Mutual press release from AOK Baden-Württemberg und Gesundes Kinzigtal, July 2014
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Stuttgart / Haslach [July 2014]. A good quality care and high cost effectiveness are not mutually exclusive. The Integrated Care pilot Healthy Kinzigtal [Gesundes Kinzigtal] proves this again. They succeeded for the sixth year in a row to achieve an improved contribution margin. For 2012, a positive contribution of 146 euros per AOK-insured persons, or 4.6 million euros was achieved for all 31,000 AOK-insured persons in the region in regard to risk adjusted normal costs of care in Germany. That is, the actual cost of the insured were almost seven percentage points lower than the expected costs. "The result is all the more remarkable because for the result calculation we include not only those AOK-insured patients enrolled in the integrated care contract but all AOK-insured persons in the region," says Helmut Hildebrandt, Director of Healthy Kinzigtal.
Current evaluation emphasizes quality of care
A recent evaluation of the PMV Research Group of the University of Cologne draws positive conclusions as well. Based on statutory health insurance routine data, for Kinzigtal AOK-insured individuals the quality of care was assessed using a control group from Baden-Württemberg. For this comparison the University of Cologne included data from 2004 based on quality indicators. The researchers conclude that there was a decline in over-, under- and misuse of healthcare in many indications in the Kinzigtal region and at the same time they observed an increase in healthcare quality. Also, they did not find any evidence for a risk selection of more healthy insured individuals in Kinzigtal. This is especially noteworthy since in Kinzigtal especially older insured persons are enrolled and they are characterized by a higher morbidity.
Therefore, positive effects obviously are related to the special Kinzigtal health management programs for chronically ill insured individuals, such as for patients with a risk for osteoporosis: Insured persons who join this group have significantly less painful and difficult-healing fractures in old age than the control group with a similar risk status. "The alliance between doctor and patient initiated in the Kinzigtal helps to improve the care for the benefit of patients," says Martin Wetzel, general practitioner and Chairman of the Kinzigtal doctors network. The good quality of care also is reflected in a rising number of memberships. "From 2006 to 2012, approximately 1,500 people in the Kinzigtal have opted for the AOK Baden-Württemberg" says Petra Spitzmüller, Deputy Managing Director of the Regional Office in the Southern Upper Rhine AOK Baden-Württemberg. "I am convinced that we can trace this success to the special quality of care and the joint commitment of AOK and Healthy Kinzigtal".
Partners intend to continue contract from 2016
The existing contract will run until the end of 2015. AOK Baden-Württemberg and Healthy Kinzigtal intend, however, to continue the contract from January 1st 2016 for an unlimited period. The parties have signed a letter of intent. The contract will be developed further with regard to content and will incorporate experiences of recent years. "We want to give the new contract additional innovation impulses. This includes the direct connection of integrated care in the Kinzigtal with the successful AOK contracts for GP-centered care and the specialist programs" says Dr. Christopher Hermann, CEO of AOK Baden-Württemberg.
About Healthy Kinzigtal
Healthy Kinzigtal [Gesundes Kinzigtal] is a joint formation of the health sciences oriented OptiMedis AG and the Network of Doctors in Kinzigtal (MQNK). It coordinates and controls the total medical care for all 31,000 AOK insured individuals of the Kinzigtal region, for all medical diagnoses and for healthcare professionals. It is based on a contract for integrated care completed with the AOK Baden-Württemberg in 2005.
The success is sustainable: Currently the aim is to invest a higher amount in prevention and in controlling health service processes smartly. On the long run, these investments will maintain health at a high level, will enhance the quality of life of patients and will avoid unnecessary costs. The company is financed by a contribution related to the performance contracting which is earned only if the health status of the population improved measurably and what is measured by a comparison of total costs of care of the population living in Kinzigtal with the normal costs of care in Germany using the risk adjustment system in Germany.
For further information please see www.gesundes-kinzigtal.de.
On the AOK Baden-Württemberg
The AOK Baden-Württemberg insures more than 3.9 million people in the country and pays more than 13 billion euros per year for services in the frame of the statutory health insurance and the long term care insurance.
For further information please see www.aok-bw.de.