Quality contracts have existed since 2018 as a type of value-based reimbursement between hospitals and health insurance companies. By linking payments to patient outcomes, quality contracts incentivize better patient care. However, uptake amongst health insurance funds and healthcare providers had previously been slow, due to the time-consuming and fragmented nature of reporting. Heartbeat Medical pioneered a digital platform, PROvalue, to allow the rapid roll-out of such programs, making it simple for all stakeholders to participate and reap the benefits. At the heart of every quality contract is the patient, who benefits from improved quality of care, personalized monitoring and reduced complication rates.
The goal of PROvalue Endo is to improve care for patients undergoing joint replacement surgeries. Since it launched, nearly 600 patients have benefited from monitoring as part of the PROvalue Endo project, and demand is rapidly increasing. For hospitals, the high participation rate amongst insurance companies is a significant financial benefit.
Yannik Schreckenberger, CEO of Heartbeat Medical, welcomes the fact that more than 20 payors have joined the quality contract, with more in the pipeline. “Change does not simply happen, it requires courageous actors with a willingness to shape and create. We can see, from the growing number of insurance providers choosing PROvalue Endo, that outcome-oriented care and reimbursement in Germany is becoming mainstream. Together with innovative insurance companies and first-class healthcare providers, we are enabling a transformation towards higher quality, cost-effectiveness, and transparency for patients – made in Germany.”
A focus on patient-centered care and quality of life
The quality contract PROvalue Endo covers all elective procedures on the hip, knee, and shoulder with total or partial joint replacement. Patients are empowered to become active participants in their treatment process and continuously monitored via digital follow-up for one year post-discharge, using Patient-Reported Outcome Measures (PROMs) throughout the entire treatment pathway. Using Heatbeat’s benchmarking system, patients who show early signs of complication will trigger a notification, enabling providers to contact them immediately for further assessment.
The benefits to both patient and provider are clear — improved safety, reduced complication- and-infection risk, and better surgical outcomes. The contract offers hospitals the opportunity for reimbursement based on measurements of quality of life from their patients.