What is actually a Hybrid-DRG?

Certain medical services in Germany are currently provided in both, the out-patient and in-patient sectors. Even if identical services are provided on an out-patient or in-patient basis, they are remunerated via different forms of reimbursement with different reimbursement levels and different reimbursement components according to different rules. This is a barrier for the German healthcare system to be more effective and efficient.

The provision of services in the in-patient sector is considered to be more expensive. Not least due to medical progress over the past 30 years, many services can now be provided on an sage basis in the out-patient setting. Shifting services from the in-patient to the out-patient sector is therefore one of the current major issues. In order to give this megatrend the necessary tailwind, there are plans to introduce identica reimbursement for in-patient and out-patient services – independently from the sector of the provided service - the “Hybrid-DRG”.

Hybrid-DRGs were already introduced as a sector-equivalent reimbursement within the framework of a model project by the Techniker health insurance (TK) in the fall of 2017.

In its coalition agreement, the current German government agreed to introduce Hybrid-DRGs. On November 8th, 2022, a corresponding amendment was introduced into the Hospital Care Relief Act (KHPflEG).

introduced, presented by Health Minister Lauterbach on December 6th, 2022, at the German Hospital Conference as part of Medica, and then passed on December 8th, 2022, with effect from January 1st, 2023.

According to the law, the contracting parties had been given until March 31st, 2023, to align on “Hybrid-DRGs” and define the reimbursement components and the calculation methodology. However, the ideas of the contracting parties were too different to agree on the same definition of Hybrid-DRG. Therefore, a substitute action by the Federal Ministry is now expected.

At the moment, no one really seems to know what Hybrid-DRGs actually are.

We are curious and will report.

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