Practice budget
Practice budgets were a form of remuneration for doctors in Germany . They precisely specified upper limits for billable services according to § 85 paragraph 4 SGB V by doctors. These upper limits were not the same for all doctors, but differed according to the number of cases (treated cases) and doctor group. The extended evaluation committee abolished the EBM practice budget as part of the reform of the contract doctor remuneration on July 1, 2003.
According to the EBM ( Uniform Assessment Standard ), doctors are credited a certain number of points for certain patient services . How much a point is absolutely worth is not known a priori . This point value is only calculated at the end of the billing period: the amount of money made available by a health insurance company in the region is divided by the sum of all points that were "provided" for outpatient services in the region . The result is an average point value in cents. Now the doctors can be paid depending on their point services.
The Association of Statutory Health Insurance Physicians were able to agree on a standard benefit volume with the practice budget and thus set an upper limit specific to the doctor's group. This was to prevent doctors from expanding their services and thus compensating for loss of fees . This problem arises because doctors supposedly can determine the demand for their services themselves ( supply-induced demand ). With the so-called practice budgets, services that were above the specified limit were gradually paid less; there was talk of graduated remuneration. To compensate for this, additional services called Individual Health Services - IGeL for short - were introduced, which doctors can offer their patients with statutory health insurance against payment.
Individual evidence
- ^ The introduction of practice budgets on July 1, 1997 Reasons and content , Dtsch Arztebl 1997; 94 (13): A-860 / B-732 / C-675
- ↑ Practice budget , AOK Federal Association
