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- Document type:
- Article
- Author(s):
- Anneser, Johanna; Brown, Anna; Thurn, Tamara
- Title:
- Developments Resulting from the Introduction of the Procedure Classification Code (OPS) 8-98h ("Specialized Complex Palliative Care Treatment Provided by a Hospital Support Team") - an Initial Report from Bavarian Palliative Care Hospital Support Teams
- Abstract:
- Background In Germany, supplementary payments within the DRG (diagnosis related group)-system are presently an important basis for financing palliative care hospital support teams (HPCTs). In addition to the supplementary payment for the procedure classification (OPS) code 8-982, a supplementary payment for the new OPS 8-98h ("specialized complex treatment by a HCPT") was introduced in January 2017, whereby the new supplementary payment is negotiated by the individual hospitals. One important change compared to the OPS 8-982 is that the precondition of a minimum treatment period (seven days, a minimum of six hours per week) has been dropped in favor of a staggered, resource-related reimbursement. Methods Between November and December 2018, we conducted an online-survey among all HPCTs which had been approved by the Bavarian Ministry of Health. Our main focus was on financial, structural and organizational consequences of the introduction of OPS 8-98h. Data from surveys conducted in 2011 and 2015 were used for comparison. Results The response rate was 52 % (30 questionnaires). Eleven HPCTs (37 %) billed the OPS 8-98h. This happened significantly more frequently (59 %) in larger (> 400 beds) hospitals compared to smaller (< 400 beds) hospitals (15 %). Up to the end of 2018, invoicing was on an exclusively lump sum per patient basis (592 euro on average). In addition to the OPS 8-98h, the majority of these HPCTs (N = 9/11, 82 %) were also financed from the older code 8-982. Overall, only 13 HPCTs (43 %) were able to finance themselves solely through the supplementary payments from OPS 8-982 and/or 8-98h. None of the HPCTs could be funded solely by the OPS 8-98h. Structurally, we found a significant reduction in the percentage of HPCTs including pastoral workers/chaplains and psychologists as an integral part of the team. Discussion The introduction of the OPS-Code 8-98h is an important step towards practical and adequate financing of HPCTs. However, our survey demonstrated that the following issues should be improved: 1. Reimbursement of OPS 8-98h: currently, the amount of the individually negotiated supplementary payment of OPS 8-98h is not sufficient for an adequate financing of HPCTs. 2. Billing of OPS 8-98h in smaller hospitals: billing of OPS 8-98h appears to be financially unattractive to date. 3. Multi-professionalism of HPCTs: the restriction on remit-relevant services for specific professions as defined in the criteria of OPS 8-98h jeopardizes the provision of adequate and appropriate patient-oriented palliative care.
- Journal title abbreviation:
- Z Palliativmedizin
- Year:
- 2020
- Journal volume:
- 21
- Journal issue:
- 2
- Pages contribution:
- 73-80
- Fulltext / DOI:
- doi:10.1055/a-1082-8233
- Print-ISSN:
- 1615-2921
- TUM Institution:
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie
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