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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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Preliminary financial results of the statutory health insurance for 2020 in Germany

According to the available financial results, published by the German Federal Ministry of Health,  the German statutory health insurance companies reported a total deficit of around 2.65 billion euros in 2020. The health fund reported a deficit of 3.49 billion euros in 2020. As of January 15, 2021, the health fund's liquidity reserve was around 5.9 billion euros.

The income of the health insurance companies, which they receive primarily through pre-determined allocations from the health fund, rose by 4.0% to 260 billion euros. Expenditures for services and administrative costs also demonstrated an increase of 4.0% to 262.6 billion euros with an increase in the number of insured persons of 0.3%.

With the exception of the LKK, all other health insurance companies reported a deficit in the past year: AOK - 974 million euros, BKK - 235 million euros, IKK - 250 million euros, and Knappschaft - 138 million euros.

The health fund's deficit of around 3.49 billion euros in 2020 is mainly due to cyclical shortfalls in income and the compensation payments made to service providers that were not compensated by the federal government.

To cope with the COVID19 pandemic, around 12.2 billion euros were made available from the health fund's liquidity reserve last year. This includes, among other things, compensation payments for hospital beds that have been kept free, compensation payments for newly created intensive care treatment options, for preventive and rehabilitation facilities and drug providers, as well as expenses for corona tests and protective masks. The federal government reimbursed around 9.9 billion euros, including about 9.4 billion euros, for the hospital beds that were kept free.

The health insurance companies' expenses for services and administrative costs rose by 4.0% in 2020. The service expenditures increased by 4.0%, the administrative costs by 4.8%.

The final financial results of the health insurance for 2020 and the data for the first quarter of 2021 will be available in mid-June 2021.

The full details in German can be found here.

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