Zero night DRGs are special flat rates within the SwissDRG tariff structure that would see any treatment carried out in hospital without the patient having to stay overnight now being paid for outside of the existing TARMED structure.
In light of the introduction of outpatient service lists by various cantons and the increasing unattractiveness of TARMED for specialists and hospital outpatient departments, three of the professional associations that represent service providers – H+, FMH and FmCh – are lobbying for an alternative form of payment for hospital outpatient services known as ‘zero night DRGs’ or ‘one day DRGs’. The H+ association does not believe that the current TARMED model sufficiently covers the costs of its member hospitals, and hopes that this new payment model will bring about a significant improvement. In doing so, it would give hospitals a basic incentive to start performing procedures on an outpatient basis that are currently mostly provided as an inpatient service.
The cantons view the regulation of procedures to be performed on an outpatient basis (outpatient service lists) and financing by means of zero night DRGs as a simple yet effective counterproposal to the introduction of a uniform system of financing for outpatient and inpatient services (EFAS).
CSS Insurance is not in favour of introducing such a system as there is no need to create financial incentives for hospitals that would boost their intrinsic motivation to shift volumes away from inpatient towards outpatient treatment. What is more, inpatient structures would remain in place and the shifting of services would not lead to the expected elimination of surplus inpatient capacities, all of which would massively increase the burden of costs to be borne by mandatory healthcare insurance.