At first glance, the German health care system is a model for other nations. Germany 's citizens have universal access to care with free choice of providers, and pay premiums based on their income rather than their health or employment status.

However, just like other nations Germany suffers from rising costs and inconsistent quality, and reform efforts to date have failed to solve these problems. Future reform efforts must make value improvement, defined as patient health outcomes achieved per euro spent, the central goal.

This book lays out an action agenda to move Germany to a high-value system. This starts with reorganizing care around patients and their medical conditions. Other key elements include: true competition based on outcomes, the active role of health plans in maximizing subscriber health, and the integration of private insurance in the risk-pooling system.

The book shows that all these steps are practical and achievable. Moving to a value-based health care system is the only way for Germany to continue to ensure access to excellent health care for everyone.

Die Kosten im deutschen Gesundheitssystem steigen, zugleich werden Qualitatsprobleme immer offensichtlicher trotz aller Reformbemuhungen. Die Autoren gehen davon aus, dass nicht Kostenkontrolle, sondern die Steigerung des Patientennutzens das Ziel ist, das alle Akteure vereinen kann. In zwolf Empfehlungen erklaren sie, wie sich Leistungserbringer im Wettbewerb um Qualitat organisieren sollten, wie Krankenkassen eine aktivere Rolle spielen und das Vergutungssystem kunftig Exzellenz in der Versorgung einzelner Krankheitsbilder belohnen konnte."

The German health care system is on a collision course with budget realities. Costs are high and rising, and quality problems are becoming ever more apparent. Decades of reforms have produced little change to these troubling trends. Why has Germany failed to solve these cost and quality problems? The reason is that Germany has not set value for patients as the overarching goal, defined as the patient health outcomes achieved per euro expended. This book lays out an action agenda to move Germany to a high value system: care must be reorganized around patients and their medical conditions, providers must compete around the outcomes they achieve, health plans must take an active role in improving subscriber health, and payment must shift to models that reward excellent providers. Also, private insurance must be integrated in the risk-pooling system. These steps are practical and achievable, as numerous examples in the book demonstrate. Moving to a value-based health care system is the only way for Germany to continue to ensure access to excellent health care for everyone.