Reaching the highest efficiency: The need for a balance of ethical and financial incentives - population-based financing in integrated networks in Germany.

Most experts certainly agree that the health care payment systems of today lead to a lot of over-and misuse as well as underuse of health care services on the other side. The author argues to balance overtreatment-inducing payment systems for the individual practice (partly budgeted fee-for-service) with population based and risk adjusted shared savings for a certain regional population. He describes the model he developed with two sickness funds in Germany (AOK and LKK Baden-Wuerttemberg) and its promising results over several years. Three basic requirements are extracted out of the experiences in Kinzigtal: * The need for a balance of ethical and financial incentives to stimulate the professional pride in those who are delivering care * The need for a comprehensive set of health care utilization data for the population * The need for an entrepreneurial but health sciences based management company to reach highest efficiency rates [ABSTRACT FROM AUTHOR]