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The German Central Health Fund—Recent developments in health care financing in Germany

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  • Göpffarth, Dirk
  • Henke, Klaus-Dirk

Abstract

In 2009, Germany's Statutory Health Insurance System underwent a major financing reform. A uniform contribution rate set by government was introduced. Sickness funds retain only limited autonomy in charging additional premiums. A dynamic subsidy from general revenue was introduced. The aims of the reform were: (1) intensifying competition, (2) gearing competition towards quality and efficiency, and (3) increasing financial sustainability. This article describes the reform, presents the experiences made, and evaluates whether the policy aims have been met.

Suggested Citation

  • Göpffarth, Dirk & Henke, Klaus-Dirk, 2013. "The German Central Health Fund—Recent developments in health care financing in Germany," Health Policy, Elsevier, vol. 109(3), pages 246-252.
    • Handle: RePEc:eee:hepoli:v:109:y:2013:i:3:p:246-252
    DOI: 10.1016/j.healthpol.2012.11.001
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    References listed on IDEAS

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    1. Buchner, Florian & Goepffarth, Dirk & Wasem, Juergen, 2013. "The new risk adjustment formula in Germany: Implementation and first experiences," Health Policy, Elsevier, vol. 109(3), pages 253-262.
    2. Or, Zeynep & Cases, Chantal & Lisac, Melanie & Vrangbæk, Karsten & Winblad, Ulrika & Bevan, Gwyn, 2010. "Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systems," Health Economics, Policy and Law, Cambridge University Press, vol. 5(3), pages 269-293, July.
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    5. Peter Eibich & Hendrik Schmitz & Nicolas R. Ziebarth, 2012. "Add-On Premiums Increase Price Transparency: More Policy Holders Switch Health Plans," DIW Economic Bulletin, DIW Berlin, German Institute for Economic Research, vol. 2(2), pages 15-24.
    6. Buchner, Florian & Wasem, Jurgen, 2003. "Needs for further improvement: risk adjustment in the German health insurance system," Health Policy, Elsevier, vol. 65(1), pages 21-35, July.
    7. Henke, Klaus-Dirk, 2007. "Der Gesundheitsfonds: Politökonomische Aspekte und seine Rolle als Wettbewerbsinstrument," Discussion Papers 2007/1, Technische Universität Berlin, School of Economics and Management.
    8. Lisac, Melanie & Reimers, Lutz & Henke, Klaus-Dirk & Schlette, Sophia, 2010. "Access and choice – competition under the roof of solidarity in German health care: an analysis of health policy reforms since 2004," Health Economics, Policy and Law, Cambridge University Press, vol. 5(1), pages 31-52, January.
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    Cited by:

    1. Ahmed Mehedi Nizam, 2021. "Cost, uncertainties and profit in commercial and social insurances," SN Business & Economics, Springer, vol. 1(7), pages 1-28, July.
    2. Bauhoff, Sebastian & Fischer, Lisa & Göpffarth, Dirk & Wuppermann, Amelie C., 2017. "Plan responses to diagnosis-based payment: Evidence from Germany’s morbidity-based risk adjustment," Journal of Health Economics, Elsevier, vol. 56(C), pages 397-413.
    3. Camilo Cid & Randall P. Ellis & Verónica Vargas & Juergen Wasem & Lorena Prieto, 2015. "Global Risk-Adjusted Payment Models," Boston University - Department of Economics - Working Papers Series wp2015-021, Boston University - Department of Economics.
    4. Tsiachristas, Apostolos & Dikkers, Carolien & Boland, Melinde R.S. & Rutten-van Mölken, Maureen P.M.H., 2013. "Exploring payment schemes used to promote integrated chronic care in Europe," Health Policy, Elsevier, vol. 113(3), pages 296-304.
    5. Tsiachristas, Apostolos & Dikkers, Carolien & Boland, Melinde R.S. & Rutten-van Mölken, Maureen P.M.H., 2016. "Impact of financial agreements in European chronic care on health care expenditure growth," Health Policy, Elsevier, vol. 120(4), pages 420-430.
    6. Buchner, Florian & Goepffarth, Dirk & Wasem, Juergen, 2013. "The new risk adjustment formula in Germany: Implementation and first experiences," Health Policy, Elsevier, vol. 109(3), pages 253-262.
    7. Ozegowski, Susanne & Sundmacher, Leonie, 2014. "Understanding the gap between need and utilization in outpatient care—The effect of supply-side determinants on regional inequities," Health Policy, Elsevier, vol. 114(1), pages 54-63.

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