The controversial reduction in payments for family physicians and pediatricians, often referred to as the “fixed cost degression,” is set to be revoked. According to Christos Pantazis, SPD parliamentary group spokesperson for health policy, the Social Democrats and the Union have reached an agreement on this matter during ongoing discussions regarding amendments to the Statutory Health Insurance Contribution Rate Stabilization Act (BStabG). This change is slated to be implemented as part of the emergency reform.
The objective is to finalize the parliamentary procedure this October, allowing the corrections to take effect before the BStabG regulations come into force on January 1, 2027. Previously, SPD health policy expert Serdar Yüksel had announced the suspension of this provision.
Pantazis praised the decision, stating that it is a crucial correction and a major achievement for outpatient care. He argued that the “fixed cost degression cut would have been the wrong tool in the wrong place.” His reasoning is that clinics that take on additional patients and thus secure healthcare provision should not be penalized with lower compensation.
The BStabG was originally designed to limit payment in doctor-centered care when service or enrollment volumes increase. Under the initial plan, a specific cap applied to family and pediatric practices: if the number of treated patients exceeded a set threshold, the practice would receive less money for additional services. The German Association of Pediatricians and Adolescent Physicians (BVKJ) had warned about the damaging effects of this rule, even impacting preventive check-ups. BVKJ Vice President Anke Steuerer noted the stark scenario, where providers might have to tell parents that they had met their quota and could not afford another appointment, either practically or financially.
Pantazis pointed out that this rule was contradictory to the goal of strengthening primary care, stating that bottlenecks already exist in this sector. He asserted that it makes no sense to simultaneously discourage additional visits by financially limiting family and pediatric doctors while aiming to build a more physician-coordinated healthcare system. “We want to strengthen and develop doctor-centered care,” the SPD politician added, maintaining that setting financial disincentives that impede expansion cannot happen at the same time.
Beyond this repeal, the coalition plans other adjustments to the BStabG, including improvements to psychotherapeutic services and requiring health insurance funds to individually inform insured persons when the supplementary contribution rate increases. The package will also incorporate additional measures aimed at financially stabilizing hospitals, amounting to 550 million euros.
Fundamentally, the BStabG is intended to curb rising costs in the statutory health insurance and stabilize contribution rates, though further structural reforms are being considered, with a commission set to present suggestions later this year. Pantazis emphasized that, given the financial situation of the statutory health insurance, the stabilization of contribution rates remains necessary, but that a careful analysis must determine exactly “where we can save and where we are allowed to save.” Crucially, he reinforced that in primary care, there must be no financial incentives that make it harder to accept additional patients.
