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Erfolgsfaktoren der integrierten Versorgung aus der Sicht der Krankenkassen

Erfolgsfaktoren der integrierten Versorgung aus der Sicht der Krankenkassen

          
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About the Book

Inhaltsangabe: Zusammenfassung: Der Gesetzgeber ermöglicht mit der Integrierten Versorgung den Krankenkassen Einzelverträge mit den Leistungserbringern abzuschließen. Den Krankenkassen wird somit eine entscheidende Rolle zugewiesen, indem gezielt Leistungen für ihre Versicherten eingekauft werden können. Der Wettbewerb zwischen den Krankenkassen um die Versicherten wird gesteigert und gleichzeitig ist mehr Wettbewerb zwischen den Leistungserbringern gewährleistet. Insbesondere für das Gesundheitswesen gilt, dass nicht alles was neu ist auch sinnvoll ist. Die Integrierte Versorgung ist kein Mittel zum „schnellen Geld", sondern kann ihre Erfolge eher mittel- bis langfristig verzeichnen. Die Vorteile bestehen vor allem in der effektiven Ressourcennutzung der Versorger, bedingt durch abgestimmte Koordination zwischen den Versorgern. Die Krankenkassen können im Rahmen der Integrierten Versorgung quasi alle Instrumente des Managed Care nutzen, um stärkeren Einfluss auf die Versorgung zunehmen. Die Nachteile dieser Steuerungsinstrumente sind: steigende Verwaltungs-, Kontroll- und Berichtstätigkeiten. Qualitätssteigerung und langfristige Kostensenkung stehen dem Aufwand gegenüber. Der Erfolg der Integrierten Versorgung kann in einzelnen Projekten nachgewiesen werden. Es ist aber zu beachten, dass die Integrierte Versorgung neben der Regelversorgung existiert und ihre Auswirkung auf die gesamte Versorgung derzeitig nicht eindeutig eingeschätzt werden kann. Auch die Erfahrungen aus den USA, in denen Managed Care langfristig etabliert ist, lassen keine sichere Schlussfolgerung zu. Zugegebenen mangelt es an guten Studien in USA, die den Einfluss von Managed Care auf die Kosten schließen sowie die Qualitätssteigerung nachweisen. Grundsätzlich ist zu prognostizieren, dass solitär arbeitende Praxen und Krankenhäuser nicht die Modelle der Zukunft sind und Krankenkassen mit der Integrierten Versorgung nun die Möglichkeit haben neue Versorgungsformen mitzugestalten. Gang der Un


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Product Details
  • ISBN-13: 9783838695914
  • Publisher: Diplom.de
  • Binding: Paperback
  • Language: German
  • Returnable: N
  • Spine Width: 10 mm
  • Width: 148 mm
  • ISBN-10: 3838695917
  • Publisher Date: 16 May 2006
  • Height: 210 mm
  • No of Pages: 168
  • Series Title: German
  • Weight: 231 gr


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