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[Collective versus selective contracts from a legal point of view].

作者信息

Schirmer Horst Dieter

机构信息

Justitiar der Kassenärztlichen Bundescereinigung und der Bundesärztekammer, Berlin.

出版信息

Z Arztl Fortbild Qualitatssich. 2006;100(1):56-64.

PMID:16524232
Abstract

The historically proven organisational model of service relations between sickness funds and healthcare providers are collective contracts. A collective contract as a standards treaty ("Normenvertrag") is particularly pronounced concerning the panel doctor law ("Vertragsarztrecht") defining medical care on the basis of the principle of benefits in kind governing benefit claims of the insured in case of illness. The collective contract is a suitable instrument for ensuring both consistent and exhaustive provision of care and for organising the conditions of care, especially the quality and reimbursement of professional medical services. For several years the legislator has been "experimenting" with parallel contract design patterns such as the contract of integrated care in the form of selective contracts between health insurances or their associations and healthcare providers or groups of healthcare providers. More recently, allowances for conclusion of such contracts have been supposed to lead to competition between the contractual systems. It is doubtful whether this "push-start" will contribute to overcoming the systematic legal disadvantages of selective contracting as an organisational model for the provision of healthcare services to the insured.

摘要

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