Hospitals were supposed to keep enough beds free for patients affected by the pandemic during peak times in the Corona crisis. This was a major problem because hospital financing is only profitable if the utilization of bed capacities is also optimal. Therefore, non-medical services were partly outsourced to separate companies.
The patchwork of hospital financing that has emerged in the last few decades is partly opaque and varies from country to country. However, there are two or three streams through which German hospitals are financed. A distinction is also made between the costs for the statutory and private health insurance funds (GKV and PKV) that arise when current operating costs have to be covered within the framework of the prescribed hospital remuneration. The PKV does not know such service coverage assumptions.
The case flat rate catalog system contains 1,200 case flat rates, each of which can be billed differently and varies according to the federal state. In addition, the fee-per-case catalog obliges health insurance funds to reimburse the treatment of their patients/insured persons in hospitals that are integrated into the state hospital plan. The nursing costs, i.e., the costs for the work of the nursing staff, are no longer found under the heading of per-case flat-rate remuneration but are paid by the health insurance funds through a cost-covering nursing budget.
For each hospital, an annual budget for full and partial inpatient hospital services must be negotiated with the health insurance funds, including a service volume in the following year that depends on the federal state according to the agreed scope of services. Accordingly, deviations may occur in the following year: Additional services and the resulting additional revenues cannot be fully considered. Shortfalls in services or revenues are then adjusted in the following year using so-called revenue equalization.
Smaller facilities are also threatened with closure because they operate too uneconomically since larger facilities are cheaper in the hospital landscape. The reason for this is the better purchasing conditions.
Source: www.heise.de