Cancer Care: New Value Chains Challenge German Hospital Structures—A Comprehensive Cancer Center Perspective

Economic evaluation of chronic lymphocytic leukemia from a hospital management perspective

“…In our major DRG group R61H, we have estimated 1/3 of inpatient cases that are potentially shiftable in an ambulatory setting. Although outpatient remuneration systems in Germany including special reimbursement for university hospitals and academic centers seem to be complex, but up‐to‐date care in the ambulatory sector seems to have potential benefits in patient quality and economic performance .…”

Economic Impact of the Introduction of Outpatient Medical Specialist Care (ASV) of Gastrointestinal Cancer Patients from a German Hospital Management Perspective

“…However, cross-sectoral remuneration is missing as similar services are either remunerated based on the Uniform Value Scale (EBM: “Einheitlicher Bewertungsmaßstab”) for treatments of statutory insured patients in an ambulatory setting or according to Diagnosis-Related Groups (DRGs) in case of stationary treatments [1]. Resulting in double standard, double investments, and double examinations [2, 3], this inefficiency contributes to the ever-increasing cancer-related healthcare costs. In 2015, these accounted with EUR 19.915 billion for about 6% of all healthcare costs in Germany, from which EUR 5.951 billion have been invoiced by service providers in the ambulatory setting [4].…”

“…According to the efficiency demand §12 SGB V and the cost-reduction principle “ambulatory care has precedence over stationary care” §13 SGB XII, the German politics has undertaken many efforts to interlink the parallel structures of the ambulatory and stationary care sectors since 1993 [1, 5]. These efforts are further amplified by the patients’ demand for ambulatory care, highly specialized treatments, and the scientific progress regarding novel therapies (e.g., personalized therapies, immunotherapies, and oral therapies) [3, 6]. In order to address these challenges, the latest approach is the introduction of the Guideline of Outpatient Medical Specialist Care in accordance with §116b SGB V (ASV) adopted in 2014.…”