In Germany, healthcare is considered a right rather than a privilege. Furthermore, health insurers are non-governmental and not-for-profit, regulated by public law. It is a multiple payer system, and everyone is insured.
Statuary Health Insurance (SHI) is mandatory; 86% of the German population with incomes of up to 55,000 Euro utilize SHI. Meanwhile citizens over 55,000 Euro may choose to switch to private insurance.
Statuary Health Insurers struggle with three main difficulties:
- Competition while maintaining a uniform premium rate
- Changes in government policy because SHI companies are 90% regulated by law
- Rising costs
AOK, the leader of Statuary Health Insurers with a market share of 35%, is aiming to reduce the complexity due to large amounts of data. The IT division of AOK teamed with SAP to make a cross industry solution called Oscare. Oscare is a technical platform that is available to all SHI companies (not just AOK) to support all processes of SHI.
Oscare is customizable, as each SHI-company can specify their own terms and differentiate themselves from competition. All regulations are continuously updated to comply with the evolving laws. Oscare is able to analyze large amounts of data that filter through AOK on a daily basis.
Summary by MedicalGroups.com
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