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Green light for community-based care in the state of Hesse - BKK Werra-Meißner and OptiMedis conclude performance-related agreement
The regional and statutory health insurance BKK Werra-Meißner and OptiMedis AG want to work together to establish integrated and community-based health care in the northern Hessian district of Werra-Meißner. In May 2018, the partners concluded a long-term, performance-related agreement with partial assumption of budget responsibility in accordance with § 140 a SGB V (German Social Code). Together with the administrative district, networks of physicians, social institutions and the office for economic development, the partners are now planning to set up a comprehensive health network. It will be based on the success of the ´Gesundes Kinzigtal´ integrated care project in the state of Baden-Württemberg, with the aim of improving health service provision and reducing inefficiencies in care. A regional integrator company will be established, in which doctors and other partners can participate.
The region has 100,715 inhabitants. BKK Werra-Meißner's share of those with statutory health insurance is almost 25%, and the company has a great interest in improving and securing regional care. "We have long been committed to improving the health and well-being of those living in the Werra-Meißner district. With OptiMedis, we have now found a very experienced and highly innovative partner. Alongside them, we can not only implement individual projects, but we will also be able to make healthcare future-proof by means of a comprehensive approach," says Marco Althans, CEO of BKK Werra-Meißner.
The plan is for insured persons to be able to actively participate from the beginning of 2019 and make use of the services offered by the network. "We will reorganise health care, connect the medical sector with the social sector, and give people the opportunity to develop more personal initiative with regard to their health," explains OptiMedis board member Dr h. c. Helmut Hildebrandt, who grew up in the Werra-Meißner district himself. This plan is based on an approach that has been tried and tested over many years in Gesundes Kinzigtal, the objective of which has been to reverse the incentives in the health care sector - and move towards a system in which people are rewarded for looking after their health. "We don't just want to react to existing illnesses and conditions, we want to actively contribute to developments in peoples' health. In line with this, we are investing heavily in prevention, health promotion, patient activation, and targeted care management, especially for those with chronic illnesses," says Hildebrandt.
Securing outpatient care - promoting health competence
Initial discussions with doctors from the Werra-Meißner district have shown that securing outpatient care will be a particular area of focus in the region, given that there have already been several practice closures. Other factors important to the doctors include the further training of medical assistants in their practices, the promotion of patient initiative, and that practices are provided with additional remuneration in return for providing targeted advisory services that are geared towards the health maintenance of their patients.
To ensure that as many insured persons as possible can participate, contracts are to also be concluded with other health insurance companies in the region. "And partners from other sectors are, of course, very welcome as well," Hildebrandt emphasises. The initial investment for the health network is financed by banks, third-party funds, and guarantees. It will be borne in the long run by the improvements achieved by the health insurance companies.By promoting health and preventing or detecting diseases at an early stage, the costs of medical care in the region will be reduced in the long term.