Projects

Every year, more than 465,000 people suffer from heart failure. Due to the aging society, the rate is expected to increase. Growing cost pressure is a rising challenge for the German healthcare system. The majority of costs associated with heart failure occur in the hospital. The number of hospitalizations can be reduced by adequate management of office-based physicians and better coordination between the different sectors. Currently, many hospitalized cases could also be treated as outpatients. At the same time, some severe outpatient cases would benefit from a referral to the hospital. Thus, there is a lack of need-based guidance of patients to the appropriate outpatient or inpatient treatment. In addition, the different reimbursements in the outpatient and inpatient sectors set false incentives. While flat rates per patients are applied in the outpatient sector, flat rates per case are used in the inpatient sector. When in doubt, this difference in reimbursement systems reinforces the tendency to treat patients as inpatients.

The goal of sekTOR-HF is the need-based and resource-optimized cross-sectoral care of patients with heart failure. For this purpose, coordination and communication structures are established as a bridge between the sectors. These include an eHealth platform for communication between all parties involved, a electronic patient file, and a regional network office that supports the monitoring of patients and thus coordinates the available resources in the outpatient and inpatient sectors. The network office continuously monitors patients by evaluating digitally transmitted vital data. In the event of any deterioration, the network office can activate service providers at the appropriate level of care at an early stage.

The second objective of the project is to develop a new cross-sector reimbursement model that provides incentives for cost-efficient care. For this purpose, the inav is conducting a theoretical and empirical analysis of various international cross-sector payment models, such as bundled payments. This is being done in exchange with international experts who contribute their experience on already existing models.

The second objective of the project is to develop a new cross-sector reimbursement model that provides incentives for cost-efficient care. For this purpose, the inav is conducting a theoretical and empirical analysis of various international cross-sector payment models, such as bundled payments. This is being done in exchange with international experts who contribute their experience on already existing models. The data of the participating heart failure patients collected in the project are the basis for examining different models with regard to incentives, resource consumption and transferability to the German context.

The project will receive ca. 3.8 million euros in funding from the Innovation Fund over a period of three and a half years.