General Practitioners Call for Revisions to GKV Cost-Saving Law

The association representing general practitioners in Germany has voiced strong concerns regarding the proposed cost-saving legislation for the statutory health insurance system (GKV). The Federal Ministry of Health, aiming to address a significant budget shortfall and control the rising additional contributions, has introduced a draft law that would implement cuts across various sectors of the healthcare system.

One major component of the draft legislation is an increase in the mandatory discount that pharmacies must grant to health insurers, raising it from EUR1.77 to EUR2.07 per prescription. However, this measure faces potential opposition from several federal states, which could hinder its implementation.

Physicians, particularly those in general practice, are also affected by the proposed savings. During a press conference in Berlin, representatives of the national general practitioners' association highlighted the ongoing economic challenges faced by medical practices. According to the association, the net earnings of general practitioner offices declined by 6.3 percent between 2022 and 2023, primarily due to increased personnel costs. The association warned that further reductions in funding would threaten the sustainability of outpatient care nationwide.

The proposed law introduces a fixed cost degression for practices participating in the General Practitioner-Centered Care (HZV) program. Under this system, practices that treat more patients than in the previous quarter would receive a reduced reimbursement rate for each additional patient. The association argues that this would effectively penalize practices for expanding access and accommodating growing patient demand.

Further concerns have been raised about the partial reversal of the previously achieved removal of budget caps for primary care and pediatric services. The draft law proposes that if a practice's range of services expands, corresponding reimbursements would be reduced, a move the association contends undermines the incentive structure for practices to take on additional responsibilities.

Association leaders have described these measures as contradictory. While the government expects general practitioners to deliver more services and play a central role in patient management, the proposed reimbursement reductions would, in their view, make it increasingly difficult for practices to remain financially viable. The association maintains that such policies could destabilize the foundation of primary healthcare in Germany.

Another central issue is the government's plan to introduce a primary care system as a significant structural reform within the German healthcare landscape. The association notes that similar large-scale reforms in the past, such as the restructuring of healthcare in eastern Germany, were accompanied by substantial government funding and support. In contrast, general practitioners are not asking for direct subsidies but are calling for a halt to measures that would further erode their economic stability, particularly those related to fixed cost degression.

The ongoing debate highlights the complex balance between ensuring financial sustainability for the statutory health insurance system and maintaining high-quality, accessible primary care. Stakeholders from across the healthcare sector continue to voice their concerns as the legislative process moves forward, with the final version of the law likely to be shaped by feedback from professional associations and regional governments.