Criticism of the billing system for psychiatry

Adaptation of the flat-rate pay system for psychiatry and psychosomatics (PEPP)

04/11/2014

The remuneration system for psychiatric hospitals should, according to a report of the Central Association of Statutory Health Insurance (GKV-Spitzenverband) in the future allow a more targeted billing. The self-government partners - the GKV-Spitzenverband, the German Hospital Association (DKG) and the Association of Private Health Insurance (PKV) - had agreed on a new agreement on the flat-rate pay system for psychiatry and psychosomatics (PEPP). From next year, the changes will come into force to achieve fairer compensation and reduce existing disincentives.

The PEPP was introduced around two years ago and was initially heavily criticized. For example, the case lump sums, whose daily rates reduce with the length of stay, would create incentives for on-schedule discharge, even if mentally ill people may not yet have been healed, one of the main criticisms. The starting points were, according to the notification of the GKV-Spitzenverbandes of „taken on the self-government partners and commissioned a revision of the lump-sum catalog.“ In the future, this should more accurately reflect the care costs of the psychiatric patient groups and, for example, through the introduction of supplementary care „Fees for certain intensive care and 1: 1 adult care“ eliminate the known maladministration. For this purpose were also „Indication and retention time dependent same daily rates“ agreed.

Health insurance companies and clinics decide to adjust the billing system
With the current decision to adjust the pay system, all parties have demonstrated the common will, „to further develop the compensation system for psychiatry and psychosomatics, which was conceived as a learning system“, explained the deputy chairman of the GKV-Spitzenverband, Johann-Magnus v. Stackelberg. Now lie „the ball at the psychiatric hospitals.“ They were called upon to switch to the PEPP system as soon as possible, because only then could „the remuneration is properly developed further, the performance documentation is improved and the long overdue quality assurance measures are taken forward.“

Disagreement over the mandatory introduction of PEPP
From when the new billing system should be binding, but remains between the health insurance and clinics quite controversial. During the DKG managing director Georg tree opposite the news agency „dpa“ pronounced for an extension of the option phase, emphasized Johann Magnus v. Stackelberg in the press release of the GKV-Spitzenverbandes that „An extension of the option phase, as it is currently being discussed by some hospital officials, is completely counterproductive“ would. (Fp)

Image: Claudia Hautumm