Brief Update on Hybrid DRGs

It has now been two months since hybrid DRGs were introduced in Germany. These hybrid DRGs allow for certain outpatient procedures to be reimbursed using the DRG system (at a lower rate). However, the implementation has not been totally painless.

(February, 2024) Now, several medical associations are warning against the flat rate DRG reimbursement payments for outpatient operations; particularly for expensive devices, such as implants (bone plates/prosthetics/anchors). Until now, such implants were typically reimbursed based on consumption by the insurances. With the introduction of the hybrid DRG flat rate system, there is now a lumpsum including treatment and material costs.

From the perspective of the medical associations, this will put economic pressure on medical decisions in the outpatient surgery setting. According to a referenced survey, over 80% of surgeons think that patients could be treated better if materials for surgeries would be reimbursed as they have been up until now.
 
It will be seen how the Ministry of Health responds to these critiques.

For more information, please contact AiM’s team: info@aim.iges.com