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Patient care in the German homecare market is increasingly supplied by specialized health care providers. Therefore it seems logical that whole segments, rather than just individual product provisions, should be contractually regulated. Techniker health fund has signed an individual membership contract for homecare services. It governs the care provided in the product areas enteral and parenteral nutrition, stoma and revulsive incontinence aids. While this is a good approach, it definitely does not go far enough.

We think that it is inherently more efficient for a health fund and health care provider to sign such an agreement. The administrative costs for each care case should reduce drastically if the patient needs several products listed in this contract. Unfortunately, there will only be a few patients who require artificial feeding, have a stoma or need revulsive incontinent aids. A combination of – for instance – absorbing incontinence aids and nursing bed including the mattress will occur much more frequently. However, then there might be the problem of consumables and articles of use as part of one care case.

The attempt or trend to bunch together several combined product and care issues or themes in one contract, is the right way to go. Combined issues or theme experts will prevail for the benefit of the patient; here homecare is the vanguard. Administrative costs to implement the contracts should be lower than the sum of the costs of individual contracts. Health care providers in the homecare market could thus strengthen their position against the manufacturers.

The following questions are especially important considering the background just discussed: Do reports of someone’s experience with this type of contract already exist? Do other health funds intend to do the same? Are these contracts also worthwhile in terms of price or will there be cuts across-the-board?