As of: March 24, 2024, 6:01 p.m
By: Olivia Kowalak
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Health insurance companies refuse to pay millions in nursing salaries in the course of insolvency proceedings.
Experts warn that this could mean the death knell for hospitals.
The healthcare system is faced with drastic structural changes.
Clinics have been in financial difficulties for a long time.
The German Hospital Association (DKG) expects a record number of 80 bankruptcies this year.
As the
Handelsblatt
reports, health insurance companies are now set to take a stand when it comes to paying out nursing salaries as a result of insolvency proceedings in Rhineland-Palatinate.
Health insurance companies refuse to pay millions of dollars to insolvent clinics.
© Julian Stratenschulte/dpa/dpa-tmn
Insolvency negotiations: subject of dispute between health insurance companies and clinics
According to the report, the current insolvency negotiations show that health insurance companies wanted to withhold amounts in the millions.
The reason for this is that insolvency money is already being paid to employees by the Federal Employment Agency.
This meant that the clinics had lower personnel costs, as the health insurance companies said.
The demand is met with incomprehension among hospitals.
Ultimately, the insolvency money will be financed by monthly payments from all employers, it said.
All employers who employ people in this country are obliged to make these payments.
This is intended to cover employees' wage claims in the event of bankruptcies.
In 2023, this amount was reduced from 0.09 percent to 0.06 percent compared to the previous year.
For example, with a monthly sum of wages subject to pension insurance of 25,000 euros, this results in an insolvency allowance of 15 euros (source:
Haufe
).
For this reason, the hospitals are calling on the health insurance companies to still pay the wages for the nursing staff.
Hospitals in trouble: Inflation, bureaucracy and wage pressure inhibit profitability
The clinics' demand for payment of the money is essential for their continued existence.
In most cases, the cost-revenue gap between hospitals is becoming ever wider.
Clinics are increasingly in the red, particularly due to inflation as a result of the energy crisis, excessive bureaucratic effort, tariff increases and the significant shortage of nursing staff.
That's why the government is currently working on a major hospital reform to improve the situation of the clinics.
The legislature wanted to address the issue as early as 2003 and introduced the flat rate per case in order to increase the profitability of hospitals.
Since then, a flat rate payment has been made available for every diagnosis and corresponding therapy.
The aim was also to shorten hospital stays.
Since 1991, the number of hospital beds has steadily decreased, while the number of patients has increased at the same time.
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The health insurance companies see this as a problem and accuse clinics of scheduling too many unnecessary operations so that they can get their money's worth.
With the current hospital reform by Health Minister Karl Lauterbach (SPD), the aim is to initiate “de-economization” in order to relieve the pressure on clinics to treat more patients.
German Hospital Association sees numerous location closures coming
Against this background, DKG boss Gerald Gaß warns against the scam of the health insurance companies and the resulting consequences for clinics.
“The clinics need the full amount of insolvency money in order to create economic prospects and continue to exist,” he says.
Gaß describes the health insurance companies’ actions as “simply perfidious”.
“You are giving the affected hospitals a death blow.”
In several federal states, claims have already been made by the health insurance companies: “We have to fear that the health insurance companies' scam will catch on,” said Gaß, concerned.
Experts see the care budget that has been accrued since 2020 as another reason for the dispute between health insurance companies and clinics.
This means that health insurance companies would no longer have to pay nursing staff costs as a flat rate, but separately.
At around 100 billion euros, clinics are already the largest expenditure item for statutory health insurance companies.
Lauterbach's hospital reform: Will contributors now have to pay even higher contributions?
The financial problem of the clinics is to be addressed with the upcoming hospital reform by Health Minister Lauterbach.
A draft bill in this regard was presented at the weekend - and met with a lot of criticism.
In order to finance the reform, contributors are asked to pay.
“When Minister Lauterbach talks about financing by the federal government, he means financing from contributions from the insured and their employers to the statutory health insurance,” says Frank Firsching
,
chairman of the AOK-Bayern administrative advisory board for the insured side.
“The GKV contribution funds are there to finance the treatment costs of the insured and not for hospital investments,” explained Firsching.
Financing from the health fund inevitably leads to increases in contributions without expanding services.