contributions from which health insurance contributions are to be paid, i.e. the nationwide total of the contributions to earnings from which the health insurance contributions are calculated. The contribution revenue from the basic wage bill is the main source of income for the health fund . The contributions are first collected by the health insurance companies, then transferred to the health fund. The health insurance companies then receive allocations from the health fund based on a certain key (Morbi-RSA, or risk structure compensation ). Section 71 (3) SGB V stipulates that the remuneration for statutory health insurance benefits is to be structured in such a way that, in principle, no increase in contribution rates is necessary (principle of contribution rate stability ).

The annual rate of change in the basic wage bill (basic wage change rate) was used in 2003 within the framework of the Health Structure Act as a reference value for updating the individual budgeting in the healthcare system.

The rate of change is published by the Federal Ministry of Health (BMG) on September 15 each year . It is calculated from the average rate of change in the income subject to contributions of all members of the health insurance funds for the period of the second half of the previous year and the first half of the current year compared to the respective previous year period. It is then used as a reference value for the following year.

The GLS change is only one of several criteria that serve as the basis for the annual contract negotiations between statutory (dental) medical associations and health insurance companies with regard to the fee adjustment. It serves the income-oriented spending policy.

Rate of change in accordance with Section 71 (3) SGB V

Announcements by the BMG in the Federal Gazette , as of September 3, 2019 - valid for the specified following year.

Basic wage rate of
year Rate of change
2020 3.66%
2019 2.65%
2018 2.97%
2017 2.50%
2016 2.95%
2015 2.53%
2014 2.81%
2013 2.03%
2012 1.98%
2011 1.15%
2010 1.54%
2009 1.41%
2008 0.64%
2007 0.79%
2006 0.97%
2005 0.38%
2004 0.17%
2003 1.06%
2002 1.89%
2001 1.63%
GLS estimate of the group of
year per insured person *
2020 3.6%
2019 3.7%
2018 4.8%
2017 3.9%
2016 3.4%
2015 3.7%
2014 5.4%
2013 4.9%
2012 3.5%
2011 2.2%
2010 −0.2%
2009 0.6%
* Increase in
health fund grants
Inflation rate
year %
2020 0.6% **
2019 1.4%
2018 1.9%
2017 1.8%
2016 0.5%
2015 0.3%
2014 0.9%
2013 1.5%
2012 2.1%
2011 2.3%
2010 1.1%
2009 0.4%
2008 2.6%
2007 2.3%
2006 1.6%
2005 1.5%
2004 1.7%
2003 1.0%
2002 1.5%
2001 1.9%
** Destatis forecast
Change in the
assessment ceiling ***
year compared to the previous year
2020 2.96%
2019 2.27%
2018 3.13%
2017 2.40%
2016 2.46%
2015 2.52%
2014 2.59%
2013 2.66%
2012 2.73%
2011 −1.00%
2010 2.04%
2009 1.41%
2008 2.08%
2007 0.00%
2006 1.05%
2005 1.09%
2004 1.07%
2003 2.22%
2002 1.38%
2001 1.16%
*** Health and nursing care insurance
2020: € 62,500

The items marked orange were reduced by Section 85 (3f) SGB V: The maximum rate of change was reduced by 0.25% to 0.98% for 2011 and by 0.5% to 1.48% for 2012.


The basic wage for the period July 1, 2017 to June 30, 2018 is compared with the basic wage for the period July 1, 2018 to June 30, 2019. This rate of change is the reference value for the calendar year 2020 (+ 3.66% in the table).

Appraisal board

Regardless of the basic wage increase rate and the basic wage increase, the group of appraisers at the Federal Social Security Office determines the increase in the per capita amount that the health insurance companies receive from the health fund for each insured person. The estimates refer to the calendar year. The rate of increase for 2018 is 4.8%. The rate of increase for 2016 was 5.4%. For 2016, the group of appraisers is expecting statutory health insurance expenditure of EUR 220.6 billion, which corresponds to an increase of 5.4% (4.6% per insured person) compared to 2015.

The group of appraisers assumed expenses of EUR 200.4 billion for 2014. This corresponds to an increase of 5.0% per insured person. The estimated expenditure of the health insurance companies for 2015 would amount to 209.5 billion euros, according to the group of estimates. This corresponds to an increase of 4.1% per insured person.

Inflation rate / income threshold

The inflation rate and the rate of change in the assessment ceiling for health and long-term care insurance are shown next to them for comparison. The assessment ceiling is adjusted annually in the ratio in which the gross wages and salaries per employee (in accordance with Section 68 (2) sentence 1 SGB VI) in the previous year are compared to the corresponding gross wages and salaries in the previous calendar year (rounded up to the next higher multiple of 600).

Right of objection by the supervisory authorities

Section 71 (4) SGB V grants the supervisory authorities the right to object, i.e. to monitor compliance with the fee statements:

“The agreements on the remuneration of services according to Section 57 Paragraphs 1 and 2, Sections 83, 85 must be submitted to the supervisory authorities responsible for the contracting parties. ... The supervisory authorities can object to the agreements in the event of a legal violation within two months of submission. "

The supervisory authorities for the statutory health insurance associations , the statutory health insurance associations and the regional health insurance funds are the health ministries of the federal states.

Authority for the Kassenärztliche Confederation , the Kassenzahnärztliche Confederation and nationwide or regional health insurance is the Federal Office for Social Security .


The fixed connection of the (dental) medical fee increases to the GLS rate of change, since this is largely below the inflation rate , led to a real fee reduction every year. The annual inflation rate in the same period from 2001 to 2012 was between 1.4% and 2.8%, an average of 1.6%. In contrast, the average GLS change was 1.13%. In the dental sector, it theoretically even fell by 0.53% annually below the inflation rate in the period shown: For 2011 and 2012, it was additionally reduced by a further cost-containment instrument: It says in Section 85 SGB V for the field of dental care :

"(3f) The changes to the total remuneration to be agreed in accordance with paragraph 3 as the volume of expenditure for the entirety of the contract dental services to be remunerated without dentures may be reduced by a maximum of 0.25 percentage points in 2011 and by a maximum of 0.5 percentage points in 2012 Change percentage points reduced rate of change determined for the entire federal territory according to § 71 paragraph 3; this does not apply to individual prophylaxis and early diagnosis services. "

As a result of this alone, the real value of the fees in the dental sector has fallen by over 6% since 2003, provided that the full GLS increase was actually agreed upon in all annual contract negotiations with the health insurance companies. In many cases this has not been achieved.

In this article, only the basic wage bill and its changes are considered in isolation. With regard to the actually achieved fee for the individual doctor, however, numerous other components must be included. For example, if there is an increase in the amount of services, i.e. the total of all medical services, which may be higher than the GLS change, no additional fee volume is generated. Therefore, even if the total remuneration increased by the GLS change, there was a fee reduction for the individual doctor. The (dental) medical profession bears the risk of morbidity . Likewise, if the number of doctors increases, the total remuneration is distributed among more doctors, so that this can also lead to further fee reductions for the individual doctor. The complexity of the topic of fee increases is illustrated by the example of the volume of control power . The amount of the total remuneration does not follow the demographic development , changes in morbidity , medical progress or the development of the number of doctors, but is limited by law to an increase in the basic wage. So it does not follow the demand, but a less growing non-relevant parameter. However, other factors can also allow a higher increase in the total remuneration cap.

Other professional groups and all medicine providers are also dependent on the basic wage. The German Association for Physiotherapy (ZVK) and the Federal Association of Independent Physiotherapists (IFK) have been trying for some time to abolish the basic wage commitment for physiotherapy . In particular, poorly paid occupational groups suffer from the constant relative lowering of wages, which in some cases has an existence-threatening effect.

Further adjustment criteria

In addition to the rate of change in the basic wage bill, further adjustment criteria will apply to contract dental care from 2013. Pursuant to Section 85 (3), the contracting parties to the overall contract agree on changes to the overall remuneration, taking into account

  • the number and structure of the insured,
  • the development of morbidity,
  • the cost and supply structure,
  • the working time to be used for contract dental work and
  • the type and scope of the dental services, insofar as they are based on a change in the statutory or statutory scope of services.

When agreeing changes to the total remuneration, the principle of stable contribution rates (Section 71 of the Book V of the Social Code) with regard to the volume of expenditure for the entirety of the contract dental services to be remunerated (excluding dentures) must be taken into account.

Individual evidence

  1. BAnz AT 08/30/2018 B1 Search in the Federal Gazette. Announcement of the rate of change according to Section 71 (3) SGB V in the Federal Gazette of September 3, 2019
  2. Destatis forecast 10/2017
  3. Social Insurance Calculation Size Regulation 2020 , Federal Ministry of Labor and Social Affairs , October 10, 2019. Accessed on November 21, 2019.
  4. GKV estimator group estimates the financial framework conditions of the GKV for the years 2017 and 2018 .
  5. Estimator table of the GKV Estimator Group for 2014 (PDF)
  6. Federal Insurance Office, circle of appraisers 2009, 2010 (PDF; 20 kB)
  7. Federal Insurance Office, Estimators 2013, 2014 (PDF; 25 kB)
  8. a b Federal Insurance Office, Estimator Circle 2015, 2016 ( Memento of the original dated August 4, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved February 4, 2016. @1@ 2Template: Webachiv / IABot /
  9. GKV appraisers estimates the financial framework conditions of the GKV for the years 2014 and 2015 (PDF)
  10. Destatis - Federal Statistical Office for Inflation Rate (PDF)
  11. § 85 SGB V
  12. BHV, signature campaign for an appropriate remuneration  ( page no longer available , search in web archivesInfo: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.@1@ 2Template: Toter Link /