Harald Schmidt, M.A., Andreas Gerber, M.D, Ph.D., and Stephanie Stock, M.D., Ph.D.
H. Schmidt, A. Gerber, and S. Stock, "What Can We Learn from German Health Incentive Schemes?" BMJ, Sept. 24, 2009 339:b3504.
Since 1989, Germany has introduced a variety of incentive schemes into its health care system to improve population health, maximize efficiency, and enhance competition among its sickness funds (nonprofit health insurance providers).
According to this Commonwealth Fund–supported study, the most popular German incentive programs are aimed at:
While initial evidence suggests Germany's combination of "carrot and stick" approaches has a "clear potential for cost savings," it is unclear whether the programs benefit socioeconomic groups equally—as it is "well established that people who are better off are more likely to participate in preventive measures than poorer people."
Future evaluations will determine whether the incentive programs are financially viable in the long term, the authors say. In addition, the government will need to assess "the potential for achieving sustainable behavior change" and ensuring all social groups are able to benefit.