Based on a report from the GKV-Spitzenverband, circulated among Funke-Mediengruppe newspapers, a minority of insured individuals who receive alerts from their health insurance funds regarding potential health risks subsequently act on these recommendations.
The evaluation is based on the implementation of the Health Data Usage Act, which officially took effect in March 2024. This law allows health insurance providers to specifically analyze billing and insured data to identify signs of previously unknown illnesses and health dangers, such as cancer, drug-related risks, undiagnosed dependency needs, or lack of necessary immunizations. Insured persons identified this way are then informed by their fund and advised about suitable screenings or care options.
Stefanie Stoff-Ahnis, vice-president of the GKV-Spitzenverband, commented to the Funke-Mediengruppe that this proactive approach, using individual data, has the potential to significantly improve health care. She noted that early identification can help catch diseases early or prevent their progression, ideally avoiding severe medical courses.
For instance, in breast cancer prevention programs, women aged 52 to 75 who had additional risk factors, such as a family history, were identified even if they had not yet received gynecological screenings or mammograms. Similarly, individuals diagnosed with gestational diabetes were alerted to their elevated risk for later-stage Type 2 diabetes if documented blood sugar monitoring was missing.
Health funds utilized these new capabilities quite frequently to highlight missing vaccinations. Approximately 1.3 million insured persons were contacted in this regard, and at least eight percent subsequently received the recommended vaccination. This group includes children and adolescents who lacked complete protection against Human Papillomaviruses (HPV), a vaccination that helps prevent specific cancers.
However, adoption of these new features is not uniform across all carriers. Out of 94 health funds, only 15 have implemented corresponding measures by the end of 2025, despite these funds representing around 64 percent of legally insured persons. Many other funds cited issues such as staff shortages, financial constraints, and legal uncertainties. Furthermore, the delays in receiving billing data make it difficult to definitively track whether insured individuals followed through with recommended care based on the fund’s alerts.
It is important to note that the health data analysis is voluntary. Insured persons retain the right to object to the use of their data at any time, and according to the report, about 17,600 people have registered an objection so far. This represents less than 0.4 per mille of the insured within the participating funds. Stoff-Ahnis assured that the data usage is compliant with privacy regulations and is aimed at benefiting the individuals. She affirmed that the discreet and targeted application of existing data helps continue improving the health care system.
