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Surgeons and insurers agree to flat-fee pricing

Published on February 13, 2018

Swiss health insurance companies and surgeons have reached agreement on charging flat rates for certain ophthalmic operations. Talks are continuing regarding other surgical areas. The move is seen as a step towards reducing rising health costs.

Santésuisse, the association of Swiss health insurers, said in a statement on February 9 that it had signed a contract with the association of Swiss surgeons (FMCH) regarding a flat-rate outpatient plan for certain ophthalmic operations. Fixed rates will be paid for cataract and glaucoma operations, as well as procedures on the vitreous.

The contract must still be approved by cantonal health directors. Participation in this new fixed-price system is voluntary, and doctors who will use flat-fee billing will also automatically participate in a European quality assurance programme.

+ Inside the workings of and debates around the Swiss healthcare system

The Swiss healthcare system is known for its excellent level of care, but is also among themost expensive in the world. Switzerland spends 11% of its gross domestic product (GDP) on healthcare, behind the US (17%), Netherlands, France, Germany and Canada. The government has been trying to reduce health costs and health insurance premiums.

According to the associations, flat rates for outpatient treatment simplifies billing and controls, andreduces administrative charges and costs.

The prices agreed with the eye surgeons are slightly below their previously charged average treatment costs. Verena Nold, the director of Santésuisse, is convinced that savings can be made in this way, she told swissinfo.ch.

Efficient and cost-conscious doctors will be rewarded under this new system, whereas doctors who continue to adhere to the old and expensive system of individual tariffs will face critical questions from insurance companies in future. Nold said that this method would hopefully root out the few black sheep in the medical profession which had been exploiting the complicated system and driving up medical costs.

The Swiss Federal Council (executive body) estimates that half a billion francs could be saved with this new healthcare model.