Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract.

Introduction: Integrated care solutions need supportive financial incentives. In this paper, we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal.

Description Of Integrated Care Case: Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications.

[Aims of the health system modernisation act (GMG) from a medical point of view].

Like all its predecessors the Health System Modernisation Act (GMG) means to preserve solidarity-based statutory health insurance and to ensure a sufficient, appropriate and efficient treatment of all patients. The instruments are higher co-payments from patients (such as practice fees), cost containment through exclusion of certain services, and more competition. Competition is supposed to be encouraged through new forms of care.

[Networking: ambulatory and stationary mesdical care].

A better co-operation between health care sectors and primary and specialised treatment levels is inevitable for ensuring good patient care. Many informal co-operations already exist, and their experience may be used for developing new forms of co-operation. Therefore, the existing legal basis has to be changed, barriers must be abolished and new incentives established.

[Networking physicians' practices: teleconsultation/teleconferencing].

Tele-medicine offers clear possibilities to improve the work of the doctor, in order to ensure the optimal treatment of the patient. In particular, cooperation between outpatient and inpatient doctors can be organised more efficiently using new forms of communication and information via the electronic network and EDP-based information processing. Problems with the utilisation of tele-medicine lie in both the design of the fundamentals and standards with regard to legal unity as well as in a lack of knowledge of many doctors in the utilisation of these new techniques.