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Updated: May 20, 2026
06:55
Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
[Remuneration distribution - should morbidity-dependent overall remuneration also be distributed after adjustments
A Walendzik1, M Trottmann, R Leonhardt
1Alfried Krupp von Bohlen und Halbach-Stiftungslehrstuhl für Medizinmanagement der Universität Duisburg-Essen. Anke.Walendzik@medman.uni-due.de
Gesundheitswesen (Bundesverband Der Arzte Des Offentlichen Gesundheitsdienstes (Germany))
|July 28, 2012
Summary
German healthcare reform shifted morbidity risk to health funds but not to physician groups. Diagnosis-based risk adjustment in outpatient care did not improve expenditure prediction at the practice level compared to age-based methods.
Area of Science:
- Health economics
- Medical policy
- Public health
Context:
- The 2009 German healthcare reform transferred morbidity risk to health funds.
- Failure to adjust remuneration for physician groups can distort budgets and incentivize risk selection.
Purpose:
- Analyze the German outpatient care remuneration system regarding morbidity adjustment.
- Develop and present a risk adjustment model for predicting individual healthcare expenditures.
- Explore conditions for successful implementation of diagnosis-based risk adjustment.
Summary:
- A risk adjustment model was developed using diagnostic and pharmaceutical data for half a million individuals.
- The model predicts individual expenditures and can allocate care burden across physician groups.
- Simulations showed diagnosis-based risk adjustment did not outperform current age-related calculations for predicting practice-level expenditures.
Impact:
- Morbidity-based risk adjustment can enhance distributional justice and incentivize appropriate care in German outpatient medical services.
- Limitations exist, particularly with lump-sum payments for certain physician groups.
- The findings inform potential transformations of collective remuneration systems to better align with patient needs and physician incentives.
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