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Die Reform des Risikostrukturausgleichs: Eine Zwischenbilanz

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  • Göpffarth, Dirk
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    Abstract

    Das Gesetz zur Reform des Risikostrukturausgleichs in der Gesetzlichen Krankenversicherung aus dem Jahr 2001 umfasste zwei kurzfristige Maßnahmen, um den Risikostrukturausgleich stärker zu fokussieren: Der „Risikopool“ als solidarische Finanzierung besonders aufwändiger Leistungsfälle und die Einbindung der strukturierten Behandlungsprogramme. Gleichzeitig wurde ein Zeitplan zur Einführung einer direkten Morbiditätsorientierung im Risikostrukturausgleich gesetzlich verankert. Der vorliegende Beitrag untersucht die Auswirkungen der kurzfristigen Maßnahmen und prüft, ob die langfristige Agenda noch zeitgemäß ist. Es wird gezeigt, dass die kurzfristigen Maßnahmen zwar bislang wenige Auswirkungen hatten, aber dass die direkte Morbiditätsorientierung umso notwendiger ist. -- In 2002, the German Bundestag enacted a major reform of the risk adjustment procedure between sickness funds. This reform consisted of two short-term measures, the “risk pool” as stop-loss reinsurance for sickness funds and the introduction of financial incentives for disease management programmes. In the long term, the socio-demographic categories of the risk structure are to be complemented by morbidity based categories. This paper evaluates the short-term measures and reviews the arguments for the long-term measure. The short-term measures are shown to have had little effect so far, but the need for the introduction of a directly morbidity based system remains an important measure to ensure competition between sickness funds.

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    Paper provided by Technische Universität Berlin, School of Economics and Management in its series Discussion Papers with number 2004/18.

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    Date of creation: 2004
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    Handle: RePEc:zbw:tubsem:200418

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    Web page: http://www.wm.tu-berlin.de/menue/fakultaet_vii/
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    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
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    1. Johannes Schwarze & Hanfried H. Andersen, 2001. "Kassenwechsel in der gesetzlichen Krankenversicherung: welche Rolle spielt der Beitragssatz?," Discussion Papers of DIW Berlin 267, DIW Berlin, German Institute for Economic Research.
    2. Arlene Ash & Randall P. Ellis & Gregory Pope & John Ayanian & David Bates & Helen Burstin & Lisa Iezzoni & Elizabeth McKay & Wei Yu, 2000. "Using Diagnoses to Describe Populations and Predict Costs," Papers 0099, Boston University - Industry Studies Programme.
    3. Friedrich Breyer & Mathias Kifmann, 2001. "Optionen der Weiterentwicklung des Risikostrukturausgleichs in der GKV," Discussion Papers of DIW Berlin 236, DIW Berlin, German Institute for Economic Research.
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    Cited by:
    1. Udo Schneider & Volker Ulrich & Eberhard Wille, 2008. "Risk Adjustment Systems in Health Insurance Markets in the US, Germany, Netherlands and Switzerland," CESifo DICE Report, Ifo Institute for Economic Research at the University of Munich, vol. 6(3), pages 37-49, October.

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