It sounds like a revolution: the Commission consulting the German Ministry of Health has proposed a significant change in the German hospital sector. So far, inpatient care always includes overnight stays to be reimbursable. Now inpatient care by hospitals shall be re-defined. According to the Commission’s proposal, it could also be performed without overnight stays of the patient. These “day treatments in hospitals” shall not be limited to certain indications, but left to the responsibility of the hospital to choose those patients that are eligible to spend the night(s) at home.
The reimbursement shall follow the existing DRG system, with deductions for every night the patient does not stay in the hospital – at an amount similar to a hotel rate. Of course, there are limitations in the Commission’s proposal. Still, the inpatient care in the hospital has to be medically necessary. It shall not be a competition to outpatient care. The minimum length of stay for full reimbursement of the DRG shall remain unchanged and an eligle day treatment would require a stay for medical or nursing services for at least 6 hours a day.
There are positive comments by the Minister of Health on the proposal. This makes it likely that the proposal of the Commission could become reality by a law change soon. Certain issues still have to be defined in more detail. Kalms Consulting will monitor the process and evaluate the market access consequences for customers.Published on: October 20, 2022