Austria's healthcare system got a long-anticipated makeover. After years of small-scale adjustments, a collective amendment – the "Vereinbarungsumsetzungsgesetz 2024" ("VUG 2024" or the "reform") – has brought a new wave of changes somewhere revolutionising healthcare in Austria. The VUG 2024 refers to a comprehensive and coordinated change made to a total of 13 legal matters, which are being modified together as a unified act for a more holistic approach. This happens to be one of the biggest reforms in the healthcare sector in recent decades.
Healthcare reform in a nutshell
The VUG 2024 aims to strengthen the private practice sector, simplify the establishment of group practices, expand the range of medical services, including services during off-peak hours, improve financial support and relieve the burden on hospitals. It also includes measures for the expansion of digital services and vaccination programmes, better health promotion and illness-prevention, and measures for the supply of medicines.
According to the government bill, most of the changes were planned to come into force on 1 January 2024, with the last ones by 2028.
Was it time for a reform?
Austria has one of the ten best healthcare systems in Europe. Nevertheless, many services that could be more efficiently and affordably provided by doctors in private practice are currently offered within hospitals, leading to significant costs for the system and inconveniences for both practitioners and patients. At the same time, fewer and fewer doctors wish to work in the public system and practice vacancies remain unfilled. As a result, there are long wait times for panel doctors who have a reimbursement contract with public social insurers and an increasing number of fee-based elective doctors. Given that people with lower incomes rely heavily on panel doctors, it is imperative to uphold easy access to healthcare for all.
For a long time, the Austrian healthcare system was only geared towards the treatment of illnesses, lacking clear responsibility for health promotion or illness-prevention. Consequently, there has been a lack of emphasis on increasing the proportion of healthy life years.
Furthermore, current vaccination rates in Austria are not particularly high. International comparisons show that higher vaccination rates can be achieved through free vaccination programmes. In addition, the supply of medicines is constantly at risk, not only in Austria but throughout Europe. Little has been done in the past to prevent medical shortages.
Taking all these points into consideration, a reform was quite necessary.
The most important changes at a glance
Expansion and services:
Several hundred additional health insurance fund posts are to be established, the number of primary care centres is to be tripled, and group practices and outpatient clinics are to be given a simpler approval process.
Funds and programs:
An additional EUR 60m per year shall flow into health-promotion and illness-prevention programmes. EUR 90m a year should be made available for free vaccinations in the future.
Evaluation board:
A new evaluation board is to prevent shortages in medication, especially for selected high-priced and specialised pharmaceuticals and other highly specialised forms of therapy. The evaluation board is to prepare uniform nationwide recommendations for application, framework conditions and for supporting price negotiations. It will make its decision based on a comparison between therapeutic alternatives and cost-effectiveness. However, the composition of the evaluation board has been met with fierce criticism, especially as representatives of patient advocacy groups have no voting rights. There is great concern that access to medicines will be restricted because decisions are made on a purely economic basis.
Telemedicine in the spotlight:
In line with the motto "digital before outpatient before inpatient", digital health services, the electronic health record ("ELGA") and the health advice hotline "1450" will be expended and strengthened. Mandatory diagnosis coding is to be introduced in the private practice sector. Thus, elective doctors and not only physicians who have a reimbursement contract with the public social insurers will be obliged to use the ELGA and e-card system from 2026 onwards. This should have a steering effect, as people will no longer automatically go to hospitals but will be treated at the "best point of service".
Austria is thus striving to maintain its position in the top tier of the healthcare sector.
Stay tuned for details on the reform.
By Iliyana Sirakova, Counsel, Schoenherr
