[Ambulatory emergencies and Tarmed on 2018].

Area of Science:

• Healthcare Management
• Medical Economics
• Swiss Health System Analysis

Background:

• Emergency medical centers (EMCs) are increasingly utilized in Switzerland as a primary point of care, offering walk-in services.
• These centers are integrated within the Swiss healthcare system and provide care for diverse medical and surgical emergencies.
• Despite their role, EMCs bill services using rates typically applied to general practitioner offices.

Purpose of the Study:

• To examine the impact of the 2018 Tarmed overhaul on the billing practices of Swiss emergency medical centers.
• To identify specific services within EMCs that became complex to bill post-Tarmed revision.
• To analyze the financial implications for EMCs dealing with time-consuming care or extended observation.

Main Methods:

• Analysis of billing data and service codes from Swiss emergency medical centers.
• Review of the 2018 Tarmed tariff structure revisions.
• Case study approach focusing on services involving extended patient care or observation.

Main Results:

• The 2018 Tarmed overhaul introduced complexities in billing for certain services provided at emergency medical centers.
• Services requiring significant time investment or prolonged patient observation became particularly intricate to bill accurately.
• This intricacy may affect the financial viability and operational efficiency of EMCs.

Conclusions:

• The Tarmed reform has created billing challenges for Swiss emergency medical centers, particularly for complex cases.
• Further clarification or adjustments to billing codes may be necessary to ensure fair reimbursement for EMCs.
• Understanding these billing intricacies is crucial for healthcare providers and policymakers in Switzerland.