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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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The opinion of curafutura on the preliminary draft for the uniform financing of outpatient and inpatient services

In 2009, a member of the People’s Democratic Party (PPD) proposed an initiative for the change of the financing system in Switzerland. The proposal was the following: a monistic funding system to be introduced through a modification of the Federal Health Insurance Act (LAMal), in order for the cantons to be able to maintain control over public resources. The proposal points out the need for a change in which the following cardinal points are specifically considered:

  • The funds of the public bodies should be used in the fields of training and further education of the health professions, risk compensation, public health and services of public interest as well as for the reduction of premiums
  • The share borne by the public bodies for the financing of the services covered by the basic insurance must be guaranteed and adequate for the increase in costs in the health sector
  • All stationary and ambulatory benefits according to the LAMal/KVG are financed by the health insurers

The Commission for Social Security and Healthcare of the Federal Council (CSSS-N) asked curafutura to express an opinion on this legislative initiative “Uniform financing of outpatient and inpatient services” (EFAS) in May 2018. curafutura published their opinion online (the whole letter to the CSSS-N in Italian can be found here) at the beginning of September.

curafutura supports the preliminary project for the uniform financing of outpatient and inpatient services (EFAS). In their opinion, EFAS creates better incentives for choosing the most efficient healthcare, thus reducing the overall costs without compromising the quality of care. Advances in the medical field increasingly favor the transfer of services from the hospital to the outpatient sector. With EFAS, the services provided on an outpatient basis will no longer be exclusively financed by the health insurance companies, but will also be funded through cantonal contributions. The reduction in premiums made possible by the uniform funding of benefits will make alternative insurance models more attractive and will give further impetus to integrated care. Unnecessary hospitalization will be avoided.

curafutura believes that this is a meaningful reform that should happen in the Swiss system and invites the authorities to make adapt this initiative soon.

You can find the full article in Italian here.

Several days later, curafutura communicated to the public that even other actors, such as santésuisse (another insurance funds’ association), FMH (Swiss Physicians’ Association), OSP (Organization of Swiss Patients), vips (Association of Swiss Pharmacies) and others stand together with curafutura and have the same attitude towards the EFAS. More information on this can be found here.

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