Approaches to managed care in Germany

The economic burden of growing health care expenses requires self-sustaining limitations to spending on health care all over the world. Germany is no exception. In the search for solutions different managed care systems are being introduced into the German public and private health care system commencing in 1996. The gatekeeper project of the largest German public health care corporation and the Berlin network project of a competing public health care corporation are described and evaluated. Managed care as a concept of techniques limiting health care spending will thoroughly change the German health care system within the next decade.