🇩🇪Germany
Verlorene Abrechnungen durch DRG-Änderungen
3 verified sources
Definition
Reimbursement restructuring affects home health episode billing tied to inpatient transitions, leading to pricing errors and lost claims.
Key Findings
- Financial Impact: €3.7B sector-wide savings target implies 2-5% revenue leakage per provider on non-adapted billing
- Frequency: Per episode from 2025-2029 transition
- Root Cause: Manual processes not updated for hybrid DRG/flat fee model
Why This Matters
This pain point represents a significant opportunity for B2B solutions targeting Home Health Care Services.
Affected Stakeholders
Abrechnungsleiter, Verwaltungschef
Deep Analysis (Premium)
Financial Impact
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Current Workarounds
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Methodology & Sources
Data collected via OSINT from regulatory filings, industry audits, and verified case studies.
Evidence Sources:
- https://mtrconsult.com/news/healthcare-system-changes-2025-germany
- https://eurohealthobservatory.who.int/monitors/health-systems-monitor/analyses/hspm/germany-2020/the-hospital-care-improvement-act-came-into-force-on-1-january-2025
- https://www.simon-kucher.com/en/insights/german-hospital-reform-2025-what-it-means-medtech-companies
Related Business Risks
Verzögerte Zahlungen durch ePA und Digitization
30-60 Tage DSO increase; 20-40 Stunden/Monat manual ePA data entry
AMNOG-Verhandlungsverzögerungen
7-month reimbursement delay; €5B sector savings target impacts claims
Verzögerte Abrechnung durch Qualitätsprüfungen
40-90 Tage DSO; 1-3% Zinskosten auf €1 Mio. Forderungen (€10.000-30.000/Jahr)
Verzögerte Abrechnung bei Heimversorgung
30-60 days delayed payments on €10,000/month = 5% financing cost (€6,000/year)
Bußgelder für unzureichende Pflegekraft-Qualifikation
€5.000–€50.000 pro Audit-Versäumnis; 2–5% Umsatzverlust durch Leistungsgruppen-Ausschluss
Überstunden durch manuelle Betreuungs-Supervision
€2.000–€4.000/Monat pro Team (bei €50/h Überstunden)
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