Report: German Physicians With In-Office Labs Struggle under GKV Cuts

NEW YORK, Oct. 14, 2014 /PRNewswire/ -- German physicians who perform lab tests as part of their practices face declining income as a result of recent cuts to the German healthcare system, according to Kalorama Information. The healthcare market research publisher says that Germany's Gesetzliche Krankenversicherung (GKV) has had funding difficulties, forcing administrators to reduce schedule test fees, and this and other healthcare system cuts around the world will have an impact on the 2.5 billion-dollar physician office lab diagnostics (POL) market. Germany is one of the largest POL markets in the world, according to Kalorama's report Physician Office Laboratory Markets. 

The report is available at http://www.kaloramainformation.com/redirect.asp?progid=86705&productid=8375301.

"While the German POL market remains noteworthy due to the total size of the market, its development has stalled with continued reductions to reimbursement schedules and the resultant unprofitability of in-office testing," said Emil Salazar, analyst of physician lab diagnostics for Kalorama and the author of the report. "At least one literature review found that POC hematology tests, pregnancy tests and cardiac marker tests did not receive reimbursement sufficient to cover the cost of the test kit or assay. "

According to Kalorama, that's bad news for makers of point-of-care devices (POC) sold to physician labs, but does not appear to be avoidable. The GKV program relies upon a federal premium deducted from income as well as additional premiums charged by Krankenkassen for funding shortfalls. Additional premiums have yet to be collected, but may as soon as 2015.  Physician self-referral or performance of lab tests was restricted by federal laboratory reform in 2009. Under the reform, self-referral or in-office (POL) performance of lab tests is recognized under the GKV's point-based schedule (EBM) only in cases where the test is recognized within the same specialty or practice area as the performing physician or office.

The report says that reimbursable POL tests are quite broad in Germany depending upon physician specialty. Under the GKV's EBM, basic dipstick urinalysis is not reimbursed for general practitioners, but other tests are. Glucose, prothrombin time, other coagulation tests, D-dimer, urinalysis by microscopy, FOB, cardiac markers, strep tests and microbiology cultures are among those reimbursed when physicians perform them.    

With ready outlets to laboratory organizations (Laborgemeinschaften), nearby community labs and large commercial labs, German physicians have been able to phase out, minimize, or abandon altogether their POLs. Recently the issue was publicized when a German practitioner with several decades of experience in POL operation wrote an opinion piece in one of the nation's largest physician newsletters (Deutsches Ärzteblatt) noting the potential of advances in POC device technology, but the futility of benefiting from those advancements due to declining regulatory recognition.   

"Continued targeting of lab fees as a source of healthcare cost savings under GKV and by private insurers in Germany will continue to squeeze the German POL market and severely limit growth," Salazar said.

Kalorama Information's Physician Office Laboratory Markets, 3rd Edition presents readers not only the leading opportunities for IVD sales growth in the POL channel, but is also a valuable resource for determining competitive positioning within the channel vis-à-vis its leading players. Find this report in addition to other industry leading research from Kalorama Information at: www.kaloramainformation.com/.  

About Kalorama Information -- Kalorama Information, a division of MarketResearch.com, supplies the latest in independent medical market research in diagnostics, biotech, pharmaceuticals, medical devices and healthcare; as well as a full range of custom research services. We routinely assist the media with healthcare topics. Follow us on Twitter, LinkedIn and our blog.

Contact:
Bruce Carlson
(212) 807-2622
[email protected] 
www.KaloramaInformation.com

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SOURCE Kalorama Information