While there were 30.3 million primary care physician visits to patients in 2009 and about 27 million in 2010, there were only 25.2 million in 2016. Last year, according to a projection, there was probably a further drop to 24.6 million visits. That's according to a response from the German government to a Left Party question, first reported by ARD's capital city studio. The number of home visits per physician fell from 592 to 484 from 2009 to 2017, according to data from the National Association of Statutory Health Insurance Physicians. "While doctors in Westphalia-Lippe made the fewest home visits (an average of 349), there had been the most in Saarland (an average of 894 visits per year and doctor)," according to the univadis portal.de.
Left-wing health expert Achim Kessler said people in rural areas in particular must be able to rely on good care with home visits if they are unable to see a doctor. "It should be self-evident that medically necessary home visits are possible without fear of repayment demands from health insurers," dpa quoted him as saying. The declines suggest that physicians are also cautious about making house calls because they could face claims for reimbursement of fees after performance audits.
"According to the federal government, it is the responsibility of the associations of panel doctors (KVs) and health insurers to review medical services for their cost-effectiveness," according to univadis.de. "Whether this is done according to averages or other criteria varies across the country and is not mandatory. How this is designed is the sole responsibility of the respective KVs and insurance companies."
The German Foundation for Patient Protection spoke of an alarming development. The losers were those in need of care and dementia patients who hoped for the family doctor at home. "If they lack the strength to visit the doctor's office, they are in danger of becoming even more disconnected this way," said board member Eugen Brysch. It would be absurd if too many home visits were punished with fee cuts.