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CSS Insurance

TARMED revision

CSS considers the complete overhaul of TARMED, which is being conducted by the tariff partners, to be necessary. In some instances, the existing TARMED tariff structure no longer reflects individual services in a way that corresponds to the medico-technical or economic realities of service provision. This leads to false incentives in the behaviour of service providers, which has negative consequences for both the cost efficiency and quality of service provision. The foremost priority of any revision by the partners must be the appropriate restructuring of TARMED using evidence and data-based practices. This includes both making the necessary adjustments to the underlying cost models to bring them into line with current practice models, and modifying the intrinsic values. In addition, ways of further simplifying and aggregating the tariff structure and of adapting the minute values to modern circumstances must be looked into. CSS supports the professional tariff office ats-tms AG as a crucial factor in the complete overhaul and subsequent maintenance of the tariff structure. CSS plays an active role in the necessary preparations through its involvement in curafutura. As the partners in this process have not yet been able to reach agreement on a tariff structure, the Federal Council has for the second time made use of its subsidiary powers to adjust the tariff structure. CSS welcomes this intervention by the Federal Council, which should achieve cost savings of CHF 470 million, while regretting the occasional lack of clear billing rules. The revision of the tariff structure should preferably proceed on a renewed basis of partnership going forward. To make the work of the tariff partners easier, CSS Insurance joins with the group of experts appointed by the Federal Council to recommend measures for reining in the rising costs under mandatory healthcare insurance in supporting the creation of a national tariff agency (like SwissDRG) for the standardised outpatient service tariff . The existence of an agency of this kind could unblock the process and would most likely lead to efficiency gains.

You can find further information on the topic of TARMED revision in our publication on health policies "im dialog" 1/2015.