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Who we are and what we do

Herr Steffens needs to see a doctor. In his home country Germany that´s pretty easy: with his doc search app he finds Dr. Scheel nearby. At her surgery he hands over his electronic health insurance card, is treated and returns home.

To Herr Steffens that´s normal. Made possible by many involved behind the scenes.

Everyone in Germany is free to chose their own doctor or psychotherapist whom they trust most. This freedom of choice is guaranteed by the Kassenärztliche Bundesvereinigung and its 17 regional associations.
They also take care of finances; settling everything with each health insurance – there are more than a hundred. Thus ensuring that Herr Steffens can concentrate on getting well soon, without having to deal with paperwork.

Herr Steffens can rely on Dr. Scheel´s competence: Like all her colleagues she attends advanced training regularly; and proves that to her regional association. They are responsible for the high quality of treatment in all independent surgeries cooperating with statutory public health insurances.

As most Germans Herr Steffens is a member of the statutory health insurance. More than 70 million are entitled to the same high standard in treatment; despite age or income. The insurance fees are split in half between the members and their employers.
The KBV and its regional associations are mandated by the state as part of this self-governing health system.

In order to ensure that Herr Steffens receives treatment according to state of the art science the KBV makes suggestions: for treatments to be included in the portfolio of the public health insurances for their statutory members. This portfolio is regularly updated by KBV along with health insurances, hospitals and patient organisations.

Good treatment needs good working conditions for doctors and psychotherapists. That´s why they´re also represented politically by the KBV and its regional associations. One aim: a modern freelance framewo rk attractive for young professionals. To ensure that Dr. Scheel finds a successor and buyer for her surgery. Thus ensuring that Herr Steffens´children can also rely on finding a specialised doctor nearby – by the time they have grown up themselves.

The German health system is faced with a number of challenges. The KBV will continue playing its part in building and upholding a sustainable health system accessible and attractive for all – for Herr Steffens as well as Dr. Scheel.

The National Association of Statutory Health Insurance Physicians and the regional Associations of Statutory Health Insurance Physicians

Short distances, a wide range of services, and high standards: Whoever needs a doctor in Germany is in good hands. The Associations of Statutory Health Insurance Physicians (Kassenärztliche Vereinigungen; ASHIPs) make sure that 72 million compulsorily insured people can consult a physician or a psychotherapist of their own choice at any time and anywhere in the country. ASHIPs guarantee high quality of medical care. They make medical services available and improve them continuously. ASHIPs represent about 185 000 doctors and psychotherapists and lobby for keeping up and improving the medical system with its top quality. They believe that all patients should profit from medical progress even if the resources of the health insurance funds are rather limited.

On the federal level the 17 ASHIPs have established the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung; NASHIP). All ASHIPs and the NASHIP are part of the medical self-government. They are bodies under public law. The NASHIP represents the political interests of all office-based physicians and psychotherapists and informs the public on its health policy. It advocates the doctors’ positions in legislative processes, keeps the federal registry of physicians, and concludes contracts with the national confederations of the health insurance funds and other parties of the health care sector. Together with the health insurance funds it devises and revises the office-based doctors’ fee schedule, the so-called Uniform Assessment Standard. As a member of the Federal Joint Committee it is also one of the organizations that determine the benefits catalogue.

The NASHIP is legally obliged to have two organs: a delegates’ meeting and a board of directors. The delegates’ meeting consists of 60 representatives of the regional ASHIPs. Its main function is to make decisions on fundamental issues, guidelines, and regulations within the responsibility of the NASHIP. Every six years the delegates’ meeting elects a board of directors consisting of three members. The present chairman is Dr. Andreas Gassen, MD. He is also responsible for care provided by medical specialists. Vice Chairman of the NASHIP board is Dr. Stephan Hofmeister, MD also responsible for services provided by general practitioners. Third member of the board is Dr. Sibylle Steiner (MBA). About 370 people work for the NASHIP.

The establishment of ASHIPs goes back to 1931, when Heinrich Brüning, then Chancellor of the Republic, issued an emergency decree. It was meant to settle disputes between doctors and health insurance funds. It resulted in the abolition of individual contracts and paved the way for the establishment of regional ASHIPs.

Self-Governance and Ambulatory Care in Germany

Dr. Bloch is a GP in a small town in Germany. She always wanted to run her own surgery: independently and in long lasting personal bonds with her patients. With her surgery Dr. Bloch forms a vital part of Germany´s self-governed health system.

Whereas in many other countries medical care is organised by the state and its own public institutions: in Germany it is the health system itself, that organises medical care; financed by the fees from all members of the public statutory health insurances.
In other countries surgeries and hospitals are financed by the state with tax money. In difficult times that can quickly affect quality and quantity of medical care.

Also typically German: the principle of benefits in kind. Which means: members of statutory health insurances are entitled to medical treatment, therapy, cure, remedy, drugs and aids – without having to pay for any of it, especially not in advance.

Here the state limits itself to setting the legal framework and defining the duties within. The actual medical care is shaped by the care providers and their organisations – for instance independent ambulatory doctors or hospitals. In the case of independently working doctors and psychotherapists it is the KBV and its 17 regional associations. They negotiate with the statutory health insurances: the portfolio of treatments and according fees.
They also take care of settlement between each surgery and health insurance. And they ensure everyone receives ambulatory care – medical and psychological.
Even on weekends and bank holidays. Dr. Bloch regularly is on emergency duty. Its nationwide service is available 24/7. Her colleague, an eye doctor with his surgery around the corner, takes part, too. Like the psychologist next door, he and Dr. Bloch run their own surgeries: freelance and independently. Together they form a tightly woven net of around 100.000 surgeries. For patients this means a great variety of choice and short distances.
In the name of these surgeries the KBV negotiates within the Federal Joint Committee: the highest body in self-governance. Here all relevant organisations come together: doctors and psychotherapists from ambulatory care as well as dentists, hospitals, public health insurances and patients. Hence, medical care is decided upon by those who provide it.
With their surgeries Dr. Bloch and her colleagues ensure provisioning hospitals for the treatment of critical and serious conditions. An advantage, not least in times of epidemics or pandemics.
In order to maintain this provision, doctors like Dr. Bloch and their psychological colleagues campaign for good political conditions: represented by their regional and federal organisations.