The German healthcare market in transition
The German health system is facing enormous challenges. In addition to demographic and societal trends as well as changes in the spectrum of diseases that severely threaten the guarantee of the financing of the health care system. Health expenditure in 2018 was around € 387 billion. They have once again exceeded the € 1 billion mark per day. Especially the medical technical progress and structural issues are in focus. The Germans are not only getting older, the disease spectrum is also changing. So-called non-communicable diseases, which are usually chronic, are becoming more common. These include high blood pressure and musculoskeletal disorders, as well as mental illness. Sport and healthy nutrition, leisure and wellness are becoming ever more important. The role of the patient also changes. The patient calls for participation, informs himself/herself about medical issues and wants to be informed about options and other possibilities, which poses great challenges to health care facilities and their employees in terms of time and coordination processes. Immigration also has consequences for the health sector regarding health needs and intercultural challenges. Maintaining access to health care, especially in the peripheral areas but also increasing the efficiency of the healthcare system forces Germany to overthink the healthcare system as such. In order to react on the upcoming challenges, important changes in health and care were taken into effect on January 1th 2017. Some examples:
First Nursing Act (PSG I)
About 2.9 million people (social and private care insurance) in Germany are currently in need of care. As of 1 January 2015, the patient and his/her relatives have received significantly more support through the First Nursing Welfare Act (PSG I). Thus, almost all benefit amounts of long-term care insurance were raised. The services of short-term and preventive care have been expanded and can now be better combined with each other. The claim to low-threshold care services in outpatient care was extended. In addition, funds for conversion measures – such as the installation of barrier-free showers – have been increased to up to € 4,000 per measure so that people in need of care can stay in their usual environment for longer.
Second Nursing Welfare Act (PSG II)
The new need for care creates a professionally secured and individual assessment and classification in care grades. The care situation of people with mental and emotional disabilities, for example in the case of dementia diseases, will be taken into account in the assessment in the future in the same way as the care situation of those in need of care with physical limitations.
Third Nursing Act (PSG III)
So that people in need of care and their relatives, as well as people who need help in the future, can get information about the benefits of the long-term care insurance, the care advice is strengthened and the cooperation of those responsible in the communities is expanded. The law is another building block for better pay for the elderly care workers. In addition, the control options will be expanded to prevent caring fraud even more effectively and to better protect those in need of care, their relatives and also the community of insured persons.
Law for better supply through digitization and innovation
The Bundestag still has to discuss this draft, but by 2020 the “Law for better supply through digitization and innovation” should come into force. The data security and functionality of health apps will be reviewed and ensured by the Federal Institute for Drugs and Medical Devices (BfArM). In addition, app manufacturers must demonstrate that their programs actually improve patient care. After approval, healthcare insurances will pay health apps for their patients for 1 year.
Finding the path through the jungle of new regulations can be seen as a challenge as such.
Digitalization in healthcare
Germany is lagging behind other countries in digitizing healthcare. In an international comparative study of the Bertelsmann Foundation, the German health care system comes in 16th place out of 17 examined systems within Europe. Unfortunately, Finland wasn’t one of those countries evaluated.
Health apps and mobile health, telemedicine, digital health services for health insurances, audiovisual communication technologies, the use of mobile devices in health care and prevention, the use of technical assistance systems in the home environment, Big Data and AI applications can revolutionize the healthcare industry as a whole. The digital patient file is planned for 2021. Individualized medicine development has just started.
The areas of biotech, nanotechnology, pharma, medical devices, imaging procedures (3D-models) and handling of Big Data in healthcare offer large potential for enterprises which are pioneers with their innovative products and services. The AOK, Germany’s largest statutory health insurance company with 24 million insured persons, collects data on six million treatment cases per year in 2,000 hospitals, as well as the associated 55 out of million diagnoses, 18 million procedures and 55 million payment information. Just to mention it, there are over 150 different statutory and private health insurance companies in Germany compared to the one and only KELA in Finland. At the end of 2018, the German Medical Association registered around 392,400 working physicians throughout Germany. 1942 hospitals were caring for 19,4 Mio. patients and produced 105,7 Mrd. expenses in 2018.
The demand for innovative products and processes constantly increases. Already today, health care is an important and growing economic factor that contributes greatly to added value and employment.
A visit and a presentation hold by Mrs. Witte-Stremmel from the German Health Ministry, Head of Division of New Technologies and Data Use, on the Smart Health for Europe event in Helsinki in October this year made it clear: Germany likes to learn from the Finnish healthcare system, especially regarding digitalization, and is looking for cooperation with Finnish partners.
Are you interested in finding out more about your opportunities to participate in the development of the German healthcare market? We will be glad to support you!