chapter  22
8 Pages

Germany

Scaling Up a Population-Based Integrated Healthcare System: The Case of “Healthy Kinzigtal” in Germany
WithOliver Groene, Holger Pfaff, Helmut Hildebrandt

"Healthy Kinzigtal" (HK) is the flagship model of an integrated healthcare system and the only fully population-based system in Germany that has been subject to rigorous external evaluation. The German health system is also among the most expensive in the Organization for Economic Cooperation and Development (OECD). The 2000 Healthcare Reform Act and the 2004 Modernization Act were pivotal to setting up integrated care systems in Germany. The HK model is based on the "Triple-Aim" approach, according to which three aims are pursued simultaneously: improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare. HK maintains existing reimbursement schemes and financial flows, but the integrator assumes responsibility for the development of the so-called "contribution margin". The patient-centered care approach, which is paramount to the success of HK, is embedded at three levels: at the structural level, in the planning of interventions, and in the interactions between physicians and patients.