On the slow implementation of pilot projects: Suspected causes from the perspective of statutory health insurance funds / Zur zögerlichen Umsetzung von Modellvorhaben: vermutete Ursachen aus Sicht der gesetzlichen Krankenkassen

Abstract

Abstract Background The system of nursing care in Germany is currently changing. For years, a further development of cooperation in the health care sector has been discussed. And thus a change in the distribution of tasks between health care professions. In 2008, the legislature introduced the introduction of pilot projects for the transfer of medicinal tasks to nurses according to § 63 para. 3c Social Code V. The implementation is very sluggish. The aim of the study was to analyze the reasons for this sluggish implementation from the perspective of the statutory health insurance funds. Methods Quantitative survey of all statutory health insurance funds (n=124) in Germany. Results To ensure supply, 94 % of health insurance companies consider the transfer of medical tasks to non-medical care providers as a sensible approach. Also 96 % consider this to be very important in order to ensure care. Although 96 % of health insurance funds support the implementation of pilot projects, only 8 % are in fact involved in such contracts; 71 % do not plan own pilot projects for the future. In the view of the statutory health insurance funds, legal obstacles (90 %), resistance by medical representatives (84 %), unresolved financing (74 %) and liability issues (70 %) as well as non-applicable regulations in G-BA-directive (79 %) and the law (85 %). Less than half (46 %) of the health insurance companies suspect high costs causing the slow implementation. Discussion The amendments adopted by the legislature in the current reform of the law on care professions can be described as appropriate; in particular the fact that statutory health insurance funds should implement and carry out appropriate pilot projects by 31 December 2020.