Berlin – November 06, 2026 -- Participants at the 34th Plattform Gesundheit of IKK e.V. agreed that Germany's primary care reform must proceed step by step and without disruptive breaks, with quality taking priority over speed. Representatives from health policy, the medical profession and self-governance, plus about 100 guests attending on site and online, debated how a primary care system can steer patients to the right level of care without becoming an additional access barrier.
IKK chief demands unified digital triage, e-referrals and appointment booking
Hans-Jürgen Müller, chairman of the IKK e.V. executive board, called for a coherent package of standardized, low-threshold digital initial assessment, electronic referral and needs-based appointment brokering. He said better steering is neither an end in itself nor a savings programme. Qualified health professionals could handle routine tasks such as repeat prescriptions and follow-up checks, he said, provided competencies, delegation, substitution and remuneration are clearly regulated. That would free physician time for patients who need it.
Managed Care association warns against three reform mistakes
Johanna Nüsken, managing director of Bundesverband Managed Care e.V., argued that primary care is more than a coordinating GP practice. She called for a personal digital care plan and multiprofessional teams. She named three errors to avoid: limiting reform to access and steering, designing a physician-centred system, and leaving out remuneration. She also urged a move away from pure fee-for-service and quarter-based billing toward a mix of population-based base payments, pathway-based payment across organizational boundaries, and quality incentives.
Lawmakers split on funding, rural gaps and municipal health centres
Prof. Dr. Armin Grau of the Greens' Bundestag group said Germany has shifted too many tasks to specialists and given generalists too small a role. He pointed to threatened and actual undersupply in rural areas and called for interim solutions where the GP base is missing.
Ates Gürpinar, deputy chair of Die Linke, said needs planning alone is insufficient and care mandates must be defined, fulfilled and monitored, with health centres under municipal control. He warned that a reform designed under austerity conditions would be a bad law.
Dr. Lina Seitzl of the SPD parliamentary group said the debate should not be conducted as a savings exercise, because the switch could initially cost investment money and time. She said chronically ill patients must keep direct specialist access.
GP association doubts digital triage for routine care, cites 70 HäPPI practices
Dr. Markus Blumenthal-Beier, federal chairman of the Hausärztinnen- und Hausärzteverband e.V., said reliable digital triage tools exist for emergency and acute care but not yet for routine care. Without coordinated structures, nationwide digital triage could raise utilization, because patients bring several concerns on average. He said the association's HäPPI concept could serve as a foundation; more than 70 such practices already operate in Baden-Württemberg. He also called for coordinated treatment pathways and an end to quarter-centred remuneration.
Free choice of doctor stays contested but constructive
Seitzl questioned how free choice of doctor can work where appointments or physicians are missing locally. Gerd Benzmüller, chairman of the IKK Südwest administrative board, defended free choice but said patients must be guided to the appropriate care level without bureaucratic extra hurdles. He cited automatic appointment booking and a system that works across state and Association of Statutory Health Insurance Physicians boundaries. Blumenthal-Beier said binding steering does not mean patients must always see a GP first, but the path must be orderly.
IKK e.V. managing director Jürgen Hohnl said the shift toward team-based care, a stronger role for qualified health professionals and greater weight for GP-led over specialist-centred care is under way.