Diagnosing German GOÄ Reform Proposals

Research evidence excerpt

Diagnosing German GOÄ Reform Proposals

10561106811051110551106011066110751110011026110821176211999128621171111596 Drugs HIV testing 16.7638.2116.7519.43 23.9211.7812.81 -44%-37%-30%-34%

Average change (%) -42% .the price cut being borne by referring doctors. Source: Gebührenordnung für Ärzte, Bundesärztekammer

The current neuGOÄ draft is directionally negative for German Diagnostics, in our view, Chart 3 - Proposed reimbursment changes

as it appears to reduce reimbursement most sharply in high-volume routine laboratory under 'Old' GOA and 'Neu' GOA for Clinical

testing while reallocating value toward consultation-led and non-diagnostic services. The Chemistry: Chapter M2,M3 (EUR)

60draft nevertheless modernises the fee schedule, expands the number of billable codes and

50 15 3015introduces reimbursement for some newer tests, including genomics, so the risk is not 35 30

Old GOA new GOAuniformly negative across all diagnostics categories. Pay to Lab. Co. (Special tests under M3) Pay to Lab from LGS (Chapter M2)

. Pay to LGS referring Dr (Chapter M2)

However, the shift from a flexible multiplier-based system to fixed tariffs may imply a structural Source: Bundesaerztekammer.de

loss of pricing upside. While the reform modernises the fee schedule, expands the number

Chart 4 - Proposed reimbursment changes

of recognised codes, and introduces explicit pricing for newer modalities such as genomic under 'Old' GOA and 'Neu' GOA for

testing, some high-complexity tests may still see lower realised pricing vs. legacy GOÄ levels, Microbiology: Chapter M2,M4 (EUR)

60where elevated multipliers could have previously lifted reimbursement above proposed fixed 200

15 3015

rates. For mainstream diagnostics providers, however, the main issue is that the existing GOÄ 135 115