Structural characteristics and contractual terms of specialist palliative homecare in Germany

BMC Palliative Care

Table 2 Reimbursement schemes

		BW	BV	BE P	BE N	BB	HB	HH	HE 1^f	HE 2	MV	LS	NR	RP	SL	ST ^e	SX/ TH	SH	WE	Sum
	Reimbursement scheme publicly available	x	-	x	x	x	-	-	x	x	x	x	x	contract cancelled	-	x	x	-	x	12
	Differentiated care levels	x	Individually negotiated	x		x			x	x	x		x				x			8
Full care	Case fee w/o performance day^a	x		x		x					x	x	x			x	Individually negotiated		x	8
	Case fee w/ performance day^b				x				x	x										3
	Weekly rate				x	x										x				2
	Daily rate								x^c		x	x	x						x^c	5
	Daily rate w/ visit	x																		1
	Fee for service	x		x	x							x				x				5
	Nursing care (§37 SGB V) excluded if SPHC				x	x					x	x								4
Partial care	Case fee w/o performance day^a	x		x		x					x	x	x			x	x		x	9
	Case fee w/ performance day^b				x				x	x							x			4
	Weekly rate				x	x										x				3
	Daily rate								x^c		x	x								3
	Daily rate w/ visit	x																		1
	Fee for service	x		x	x						x	x	x			x	x^d		x	9
	Nursing care (§37 SGB V) excluded if SPHC					x														1
Coordination	Case fee w/o performance day^a			x		x					x	x	x			x	x		x	8
	Case fee w/ performance day^b				x				x	x							x			4
	Weekly rate				x											x				2
	Daily rate								x		x	x								3
	Daily rate w/ visit																			0
	Fee for service	x		x	x							x	x			x	x^d		x	8
Consultation	Case fee w/o performance day^a			x		x					x	x				x	x		x	7
	Case fee w/ performance day^b				x												x			2
	Weekly rate				x											x				2
	Daily rate										x	x								2
	Daily rate w/ visit																			0
	Fee for service	x		x	x				x	x		x	x			x	x^d		x	10
	Transportation expenses										x								x	2
	Fees for GPs and other physicians					x										x			x	3

BW Baden-Württemberg, BV Bavaria, BE P Berlin, physicians, BE N Berlin, nursing care, BB Brandenburg, HB Bremen, HH Hamburg, HE 1 Hesse (two contracts), HE 2 Hesse AOK health insurance fund, MV Mecklenburg-Western Pomerania, LS Lower Saxony, NR North Rhine, RP Rhineland Palatinate, SL Saarland, ST Saxony Anhalt, SX/T Saxony/Thuringia, SH Schleswig–Holstein, WE Westphalia
^a Case-based lump sum is paid for days with and without patient-related contact ^b Case-based lump sum is only paid for days with patient-related contact
^cif any kind of service is provided ^dnumber of visits with cut-off ^eonly the regulations for physicians are publicly available ^fHesse has three model contracts for different groups of health insurance funds. Two of these model contracts share the same reimbursement scheme

ISSN: 1472-684X