Second stage of German laboratory reform in force

The German laboratory reform is being implemented step by step.

Since 1 January 2008 laboratory groups have been invoicing their regional Associations of Statutory Health Insurance (Kassenärztliche Vereinigung - KV) directly — a measure meant to reduce lab costs, create more transparency and strengthen the role of on-site labs in doctors' surgeries. For physicians, this reform means that the decision that laboratory values will be requested has become more complex.

Since 1 January this year, the second stage of the reform is in force and experts warn that financial caps on lab services may negatively impact on medical care, particularly in difficult cases. Following the reform, reimbursement rates offered by health insurers for lab services have dropped about 20%. To be able to continue operations in face of these new financial constraints many doctors’ offices and labs need to forge co-operations - a route some specialised labs may not be able to take, as experts fear. Germany has only about 65 endocrinologist practices – which means they are geographically dispersed.
Thomas Eversmann, president of the endocrinologists’ professional associations, pointed out: ‘When hormone tests are being analysed, the specialist physician must be present in the lab. The on-site lab in the endocrinologist’s practice ensures the high quality of the tests, since neither time nor distance come into play. At the same time, a profound analysis of the hormone parameters requires in-depth knowledge of both the clinical findings and lab methodology. It remains to be seen how endocrinologists, who have no possibilities to enter into co-operations, will manage in the future.’
The German Society for Endocrinology (DGE) warns that, because over the last few years, endocrinology care in the university hospital sector has been reduced, the current reforms will further compromise the quality of endocrinology care. In addition, patients will have to shoulder ever longer trips to their endocrinology specialist. According to Mr Eversmann, ‘the attempt to move specialists back to the hospitals will not improve endocrinology care and will further impede access to a specialist.’


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