Zur Diskussion: Neustrukturierung der fachärztlichen Behandlung am Beispiel der ambulanten spezialfachärztlichen Versorgung (ASV): ein kritischer Blick auf Ziele und Umsetzung

The implementation is complex and has so far been very slow. The process is impeded by the legislative conflict between incentives for care providers and concerns about the uncontrolled evolution of expenditure. The procedure of furnishing the requested proof that the conditions of participation have been fulfilled is burdensome, creating yet another barrier to broad participation of doctors and institutions. Differences in competition between office-based physicians and hospitals have been reduced but not eliminated. Sectorial barriers are only partially reduced, existing structures provide alternative care. Improvement of care in rural areas, active involvement of patients and a genuine evaluation do not take place.