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The topic of a possible contribution refund by the statutory health funds has been discussed in the media for a few days now. Large profits generated by health funds in the years 2010 and 2011 has prompted various politicians to demand the funds pass on a certain percentage of these profits to the insured. Health fund managers take an opposing view, as they want to hold the money in reserve for bad times or use it to improve health care services. In any case, the health funds‘ executive boards want to decide for themselves what do to with the money.

The treasurer threatened to cut the tax subsidy for health funds if there is no refund. In addition to this discussion, some of the funds‘ executive boards demand an autonomous contribution policy. Each fund should be able to determine the amount of contributions for themselves. Encouraged by political statements, various types of health care providers are demanding a refund of contributions. KU, the hospital management magazine, reported on 20.02.2012 that fund surpluses should be transfered back to the hospitals, because these had been saving the most amount of money.

The positive economic development which is expected for the following months will ensure that the question "What should be done with the money?" will continue to be of interest.

What does this mean for the health care providers? There are a growing number of people from the health funds calling for the surpluses to be used to increase the quality of care. This would be an opportunity for health care providers to include quality elements in their contracts when the new contracts and prices are negotiated. Through this, the permanent price decline could be halted and new elements which stabilize prices could be found. Health care providers are therefore asked to define these ‚possible elements‘ and determine prices. In any case, they should prepare for possible alternative contract negotiations, maybe even take the initiative themselves. Investing in quality of care would be a new contractual pattern for statutory health funds. The health care providers should be starting to prepare their respective contractual and fund managers immediately. The following questions are particular pertinent in this regards: What general and special elements of a new contract (for each product group) could improve the quality of care aspect? Which health funds are suitable for launching a ‚quality‘ initiative?