Effizienzreserven in der stationären Pflege in Deutschland: Versuch einer Quantifizierung und Implikationen für die Reform der Gesetzlichen Pflegeversicherung

Abstract The design of the German statutory long-term care insurance (LTCI) is deficient in many respects. One of the major flaws in nursing home care is the inherent incentive problem concerning the relationship of the insured, the insurers and the nursing homes: For one, there is no competition amongst the insurers which influences the negotiation behaviour towards the nursing homes concerning the fixing of the daily payment rates. The nursing homes in turn are more or less unrestricted at setting the daily payment rate as the insured are mostly not in a position to fully practice their consumer sovereignty in case of the need of long-term care treatment. In the framework of this paper we try to quantify the efficiency reserve behind these disincentives in nursing home care and try to assess to what extent the contribution rate to LTCI could be reduced, if the efficieny reserves were exhausted.