Renumeration of Health Care Providers and interregional transfers

Presenter: Jürgen Wasem, University of Duisbrug-Essen

Abstract

In Germany remuneration level of health care providers and expenditures per capita are quite different between regions, in the inpatient as well as in the outpatient sector. This is partly due to different levels of GDP in the regions, partly also a result of differences in morbidity and of divergent levels of success of providers in their negotiations with social health insurance funds (called: sickness funds) . It also reflects different utilization patterns.
About half of sickness funds are organized on a nation-wide level (the others being active within a specific region, often a single state). The nation-wide sickness funds are not allowed to differentiate their premiums betweeen regions; instead they are forced to apply a uniform contribution rate for all regions. This leads to an interregional redistribution from low price regions to high price regions.
In the presentation we illustrate the effect by a simple example. We show the model we used to measure the effect on interregional redistribution and we give the empirical results to show how changes in the regional remuneration level would influence the redistribution between regions.