Better health, improved care and lower health care costs—the international strive for integration. Should not we be confident enough to go into risk? Integrated Care = higher quality but less costs to the sickness funds/health insurances. Results of the German and Swiss experiences of the last years

Shared savings contracts between physician networks/health maintenance organisations and insurances or sickness funds in Germany and Switzerland showed quite impressive results of between 5 and 15% savings, similar to those being demonstrated in the US during the 1990s in the beginning of managed care last century. While managed care in the US got into a lot of ethical questions the European examples are on the rise and a new international debate on integrated care is emerging. The ‘triple aim’ as Donald M. Berwick emphasized in his famous Health Affairs article in 2008 called for better health, improved care and lower health care costs and the Obama administration took this notion into its new accountable care organisation approach. The author suggests that it is time to develop comprehensive integration policies for whole regional populations. He can tear on at least five years of experiences in Germany (GesundesKinzigtal) as well as on several years of experiences of other networks in Switzerland and other parts of Germany. These experiences are indicating that effective trans-sector organisation of health care and increased investments in well-designed preventive programmes will lead to a reduction in morbidity, and in particular to a reduced incidence and prevalence of chronic diseases and offer substantial efficiency gains for sickness funds and health insurances.