[Social law aspects of medical networking]

One weak point of the German Social Health Insurance regulations valid until 1999 was that an overlapping co-operation between different sectors of medical social security (service providers of various sectors, in particular in the in-patient and out-patient sectors) was de facto almost impossible. Reason for this inefficiency is that as a rule the economic interest of the service providers in the individual sectors are contradictory and there is no incentive to foster network. A first approach was made in the out-patient sector in the middle of the nineties of the 20th century with the "Medizinische Qualitätsgemeinschaft Rendsburg" (Medical Quality Partnership Rendsburg) and the Medical Network Berlin. This network was founded to guarantee that medical services can only be used via service providers belonging to the network. At that time, however, the Code of Social Law provided no statutory basis to do so. The so-called "Strukturverträge" (structural agreements) made possible with the "Second Health Insurance New Regulation Act" were no real step forward to promote the idea of network. Contrary to this and by means of the so-called "Modellvorhaben" (pilot schemes), it was possible to replace the regulations of the Code of Social Law with new contracts between health insurance and medical practitioners or hospitals. Nevertheless, many of these projects did not really lead to a progress. With the adoption of the regulations concerning Integrated Service by the Health Insurance Reform Act 2000 network is no longer an experiment but an alternative to the former standard service. The particular goal is to achieve a service structure connecting the different sectors of social security. Standard service and integrated service are not contrary to each other. In fact the regular service is now divided into "general service" and "integrated service". Both are part of the standard service.