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CSS Insurance

Quality

Ensuring good quality and developing the necessary quality systems (criteria, indicators, etc.), as well as measuring quality and disclosing the measurement results are vital to an efficient and effective healthcare system and primarily the task of the service providers. Alongside process and structural quality, measurements of the quality of results are particularly intended to ensure transparency regarding quality among service providers. This transparency constitutes an important competitive criterion.

CSS is campaigning for the quality of service provision in the Swiss healthcare system to be transparently recorded and disclosed. This will allow premium payers to compare offers between service providers and enable the tariff partners to compete on a price as well as a quality level. CSS operates the QualiCheck portal using its own data as well as quality data that is freely available and contractually obtained. The portal lets users compare the quality of treatment and patient satisfaction in Swiss acute hospitals.

At the start of December 2015, the Federal Council passed a Dispatch on the Amendment of the Federal Health Insurance Act to Parliament. National quality programmes are intended to be established on this basis. CSS welcomes the federal government’s efforts to lay the necessary foundations for achieving substantial progress in terms of quality assurance and cost-effectiveness. However, it must be noted that primary responsibility for strengthening binding and enforceable quality transparency and cost-effectiveness rests with the service providers and tariff partners. As far as financing is concerned, CSS considers it important that premium income should not be the sole source of funding for administration tasks. Instead, financing should be placed on a broad footing involving the cantons, confederation and service providers, and not borne solely by the premium payers. CSS explicitly welcomes the efforts of the National Council’s Health Committee to make service providers and insurers more accountable. This includes the idea that tariffs and prices should be based on the compensation for those service providers that satisfy the quality requirements efficiently and cost-effectively. The committee also puts forward the idea that service providers and insurers should be obliged to sign up to national agreements on quality development, which would be assessed by the federal government and binding on all service providers. Should any service provider fail to observe the rules on quality development, it would be penalised by not having its services paid for under health insurance.

You can find further information on the topic of quality in our publication on health policies "im dialog" 1/2014 (in german).