New care financing arrangement
The Swiss Federal Office of Public Health evaluates the re-organisation of care financing. Careum Research provides its expertise on research relating to family members.
Basis
The new care financing arrangement has been in force since 1 January 2011. The changes in legislation were intended to provide clear guidelines on how costs for care are apportioned to and assumed by mandatory medical insurers, insured persons, cantons and municipalities. Thus, the people requiring care should have to contribute a maximum of 20 per cent. Cantons and municipalities have to finance the remainder. The intention was that medical insurance and people requiring significant levels of care should not have to bear increasingly high costs.
Project
The evaluation should investigate the actual effects of the new care financing arrangement. The Swiss Federal Office of Public Health (BAG) is legally obliged to review the implementation and impact of the law, which involves some highly complex issues:
- How is the new arrangement specifically being implemented at canton and municipality level?
- What are the consequences of the new arrangement, e.g. for the financial pressure on those needing care, the increase in costs for care and the financial obligations of the public sector?
- And what is changing as a result of the new financing arrangement for the service providers in terms of care services being offered?
- Not least, there is the questions of how decisions in the care process have changed from the perspectives of the various people involved.
Methods used include analysis of documentation and secondary data, interviews with professionals in the various groups at the centre of the investigation (including the Federal Council, cantons and municipalities, medical insurers, patients and organisations for the care of the elderly, social and health authorities, support organisations and drop-in centres).
Careum Research sheds particular light on the perspective of the people needing care and their relatives. It has many years of experience with service providers, people requiring care and their relatives. Few research institutions are so clearly focused on the perspective of life with a chronic illness where the private home is the location of healthcare. The focus is as much on these people as it is on their relatives providing the care and support. The results of the evaluation are published in a clear, detailed and easy-to-read final report.
Projekt consortium and team
Infras: Thomas von Stokar, Judith Trageser, Eva Gschwend, Prof. Dr. Christina Felfe
Careum Research: Prof. Dr. Ulrich Otto, Anna Hegedüs, (consultant: Prof. Dr. Iren Bischofberger)
Landolt solicitors: Prof. Dr. iur. Hardy Landolt (University of St. Gallen)
Contracting authority
Duration
April 2016–November 2017
Further information
Federal legislation regarding the new care financing arrangement (13.06.2008, geman)
Final report regarding the approach to evaluationg the new care financing arrangement (21.01.2015, german)
Parliamentary initiative for the improvement of care financing (01.09.2015, german)
Federal Council report on the responsibility for residual financing as part of care financing (21.10.2015, german)
Stellungnahme des Bundesrates
Die Ergebnisse wurden dem Bundesrat in dem nun veröffentlichten Evaluationsbericht vorgelegt. Der Bundesrat nahm diesen zur Kenntnis und veröffentlichte am 4. Juli 2018 seine Schlussfolgerungen (siehe Medienmitteilung des Bundesrates vom 4. Juli 2018). Sämtliche Unterlagen finden sich auf der Webseite des BAG:
Reaktionen
Wie brisant das Thema ist, zeigt sich in den kritischen Reaktionen von Organisationen und Verbänden, die bereits kurz nach dem Erscheinen der bundesrätlichen Schlussfolgerungen erfolgten.
- Medienmitteilung SBK-ASI, Schweizer Berufsverband der Pflegefachfrauen und Pflegefachmänner: «Bundesrat will Mittel der Spitex kürzen»
- senesuisse, Verband wirtschaftlich unabhängiger Alters- und Pflegeeinrichtungen Schweiz: «Der Bundesrat ignoriert die Mängel der Pflegefinanzierung»
- IG Pflegefinanzierung: «Bundesrat verpasst die Chance, die Weichen richtig zu stellen»
- Curafutura (Krankenversicherer CSS, Helsana, Sanitas und KPT): «Zahlen plausibel, Erkenntnisse richtig»
Medienreaktionen
Neue Zürcher Zeitung (4. Juli 2018): «Spitex wird zur Patientin»
Neue Zürcher Zeitung (4. Juli 2018): «Kosten dürfen nicht illegal auf Heimbewohner abgewälzt werden»
Tablatt (4. Juli 2018): «Pflegefachpersonen sollen künftig mehr Kompetenzen erhalten»
