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The reimbursement of new medical technologies in German inpatient care: What factors explain which hospitals receive innovation payments?

Published online by Cambridge University Press:  04 June 2019

Patricia Ex ,
Verena Vogt ,
Reinhard Busse  and
Cornelia Henschke
Patricia Ex*
Affiliation:
TU Berlin, Department of Health Care Management, Technische Universität Berlin, 10623Berlin, Germany
Verena Vogt
Affiliation:
TU Berlin, Department of Health Care Management, Technische Universität Berlin, 10623Berlin, Germany
Reinhard Busse
Affiliation:
TU Berlin, Department of Health Care Management, Technische Universität Berlin, 10623Berlin, Germany
Cornelia Henschke
Affiliation:
TU Berlin, Department of Health Care Management, Technische Universität Berlin, 10623Berlin, Germany
*
*Correspondence to. Email: [email protected]
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Abstract

Most hospital payment systems based on diagnosis-related groups (DRGs) provide payments for newly approved technologies. In Germany, they are negotiated between individual hospitals and health insurances. The aim of our study is to assess the functioning of temporary reimbursement mechanisms. We used multilevel logistic regression to examine factors at the hospital and state levels that are associated with agreeing innovation payments. Dependent variable was whether or not a hospital had successfully negotiated innovation payments in 2013 (n = 1532). Using agreement data of the yearly budget negotiations between each German hospital and representatives of the health insurances, the study comprises all German acute hospitals and innovation payments on all diagnoses. In total, 32.9% of the hospitals successfully negotiated innovation payments in 2013. We found that the chance of receiving innovation payments increased if the hospital was located in areas with a high degree of competition and if they were large, had university status and were private for-profit entities. Our study shows an implicit self-controlled selection of hospitals receiving innovation payments. While implicitly encouraging safety of patient care, policy makers should favour a more direct and transparent process of distributing innovation payments in prospective payment systems.

Keywords

Adjustment of DRG systemhospital financinginnovation paymentsreimbursement of new medical technologiestechnological innovation

JEL classification

C30: General D78: Positive Analysis of Policy Formulation and Implementation H51: Government Expenditures and Health J11: Demographic Trends, Macroeconomic Effects, and Forecasts O33: Technological Change: Choices and Consequences • Diffusion Processes
Type
Articles
Information
Health Economics, Policy and Law , Volume 15 , Issue 3 , July 2020 , pp. 355 - 369
Copyright
Copyright © Cambridge University Press 2019

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