Health Systems and Policy Monitor (HSPM)

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For detailed information on country policy responses to the COVID-19 pandemic during 2020-2021, see our separate COVID-19 Health Systems Response Monitor (HSRM).

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Updates

De-budgeting: new plans for pediatricians to be exempt from volume ceilings in ambulatory care

27 January 2023 | Country Update

 

The Federal Minister of Health announced on 26 January 2022 that a process of de-budgeting for pediatricians is underway. Therefore, pediatricians in ambulatory care will be prospectively exempt from Statutory Health Insurance (SHI) volume ceilings [1, 2].

The remuneration of ambulatory care physicians in SHI is based on a practice-based volume of standard services calculated for each physician and yearly quarter. The volume of standard services limits the overall amount that a physician can bill per quarter, and services beyond the volume limits are reimbursed with a lower amount.

With the new measure, the federal government seeks to relieve pediatricians from budgetary pressure. Additionally, it was agreed that ambulatory care pediatricians receive an additional €49 million for services provided during the last quarter of 2022 when they had to deal with an exceptionally big wave of respiratory diseases among children.

 

Authors
  • Philipp Hengel
Country

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