Improving the quality of cancer care with additional funding for centers? Support from public health policy

Background Centers, in the context of this article, are hospitals providing cutting-edge medicine by making their outstanding expertise available to patients in other hospitals in the form of consulting services. Since the introduction of the DRG system, special tasks provided by these centers were financed by means of additional funding, as they primarily involve services for patients in other hospitals. The question of what constitutes "special tasks" and who is eligible for providing these "special tasks" has been the subject of an intense debate since the legal implementation of centers. Each federal state has answered this question differently, resulting in a nationwide patchwork of centers. Legal mandate The Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) is the highest decision-making body of the joint self-government of physicians, dentists, hospitals and health insurance funds in Germany. The G-BA was mandated by the Nursing Staff Strengthening Act (Pflegepersonal-Starkungsgesetz) to define the special tasks of centers by December 31, 2019, as well as to establish uniform national quality requirements for the performance of these tasks. These typically include specifications on the type and number of specialist departments, minimum required case load and cooperation with other hospitals. Results Oncology centers have been given high priority in the G-BA's process of defining directives due to their importance for health care and the extensive preliminary work from the National Cancer Plan. The special expertise of an oncology center is characterized by its proven treatment competence in several tumor entities and is thus based on the level of the CC-Centers of the German Cancer Society (Deutsche Krebsgesellschaft, DKG). By taking up the results of the National Cancer Plan by the G-BA, for the first time a nationwide and care-relevant quality will be required for the consultation of rare or complex oncological cases.