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Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract.

H H, C H, R K, M RR, A S, W W - Int J Integr Care (2010)

Bottom Line: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a substantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach.This, in turn, is to lead to a comparative reduction in health care cost.Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether-and to what extent-cost reduction may be attributed to a real population health gain.

View Article: PubMed Central - PubMed

Affiliation: Hamburg, Germany and CEO of Gesundes Kinzigtal GmbH, Hauptstr. 7, 77716, Haslach, Germany.

ABSTRACT

Introduction: Integrated care solutions need supportive financial incentives. In this paper, we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal.

Description of integrated care case: Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH) in cooperation with the physicians' network in the region (MQNK), a German health care management company with a background in medical sociology and health economics (OptiMedis AG) and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg).

Discussion and (preliminary) conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a substantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organization of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether-and to what extent-cost reduction may be attributed to a real population health gain.

No MeSH data available.


Related in: MedlinePlus

Calculation model of an integrated care management company's financial results within the framework of a health insurers' contribution margin analysis—model case I: increasing contribution margin after the start of the intervention in 2006 (figures are fictitious—for demonstrational purpose only).
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fg002: Calculation model of an integrated care management company's financial results within the framework of a health insurers' contribution margin analysis—model case I: increasing contribution margin after the start of the intervention in 2006 (figures are fictitious—for demonstrational purpose only).

Mentions: According to the contract, the financial result of Gesundes Kinzigtal GmbH is calculated within the framework of a health insurer's contribution and profitability analysis: the financial result achieved by Gesundes Kinzigtal GmbH equals the change in the Kinzigtal region's contribution margin, with the change being measured in relation to the region's contribution margin before the intervention started. By relying on fictitious figures, Figure 2 illustrates a model case which conforms to Gesundes Kinzigtal's ‘philosophy’, i.e. to the assumption that an investment in health promotion and preventive programmes will pay off in the mid- and long-term, and that a better coordination of health services and a more rational pharmacotherapy will pay off even in the short-term, thus compensating for initial investment cost. As a result, the actual cost of the fictitious intervention region illustrated in Figure 2 increase at a lower rate that its norm cost, resulting in an increasing contribution margin in the subsequent years 2006–2008.


Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract.

H H, C H, R K, M RR, A S, W W - Int J Integr Care (2010)

Calculation model of an integrated care management company's financial results within the framework of a health insurers' contribution margin analysis—model case I: increasing contribution margin after the start of the intervention in 2006 (figures are fictitious—for demonstrational purpose only).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2914874&req=5

fg002: Calculation model of an integrated care management company's financial results within the framework of a health insurers' contribution margin analysis—model case I: increasing contribution margin after the start of the intervention in 2006 (figures are fictitious—for demonstrational purpose only).
Mentions: According to the contract, the financial result of Gesundes Kinzigtal GmbH is calculated within the framework of a health insurer's contribution and profitability analysis: the financial result achieved by Gesundes Kinzigtal GmbH equals the change in the Kinzigtal region's contribution margin, with the change being measured in relation to the region's contribution margin before the intervention started. By relying on fictitious figures, Figure 2 illustrates a model case which conforms to Gesundes Kinzigtal's ‘philosophy’, i.e. to the assumption that an investment in health promotion and preventive programmes will pay off in the mid- and long-term, and that a better coordination of health services and a more rational pharmacotherapy will pay off even in the short-term, thus compensating for initial investment cost. As a result, the actual cost of the fictitious intervention region illustrated in Figure 2 increase at a lower rate that its norm cost, resulting in an increasing contribution margin in the subsequent years 2006–2008.

Bottom Line: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a substantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach.This, in turn, is to lead to a comparative reduction in health care cost.Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether-and to what extent-cost reduction may be attributed to a real population health gain.

View Article: PubMed Central - PubMed

Affiliation: Hamburg, Germany and CEO of Gesundes Kinzigtal GmbH, Hauptstr. 7, 77716, Haslach, Germany.

ABSTRACT

Introduction: Integrated care solutions need supportive financial incentives. In this paper, we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal.

Description of integrated care case: Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH) in cooperation with the physicians' network in the region (MQNK), a German health care management company with a background in medical sociology and health economics (OptiMedis AG) and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg).

Discussion and (preliminary) conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a substantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organization of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether-and to what extent-cost reduction may be attributed to a real population health gain.

No MeSH data available.


Related in: MedlinePlus