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Auf dem Wege zu einer integrierten Versorgung: Neue sozialrechtliche Rahmenbedingungen unter Berücksichtigung der Erfahrungen aus den USA und am Beispiel Berlins

Author

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  • Henke, Klaus-Dirk
  • Rich, Robert F.
  • Steinbach, Axel
  • Borchardt, Katja

Abstract

Die vollzogene Gesundheitsreform eröffnet im Rahmen des Sozialgesetzbuches neue Möglichkeiten für Managed Care Lösungen. Bislang basierte das System auf Kollektivverträgen während Managed Care selektives Kontrahieren von Versicherungen mit Leistungsanbietern vorsieht. Im Ergebnis soll der Wettbewerb zwischen den Krankenversicherungen verstärkt werden. Die Einführung von zusätzlichen Wettbewerbselementen soll eine kostengünstigere und dennoch qualitativ hochwertige Versorgung sicherstellen. In den USA ist ein Grossteil der Bevölkerung in unterschiedlichen Formen von Managed Care Organisationen versichert, deshalb soll eine kritische Analyse der amerikanischen Erfahrungen beispielhaft in die Arbeit einfließen. Kosteneinsparungen konnten dort nur mit Hilfe eines durchgängigen Managed Care Systems erreicht werden. Im Rahmen der Arbeit soll untersucht werden, inwiefern eine Managed Care Organisation in Berlin implementiert werden könnte. Als Region soll dabei der innere S-Bahnring der Stadt Berlin dienen. Dort gibt es genügend Leistungserbringer, die zu einem Netzwerk verbunden werden könnten. Als Rechtsrahmen wird eine GmbH-Lösung empfohlen.

Suggested Citation

  • Henke, Klaus-Dirk & Rich, Robert F. & Steinbach, Axel & Borchardt, Katja, 2004. "Auf dem Wege zu einer integrierten Versorgung: Neue sozialrechtliche Rahmenbedingungen unter Berücksichtigung der Erfahrungen aus den USA und am Beispiel Berlins," Discussion Papers 2004/12, Technische Universität Berlin, School of Economics and Management.
  • Handle: RePEc:zbw:tubsem:200412
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    Cited by:

    1. Kurt Hornschild & Stephan Raab & Jörg-Peter Weiß, 2005. "Die Medizintechnik am Standort Deutschland: Chancen und Risiken durch technologische Innovationen, Auswirkungen auf und durch das nationale Gesundheitssystem sowie potentielle Wachstumsmärkte im Ausla," DIW Berlin: Politikberatung kompakt, DIW Berlin, German Institute for Economic Research, edition 2, volume 10, number pbk10, Enero-Abr.

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