Patients with rheumatoid arthritis (RA), psoriatic arthritis and spondyloarthritis (ankylosing spondylitis), which are insured by the Barmer GEK have comparatively better prospects, medical specialist, and thus to be treated optimally. For they are currently offering the opportunity to seek treatment at an internist rheumatologists who takes part in a new supply contract between the network rheumatism Westphalia-Lippe (currently 30 rheumatological practices) and Barmer GEK. In contrast, most patients with inflammatory joint diseases in Germany are not well supplied: you will usually late in specialized medical care are often not optimally adjusted medication or for clarification on a flare pass rheumatologist admitted directly to hospital. As a result of disease processes occur, which are heavier than necessary, and there are costs that are higher than necessary. For the purpose of integrated care, which will counteract the current situation of a lack of care for rheumatic patients have thirty rheumatology clinics of the rheumatic network Westphalia-Lippe - on the initiative of Dr. Ludwig
Kalthoff from Herne, the first chairman of the Rheumatic network Westphalia-Lippe and board member of the BDRh - completed in December 2011 with the Barmer GEK North Rhine-Westphalia signed a contract for the specialist care of patients with RA, psoriasis, arthritis and ankylosing spondylitis. This agreement commits the established rheumatologist to set up an early surgery for patients and ensure that waiting times generally take no longer than 10 days. Only in the event of a particularly severe course of disease in a patient admitted to five hospitals in Westphalia-Lippe, the part due to their special qualifications, also on contract. When prescribing medications can orient to the rheumatologist a positive drug list, but need not. This is a list of drugs that are equivalent in their effects on the German market but priced lower. In particular, biologics are relatively expensive, although their prices can vary, however severe.
The agreement on the additional costs the participating physicians Barmer GEK is in the form of a take over a quarter of the doctors to be paid lump sum. The insurance company hopes to turn that they can refinance the initial investment due to the improved efficiency of contract-related specialist medical treatment in the course of time. Of course nobody can predict whether and how the prescribing behavior of doctors is changing and how to develop drug prices and hospital costs. Possible savings to share the successes and the health insurance Ärtenetz but after a contractually specified key.
That the contract may lead to a reorganization of major parts of rheumatological care, which in this form did not exist before - about themselves, the three parties (Barmer GEK, practicing rheumatologists and hospitals) are well aware. The health insurance company as a contractor will only be available as long as the measurable efficiency gains due to emerging changes in medical practice. "Is the success of the contract and therefore falls to the readiness of the participating internist rheumatologists in collegial dispute over the internet and in case conferences their own medical action to be put under scrutiny," said Dr. Louis Kalthoff. "We expect, however, with the willingness the participants to learn from possible mistakes and errors, and together on the basis of a solid data base to take the path into a continuous improvement process."
Kalthoff from Herne, the first chairman of the Rheumatic network Westphalia-Lippe and board member of the BDRh - completed in December 2011 with the Barmer GEK North Rhine-Westphalia signed a contract for the specialist care of patients with RA, psoriasis, arthritis and ankylosing spondylitis. This agreement commits the established rheumatologist to set up an early surgery for patients and ensure that waiting times generally take no longer than 10 days. Only in the event of a particularly severe course of disease in a patient admitted to five hospitals in Westphalia-Lippe, the part due to their special qualifications, also on contract. When prescribing medications can orient to the rheumatologist a positive drug list, but need not. This is a list of drugs that are equivalent in their effects on the German market but priced lower. In particular, biologics are relatively expensive, although their prices can vary, however severe.
The agreement on the additional costs the participating physicians Barmer GEK is in the form of a take over a quarter of the doctors to be paid lump sum. The insurance company hopes to turn that they can refinance the initial investment due to the improved efficiency of contract-related specialist medical treatment in the course of time. Of course nobody can predict whether and how the prescribing behavior of doctors is changing and how to develop drug prices and hospital costs. Possible savings to share the successes and the health insurance Ärtenetz but after a contractually specified key.
That the contract may lead to a reorganization of major parts of rheumatological care, which in this form did not exist before - about themselves, the three parties (Barmer GEK, practicing rheumatologists and hospitals) are well aware. The health insurance company as a contractor will only be available as long as the measurable efficiency gains due to emerging changes in medical practice. "Is the success of the contract and therefore falls to the readiness of the participating internist rheumatologists in collegial dispute over the internet and in case conferences their own medical action to be put under scrutiny," said Dr. Louis Kalthoff. "We expect, however, with the willingness the participants to learn from possible mistakes and errors, and together on the basis of a solid data base to take the path into a continuous improvement process."
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