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Regional Systems of Integrated Care 4.0 – Lessons learned by OptiMedis in Germany

Author:

Helmut Hildebrandt

Optimedis AG, Germany, DE
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Abstract

OptiMedis has analyzed the German Integrated Care Models of Healthy Kinzigtal (1.0), Healthy Billstedt-Horn & Health Kiosk (2.0), Healthy Werra-Meißner County/Healthy Schwalm-Eder County (3.0), and Healthy Heringen (4.0) to compile lessons learned. In improving on the first doctor-oriented versions (1.0), we have developed models that optimize the health status of regional populations by incorporating digital solutions and support from experienced healthcare professionals (e.g. nurses, health coaches, and volunteer health coaches in the 4.0 versions). At the foundation of each region there is a contractual agreement between regional health companies and insurance providers based on a shared savings success model. 

OptiMedis can draw upon 20 years of experience in establishing and scaling up Integrated Care Networks in Germany and has identified challenges, solutions, and lessons learned. Since developing the first (1.0) version, we have undertaken meticulous evaluations and improvement processes to scale up our initial model to a 4.0 version. Through this experience, we got a deep understanding of the complexity of implementing Integrated Care Models and developing practical Integrated Care Networks in different settings. Furthermore, we developed knowledge in contractual agreements with health insurances (sickness funds) and in funding the start-up period before realizing the successes and the shared savings.

Topics that will be raised include:

- the role of sickness funds / health insurances,

- the role of the different professions in health care,

- the role of hospitals and university hospitals as initial partners in a health focused partnership even when they raise their monies through DRGs,

- the role of the social and voluntary sector

- the initial financing of shared savings contracts with banks, investors, local companies and sickness funds. 

In sharing what we have learned, we want to stimulate a discussion on cooperation within an open source network of partners throughout several countries.

To facilitate the scaling of regions, continuous development, investment, research and bold concepts are needed. The financial and health sciences capacities of the“integrator” or “orchestrator” of Integrated Care is therefore of utmost importance.

Although the experience in this presentation focuses on obstacles within the German health care system, OptiMedis has also initiated and implemented Integrated Care Networks internationally: in the United Kingdom, the Netherlands, and Belgium. We have learned that many complexities can be applied to any health system.

 

 

How to Cite: Hildebrandt H. Regional Systems of Integrated Care 4.0 – Lessons learned by OptiMedis in Germany. International Journal of Integrated Care. 2022;22(S3):269. DOI: http://doi.org/10.5334/ijic.ICIC22135
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Published on 04 Nov 2022.

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