Opinions differ on the rates for physiotherapy
Published: Friday, Nov 17th 2023, 15:30
Updated At: Friday, Nov 17th 2023, 15:33
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The Federal Council wants to intervene in the rates for physiotherapy by amending the ordinance. Its proposal is controversial. While the Professional Association of Physiotherapists sees the proposed changes as a mere cutback, the health insurance associations see a step towards greater transparency.
The background to this is that health insurance companies and service providers have been unable to agree on a tariff revision for years. In principle, the tariffs have remained unchanged since the late 1990s.
The consultation on the Federal Council's proposals ended on Friday. Today, physiotherapy is reimbursed in the form of flat rates for sessions, whereby there is a lower and a higher rate. The Federal Council would now like to introduce a time component and is proposing two variants:
In the first variant, a minimum treatment duration of 30 or 45 minutes would be introduced. In addition, there would be a new tariff item for short sessions of 20 minutes.
The second variant provides for a basic flat rate for a session of at least 20 minutes. Physiotherapists are to bill the remaining treatment time in five-minute increments.
Sharp criticism from physiotherapists
The professional association Physioswiss mobilized against the proposals with a demonstration on Bern's Bundesplatz on Friday. Two petitions signed by a total of 283,000 people demand a stop to the tariff intervention.
According to Physioswiss, the bill is ultimately only about reducing the number of treatments. There is a threat of physiotherapy practices closing - and of specialists leaving the profession. The sector is already severely underfunded.
The association criticizes that the savings potential is low, as physiotherapy only accounts for around 3.6% of healthcare costs. Furthermore, it would mean that seriously ill people would be put at a disadvantage if the cost rate for complex treatments was reduced.
Physioswiss received support from the Swiss Medical Association (FMH) during the consultation process. The Federal Council's proposal was not based on the relevant economic data.
"Advantage for patients"
The health insurance association Santésuisse, on the other hand, welcomes the tariff changes. The proposals should make it clear in future how long a physiotherapy session actually took. This would also be beneficial for patients.
Curafutura also emphasizes that opportunities to optimize invoicing must be combated. However, part of the cost increase is also due to efforts to increasingly dispense with operations. In the medium term, the entire tariff structure must be revised - in a cost-neutral way.
Cantons and parties see open questions
The Conference of Cantonal Ministers of Public Health (GDK) welcomes the second variant proposed by the Federal Council, as it actually creates more transparency. However, the GDK board sees unanswered questions regarding the reimbursement of services outside of the actual treatment, such as the coordination between doctors and physiotherapists.
Some cantons are completely opposed to the proposals. The cantonal government of Thurgau, for example, believes that the most important factors have not been taken into account. The cantonal government of Innerrhoden complains that costs would be incurred as a result of new billing systems, while at the same time the cost rate for complex treatments would be reduced.
Reservations are also evident in some of the parties' consultation responses. The center welcomes the introduction of a time component. However, the changes should not lead to an inevitable reduction in the income of physiotherapists who have previously billed correctly.
The SP writes that it is unacceptable for physiotherapists to have to wait decades for pay rises.
Liberals dissatisfied
The FDP is also calling for improvements. Today, the outdated tariffs demonstrably lead to false incentives. However, the two proposed variants do not meet the legal requirements in terms of economic tariff calculation and appropriateness.
The Federal Council should therefore first ask the tariff partners to adjust the tariffs within a reasonable period of time - and prepare a revised intervention, according to the FDP.
The SVP welcomes federal measures against what it sees as the "escalating" costs of physiotherapy. However, it is not the task of the federal government to intervene in a tariff dispute.
The Greens and GLP refrained from commenting on the consultation process, as they stated on request.
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