Austrian Health Fund Faces Financial Challenges: Calls for Contribution from Physicians

The Austrian Health Fund (ÖGK) is currently grappling with significant financial difficulties, primarily due to declining revenue from contributions amid rising expenditures. Peter McDonald, the chairman of the ÖGK, aims to address these issues through administrative cost reductions and adjustments in spending for contractual partners, including a proposed solidarity contribution from physicians for this year and the next.

McDonald emphasized the necessity of ensuring that top-tier medical services remain accessible to all residents of Austria via the e-card system for the foreseeable future. He acknowledged the financial imbalance the fund is experiencing, which cannot be overlooked. The ongoing recession has resulted in increased unemployment rates, leading to a drop in contribution income. Simultaneously, the aging population is driving up the number of medical consultations--an increase of 15 percent over the past five years--along with a rising demand for outpatient services that the fund must cover.

While the economy has seen a growth of 30 percent, the associated costs for medical practitioners have surged by 40 percent. Austria stands out as one of the few countries that provides its citizens with comprehensive access to medical advancements at no additional cost. McDonald noted that sustaining this level of service is a priority despite the economic challenges posed by the recession. He pointed out that economic recovery might not materialize until 2027, implying that the years 2025 and 2026 will require collective effort from all stakeholders.

To navigate these financial hurdles, the ÖGK plans to implement administrative savings; however, given that administrative costs comprise only two percent of total expenditures, this alone will not suffice. As such, McDonald intends to engage in discussions with physicians and other contractual partners regarding sustainable expenditure practices. He highlighted the need to control costs related to non-medically indicated services, which may include unnecessary duplicate tests and patient transport services. Furthermore, he expressed interest in enhancing patient management through improved outpatient offerings and telemedicine initiatives.

In addition to engaging with healthcare providers, McDonald plans to open dialogues with regional governments responsible for hospital care. The ÖGK is exploring new outpatient care models in specialty areas such as diabetes management, pain therapy, and chronic disease treatment, seeking to share costs for these initiatives with the federal states. The objective is to alleviate the burden on hospital facilities, aligns with the ÖGK's broader strategy to enhance healthcare delivery.

Moreover, McDonald aims to collaborate with the Minister of Social Affairs and Health, Korinna Schumann, to increase investments in preventive care. Concurrently, negotiations are underway for a comprehensive national contract for physicians, which includes a revamped service catalog and discussions regarding an agreement with dentists concerning amalgam replacements for ÖGK-insured patients.