[Specialist-centred model of care using oncology as example]

During the last ten years the management of oncological patients has been shifted almost entirely from the inpatient to an outpatient setting, but without increasing the financial budget for ambulatory medical care. This is why new contracts should be established according to Sect. 140 et seqq, especially if the number of outpatients in oncological care continues to increase. Not only should these contracts aim at optimizing the organizational links between outpatient and hospital care with respect to treatment paths and increasing treatment quality, but also at creating a solid financial foundation for ambulatory oncological care by adjusting salaries to the number of patients treated. Whether the current competitive system, which has been proposed by the social health insurances and which is based on integration contracts according to Sect. 140 et seqq, should also apply to life-threatening oncological diseases or whether the care of cancer patients should rather be negotiated within the basic medical system--with the participation of the newly aligned (regional) physicians' associations, if necessary--remains to be determined by the medical self-governing bodies.