Integrated Care in Germany: Evolution and Scaling Up of the Population-Based Integrated Healthcare System “Healthy Kinzigtal”

“Gesundes Kinzigtal” is the flagship model of an Integrated Health Care System and the only fully population-based system in Germany that has been subject to rigorous external evaluation. It is based on the IHI Triple-Aim model, simultaneously pursuing to improve patient experience of care and population health and reducing per capita cost of health care. At its core is a value-oriented population-based shared savings contract. Two central evaluation studies demonstrate the success of “Gesundes Kinzigtal,” (i) a survey among the insured regarding their perceived health, satisfaction, and health behavior and (ii) an analysis of the over-, under-, and misutilization of health services, based on the analysis of routinely available health claims data from the Social Health Insurance. Based on these experiences, OptiMedis (the management company behind “Gesundes Kinzigtal”) initiated similar integrated care networks in three further areas. Recent modeling of the OECD on the OptiMedis networks suggests that substantial improvements in outcomes and efficiency can be gained from further scaling up the model.