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. 2010 Jun 23:10:e046.
doi: 10.5334/ijic.539.

Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

Hildebrandt H  1 , Hermann C, Knittel R, Richter-Reichhelm M, Siegel A, Witzenrath W
Affiliations

Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

Hildebrandt H et al. Int J Integr Care. .

Abstract

Introduction: Integrated care solutions need supportive financial incentives. In this paper, we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal.

Description of integrated care case: Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH) in cooperation with the physicians' network in the region (MQNK), a German health care management company with a background in medical sociology and health economics (OptiMedis AG) and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg).

Discussion and (preliminary) conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a substantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organization of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether-and to what extent-cost reduction may be attributed to a real population health gain.

Keywords: German managed care approach; health care management company; population-based integrated care; shared health gain.

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Figures

Figure 1.
Figure 1.
Corporate structure of the Kinzigtal shared health gain contract.
Figure 2.
Figure 2.
Calculation model of an integrated care management company's financial results within the framework of a health insurers' contribution margin analysis—model case I: increasing contribution margin after the start of the intervention in 2006 (figures are fictitious—for demonstrational purpose only).
Figure 3.
Figure 3.
Financial architecture of the Kinzigtal shared health gain contract.
See this image and copyright information in PMC

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