Agreement In Accordance With Article 15A B-Vg Target Control-Health

Original Language Title: Vereinbarung gemäß Art. 15a B-VG Zielsteuerung-Gesundheit

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Agreement in accordance with article 15a B-VG target control-health

The Federal Government, represented by the Federal Government,

Burgenland, represented by the Governor, the country

represented by the provincial Governor, the province of Carinthia,

the province of lower Austria, represented by the Governor,

the Land Oberösterreich, represented by the Governor,

represented by the Governor, the State of Salzburg

represented by the provincial Governor, the province of Styria,

the country Tirol, represented by the Governor,

the province of Vorarlberg, represented by the Governor and

the province of Vienna, represented by the Governor,

Hereafter referred to as the parties, agree to conclude the following agreement in accordance with section 15a B-VG:

Table of contents preamble 1 section General provisions article 1 subject article 2 scope article 3 definitions 2 section public health principles article 4 direction's the framework health objectives and public health article 5 principles, objectives and fields of action targeting health article 6 patient orientation and transparency article 7 quality assurance in Austrian health care 3. section structure and process of targeting health article 8 previous of the target control process article 9 ratio of targeting health ÖSG/RSG 4. section governance and organization under section) decision-making structures and organization at the federal level article 10
Organisation of the Federal Health Agency article 11 Federal Health Commission article 12 federal target control Commission under section B) decision-making structures and organisation at national level article 13 organization of the national health fund article 14 health platform at national level article 15 country destination control Commission 5. section concrete expression of partnership targeting health article 16 orientation of targeting health article 17 Control Panel results-oriented article 18 control panel supply structures article 19 control panel supply processes article 20 specifications and content of the country control contracts article 21 annual work programmes 6 section set financial target control article 22 financial target management - general provisions article 23 strengthening health promotion

Article 24 content and subject to the financial framework contracts article 25 definition of the output damping path for the first period on the federal level article 26 definition of the output damping path for the first period in the range of countries article 27 definition of the output damping path for the first period in the area of social security article 28 virtual budget 7 section specifications for the monitoring and reporting system article 29 implementation of a monitoring and reporting system article 30 steps article 31 financing of monitoring and reporting article 32 detailed rules on monitoring and reporting 8. Cut off provisions to the sanction mechanism article 33 General article 34 rules for non-achievement of objectives article 35 regulations for violations of this agreement, the federal target control contract or the country control contracts article 36 regulations in non-realization of the federal target control treaty or the country control contracts article 37 arbitration for disputes arising from the federal target control contract or the country target control treaties in the context of targeting health 9 section vertices to legal provisions for the establishment of targeting health both federal and provincial article 38 regulations at the federal level article 39
Legal regulations on country-level 10 section other provisions article 40 special provisions in case of natural disasters or exceptional emergency situations article 41 support obligation of the Covenant 11 section duration and final provisions article 42 entry into force article 43 implementing the agreement article 44 validity, expiry of article 45 releases article 46 original Convention preamble In the interests of people living in Austria the Federal and State Governments on the one hand parties, as well as the social security on the other as equal partners , a partnership target control system for the control of structure, to set up the Organization and financing of the Austrian health care. Against the background of existing responsibilities this agreement in accordance with section 15a B-VG aims therefore to achieve optimum efficiency orientation as well as a strategic and results-oriented cooperation and coordination in carrying out the respective tasks by modern forms of a contractually-based State organization. It's about a corresponding to the interdependencies "governance" of responsibility for the health care, to the equivalent of the principles of action orientation, responsibility, accountability, openness and transparency of structures or processes and fairness and to ensure best quality health care services as well as their financing.
The principle of contractual cooperation and coordination are to be overcome the organizational and financial vested interests in the system partners.
The destination control system health it builds on following fundamental political requirements: low-threshold access to needs-based health care and high quality in the long term to secure and expand are 1 for patients.

2. the responsibility for the use of which requires instruments to increase the effectiveness and efficiency of the health care of the population provided taxes and contributions.

3. in accordance with the principle of the impact orientation in health care concerns the development of organization and control mechanisms at the Federal and State level.

4. Furthermore it's both the establishment of supply as also financial targets for the portion of health care covered by this targeting health and monitoring to measure target achievement.

5. in the future, all federal, State and social security in the context of targeting health should remain under covered measures for optimal health care of this common approach.

6. the increase in public health spending (excluding long term care) is to bring about the period 2016 to the expected average nominal growth of the gross domestic product means that in the perspective of 2020 the share of public health expenditure stable gross domestic product at about 7 per cent.

1 section

General terms and conditions

Article 1

Subject

(1) the Contracting Parties agree starting with January 1, 2013 for the structure and organization of the Austrian health care, including the social security system as an equal partner to set up an inclusive partnership targeting health and develop together.

(2) the concretization of this targeting health is comparable effect-oriented qualitatively and quantitatively to be firmly based on 1 supply objectives 2. planning values 3. supply processes and structures 4. outcome and quality parameters.

A 5 is based on as an integral part of establishing financial target control.

Article 2

Scope

(1) the scope of the planned targeting health includes all intra - and extramural areas of the Austrian health care system, as well as any affected joints (E.g. for the care and rehabilitation area) in terms of structural and organisational.

(2) the currently existing responsibilities and tasks of the partner form the basis of the system in the target control system health.

Article 3

1 "outpatient area" definitions: Ambulatory health care in hospital clinics, independent outpatient clinics and in the established field (in particular medical assistance and similar services within the meaning of the SV-).

2. "Best point of service": the curative care is to provide macro-economically possible cost at the right time at the right place with optimal medical and nursing quality.

3. "Health in all policies (health in all policies)": by reinforced taking into account of the theme of health and the health determinants in other than the directly competent political sectors promote the population's health effectively and sustainably.

4. "Health Technology Assessment (HTA)": process to systematically assess of medical technologies, procedures, and tools, but also organizational structures, in which medical services are provided. Criteria such as effectiveness, safety and cost, each taking into account social, legal and ethical aspects are investigated.

5. "integrated care": integrated care is patient-oriented joint and coordinated cross-sectoral health care together with the adjacent areas (acute in-patient care, ambulatory care, rehabilitation, seams to the health care sector). It includes process and organizational integration.

6.

"Interdisciplinary care models": cooperation of physicians/doctors of different disciplines (General Medicine, internal medicine, Gynecology, laboratory, radiology, etc.) as well as non-medical health service providers (qualified nursing staff, physiotherapists/physical therapists, etc.) in group practices or independent outpatient clinics as well as if necessary to developing forms of organization.

7 "Primary care (primary health care)": the General and directly accessible first point of contact for all people with health problems in the sense of a comprehensive primary health care. It should coordinate the supply process and provides comprehensive and continuous care. And social conditions taken into account.

8 "Public Health": creation of social conditions, environmental conditions, and conditions of a needs-based, as well as effective and efficient health care under which populations can live healthy.

2. section

Public health principles

Article 4

Orientation on the health goals of part of and public health

(1) for the purpose of "health in all policies" approach is the development of objectives, structure and organization of health care in the context of targeting health in accordance with the framework health goals to be decided by the Federal Health Commission. The concretization of the framework health goals takes place in federal and country health targets, which is to make sure that any already defined country health objectives in accordance with the framework health goals are.

(2) the Contracting Parties agree to orient public health principles in the implementation of its measures. These include: 1 focus on a comprehensive health concept 2.
Systematic health monitoring to ensure health services research to reduce article 5 5 strengthening of interdisciplinarity in the supply, as well as in research and development with the aim of improving the health for all and the health inequalities 3. further development of the public health service (EGD), taking into account public health 4. demand-oriented planning, development, and evaluation

Principles, objectives and fields of action targeting health

(1) as principles should be followed: 1. the promotion of health promotion and prevention 2. in the case of illness the curative supply the "best point of service" 3. the commitment to the active cooperation and mutual support between federal, State and social security in the implementation of the jointly agreed objectives 4. has patient-oriented quality healthcare increase the effectiveness and efficiency of health care to serve the data necessary for the target control including integrated planning are 5 for all sectors in similarly prepared and comprehensible form available to make (2) to the achievement of these principles, in particular the following goals be implemented in the context of targeting health: 1 targeted health promotion and prevention, strengthening evidence-based early detection and early intervention 2. access to and availability of all necessary services improve 3. coordinate services in all sectors, making patient - and demand-orientated and in parallel structures prevent or reduce 4. quality of treatment make sure and make more transparent 5. treatment processes, in particular through the Elimination of organizational and communication deficits improve 6 routine measurement Supply efficiency intensify 7 financing and remuneration systems closer to the supply needs align 8 at all supply levels is the establishment of multi-professional and inclusive forms of care to give precedence to individual service providers (3) to pursue these common goals are to edit the following fields of action in the context of targeting health anyway: are 1 through supply contracts to define the "best points of service" and are transparent to make the right start and further bodies. Financing is across all sectors to adapt to shifts in power (art. 24 para. 2 No. 6 or article 24 para 3 Z 7).

2. the stationary range in acute sick institutions is to relieve justified medically and macroeconomic shift by the day-clinical or outpatient services. The provision is especially in the ambulant field as needed to develop and to coordinate with respect to the services (hospital outpatient clinics, independent outpatient clinics and outpatient clinics area) and to set. Additionally, to undertake on the basis of objective cost and benefit assessments, taking into account existing workloads performance shifts towards more efficient structure alternatives and reduce inefficient structures. Parallel structures - especially outpatient specialist care in the established and hospital outpatient area - are to dismantle.

3. the range of primary health care ("primary health care") is to strengthen international models in the established range.

4. for selected diseases are to be defined-oriented standards of care the patient needs.

5. to improve the supply processes, particularly for chronic conditions, are to develop disease management programs and to implement, expand interdisciplinary and multiprofessional cooperation forms and define treatment processes.

6. a comprehensive, comparable, systematic and standardized quality management (with comprehensive measurement of the quality of the results) is to build in the intramural as well as in the extramural area.

7 financing and remuneration systems are designed to support the objectives of targeting health (especially supply the "best point of service").

Article 6

Patient orientation and transparency

(1) for the purpose of patient orientation, the health literacy of the population is to reinforce that the active participation of those affected in the decision-making process is possible. The partners of targeting health have to ensure the usage of digital information systems in the field of eHealth. Those include in particular transparent information about offers, services, and results of health service providers.

(2) surveys on the subjective health status of the population and cross-sectoral patient surveys are carried out regularly.

Article 7

Quality assurance in the Austrian healthcare

(1) the work to build, to the development of assurance and evaluation a comprehensive Austrian quality system nationally, Bundesländer -, sector - and across the profession, especially including the established area, must be made. Also the patient safety, quality development and quality promotion measures are part of the quality system. All specifications for the quality system have to comply with anyway, also targeting health and in particular the monitoring referred to therein. Quality work has also contributed to the medium to long-term increase in the effectiveness and efficiency in health care to provide and to contribute to improving the health care of the population and to their long-term financial viability.

(2) the Austrian quality work has the levels of structural, process and outcome quality based on health quality Act, Federal Law Gazette I no. 179/2004 in its current version, the Federal Government to cover. Structural, process and outcome quality have to stand, where the development and further development of outcome quality indicators and their measurement in all sectors of health care is a priority in a direct and balanced relationship to each other.

(3) the following are set in terms of the quality of the result: 1 for the stationary range is (A IQI including peer-review process, supplemented by high quality register at federal level) to continue the already existing, based on routine documentation result quality measurement and quality assurance and to expand.

2. taking into account international models and experiences is also 18 months after the entry into force of this agreement for health service providers in primary care to develop an adequate, comparable system for result quality measurement and assurance and to implement in the connection. To this end, the Federal has content requirements on the basis of the health quality law to give. In the drafting of the social security, Austrian Medical Association and the Austrian Federal Economic Chamber are (as a representative of health establishments within the meaning of article 149, paragraph 3 ASVG in the currently valid version) to include.

3. the quality of the medical profession, as well as the perception of outcome quality measurement and assurance in the established area be transferred effect according to the guidelines of the Federal Government.

(4) in the area of process quality are for those areas, where this as necessary and urgent he-respects is in the narrow connection with the fields of activity of targeting health (art. 5 par. 3 Nos. 4 and 5) Austria-wide uniform quality standards to set.


(5) the criteria in the Austrian structural plan be set in the area of structure quality health (ÖSG). For the intramural area a revision and streamlining of the structure quality criteria contained in the ÖSG 2012 on necessary requirements according to the provisions in article 4 paragraph 4 is Z 4 of the agreement according to article 15a B-VG on the Organization and financing of health care, Federal Law Gazette I no. 105/2008 in the current version, to make. In the context of future ÖSG revisions structure quality criteria are for the outpatient area to supplement necessary requirements.

(6) that is quality assurance including participation in nationwide quality assurance measures regardless of which institution or setting up the health services are mandatory. It is required by law to ensure that complying with the essential standards of quality set is a prerequisite for the provision and supply accountability of services.

(7) for the further development of quality in the health sector is to create a master plan. The Bundesländer - and cross-sectoral regular reporting about the quality in healthcare are preferably topic related to continue. Starting in 2014, also regularly reports on the quality of earnings in the inpatient and outpatient area are in the context of this reporting to create. There is also a report on the continuing education of physicians to create. A publication of these reports in an appropriate form must be ensured.

(8) Federal, State and social security can take the Gesundheit Österreich GmbH (GÖG) claim to scientific support of works referred to in paragraph 1.

3. section

Structure and process of targeting health

Article 8

Previous of the target control process

(1) the destination control process at the Federal and the State level according to approved procedures.

(2) the strategic objectives and the measures to be set to achieve targets are agreed in four-year contracts at the federal level (period-related federal target management contracts) and provincial (period-related country control contracts and agreements) and set binding. The implementation is carried out in annual work programmes.

(3) at the national level, in particular the following process steps are in terms of strategic cooperation and coordination: 1 to implement measures are the detailed design of targeting health at the federal level and at the federal level any between federal, to specify countries and social security through federal target control contracts, where macroeconomic effects and regional requirements are taken into account. These contracts have to cover the contents laid down in sections 5 and 6.

2. the federal target control Commission is the design for the federal target control contract to advise and recommend the Federal Government, the main Association of Austrian social insurance institutions and the countries by mutual agreement to the decision-making. The contract is for approval by the competent bodies of the Federal, by countries and by the social security system (main Association after voting by the media conference) to present as soon as possible a legally binding and thus acquired validity. The contractor federal target control contract is to bring within 14 days of the federal target control Commission and the country target control commissions.

3. the design of the first federal target control contract for the years 2013 and 2016 has to exist until June 30, 2013. Federal target control contracts for the further periods have to be until the middle of the year preceding the period. Any adaptations of existing federal target control contracts have also until no later than the middle of the year to be that precedes the year in which these adaptations for the target control become relevant.

4. the federal target management contracts are to be more specific in relation to each year, if necessary, to adapt and to operationalize in annual work programmes at the national level. The annual work programme for the measures at the federal level for the year 2013 is at the same time agreeing with the first federal target control contract. The annual work programmes for subsequent years are at the latest at the end of last year by the federal target control Commission.

5. a national, effective and efficient monitoring and reporting system at the federal level are set up.

(4) countries and social security are responsible at national level in terms of strategic cooperation and coordination for the achievement and implementation of the targets set in the target control health and cooperation. In particular the following process steps are: 1. is the detailed design of targeting health at country level to agree based on the contractual provisions at the federal level by country control contracts and agreements between land and social security and to implement. These contracts have to cover the contents laid down in sections 5 and 6. The financial framework agreement agreed between the country and social security is mandatory, failure to comply with the sanctions mechanism in accordance with section 8 attacks.

2. in the country target control Commission is the design for a country target control contract to advise and recommend for decision in the competent bodies of the social health insurance and the country by mutual agreement. If this draft contradicts the federal target control treaty or any other federal legislation, the Federal Government has a right of veto. The contract upon approval by the relevant competent organs by the country concerned and of the social health insurance (locally competent regional health insurance fund, public servant insurance, social insurance institution, the trade and industry, social insurance institution of the farmers and insurance institution for railroads and mining) as soon as possible a legally binding is to present and thus acquired validity. Is a contract is not signed by all health insurance carriers in the country, this agreement between the undersigned parties concluded anyway, unless the federal target control Commission sees the objectives expected not endangered and therefore no veto. The contractor country target control contract is to bring within 14 days the federal target control Commission and the respective country target control Commission.

3. the design of the first country target control contract for the years 2013 and 2016 has to be until September 30, 2013. Country control contracts and agreements have for the other periods are available until end of November of the year preceding the period. Any adaptations of existing country control contracts have also until no later than end of November of the year to be that precedes the year in which these adaptations for the target control become relevant.

4. the country objective control contracts at each country level are to be more specific in relation to each year, if necessary, to adapt, to operationalize in annual work programmes and to implement in their respective areas of action. The annual work programme for action at the country level for the year 2013 is at the same time agreeing with the first country target control contract. The annual work programmes for subsequent years are at the latest at the end of the previous year by the respective country target control Commission.

(5) it is agreed that a subsidiary of Gesundheit Österreich GmbH is established, through which the work on the implementation of the tasks in the context of targeting health, in particular monitoring (reporting) and quality work are handled. The Federal Government are represented by the Gesundheit Österreich GmbH, the countries and the social health insurance, in this subsidiary, represented by the main Association of Austrian social security institutions, to participate in equal parts (each one-third). In the sense of a resource-saving management is to specify that the Managing Director of Gesundheit Österreich GmbH runs the business of the subsidiary.

Article 9

Ratio of targeting health ÖSG/RSG

(1) the federal target control contract as well as its implementation in the respective annual work programmes health (ÖSG) builds on the already agreed provisions of the Austrian structural plan. The further orientation of the Austrian structural plan health is determined by the overall health of targeting.

(2) the country target control contract as well as its implementation in the respective annual work programmes health (RSG) builds on the already agreed provisions of the respective regional structure plan at the country level, and is the parent of this. The structural measures agreed in the context of targeting health at the country level have in accordance with the guidelines agreed in the federal target control contract and in the ÖSG content appropriately in the respective regional structure plan to infuse health.


(3) on the basis of the central provisions and requirements of targeting health, the Austrian structural plan health as central planning instruments in terms of structural and content and in accordance with the criteria of the supply, to develop the quality and efficiency are health and the regional structure plans.

4.Abschnitt

Governance and organization

Subsection A)

Decision-making structures and organization at the federal level

Article 10

Organisation of the Federal Health Agency (according to article 14 of the agreement in accordance with section 15a B-VG on the Organization and financing of health care in the currently valid version)

(1) in the Federal Health Agency, following organs are set up: 1 Federal Health Commission 2. federal target control Commission (2) also may to the advice of the Federal Health Agency a national health Conference be set up, in which the main actors/stakeholders of health care are represented.

(3) the conduct of business of the Federal Health Agency is the Federal Ministry of health.

(4) the Contracting Parties shall ensure that the Federal Health Agency to request receives the data required to carry out their tasks in accordingly prepared and comprehensible form.

(5) in the case of the tasks, the Federal Health Agency in particular has to ensure that a high-quality, effective and efficient, freely accessible and equal health care in Austria all especially by targeting health ensures and secured the financial viability of the Austrian health care in accordance with the financial framework contracts is.

(6) the Federal Minister of health presides in the Federal Health Commission. The Federal Minister for health, who first Chairman Deputy of social insurance is first Chairman Deputy of chaired the Federal Commission in the control of the target and the second second Chairman Deputy appointed Chairperson Deputy of the countries.

Article 11

Federal Health Commission

(1) the Federal Health Committee representative/representatives and 2 one / a representative/representatives per representation of interests of cities and towns, are 1 nine representatives of the Federal Government, nine representatives of the main Association of Austrian social insurance institutions and the country is a/a a / a representative/representatives of denominational hospitals, one/a representative/representatives of patient organisations and one/a representative/representatives of the Austrian Medical Association's.

3 non-voting members of the Federal Health Commission are per one/a representative/representatives of the Federal Ministry for science and research, the Austrian Chamber of pharmacists, the General accident insurance institution and the for that article 149, paragraph 3 ASVG, Federal Law Gazette No. 189/1955 in the current version, referred to hospitals considering coming legal advocacy.

(2) resolutions of the Federal Health Commission no. 1 requires a majority of votes and the approval of at least three quarters of the representatives referred to in paragraph 1.

(3) the Federal Health Committee has tasks in accordance with the provisions in the federal target control contract and the Federal Commission in the control of the target as well as taking into account macroeconomic effects and regional and country-specific needs to perceive in the context of planning, management and financing of health care in Austria. In the Federal Health Commission determinations (decisions) are carried out at the following points: 1 on matters of the Federal Health Agency as Fund: a) ongoing maintenance and updating and advancement of the performance-oriented hospital financing model (LKF) including its basis b) requirements for the use of purpose dedicated to agents of the Federal Health Agency in accordance with the provisions of article 30, 32, 33 and 45 of the agreement in accordance with article 15a B-VG on the Organization and financing of health care in the current version of c) estimate and accounts of the Federal Health Agency 2 on general health matters : a) (further) development of the (framework) health objectives including the establishment of indicators and monitoring in accordance with article 4 (incl. strategies to implement) b) frameworks for joint management between the various sectors of health care c) development of relevant health information and communication technologies (such as ELGA, eCard, telehealth, telecare) d) guidelines for a nationwide, comprehensive with all sectors of the health-care documentation, as well as further development of the documentation and information system for analysis in the health sector (DIAG) e) evaluation of the tasks of the Federal Health Commission article 12

Federal goal Control Commission

(1) four representatives of the Federal Government, the Länder and social security include the federal target control Commission.

(2) for decision-making within the federal target control Commission, unanimity is required.

(3) in the federal target control Commission is the design for the federal target control contract to advise and recommend the Federal Government, the main Association of Austrian social insurance institutions and the countries by mutual agreement to the decision-making. This agreement constitutes the basis and the framework for the tasks referred to in paragraph 4 and 5.

(4) in the federal target control Commission determinations (decisions) are carried out at the following points: 1 coordination, polls, and specifications of all resulting from the federal target control contract including financial framework contract tasks 2. annual work programmes for measures at the national level to the concrete implementation of the federal target control treaty 3. principles for a nationwide monitoring of the targeting health, including the Finanzzielsteuerungsmonitorings 4 issues of the monitoring and reporting system in accordance with section 7 5. perception of agendas to the sanction in accordance with section 8 6 matters from the framework for contractual and to howsoever by social security and countries together cross-sectoral financing and allocation mechanisms at the country level (E.g. hospital outpatient clinics, group practices and established physicians/specialists, clinical day care, innovative forms of care etc.); Development, testing of billing models for cross-sectoral funding the outpatient area 7 (further) development of remuneration systems 8 Affairs of quality 9 principles, objectives and methods for planning in the Austrian structural plan Gesundheit/in the regional structure plans health 10 Affairs of the Austrian structural plan health incl. structure quality criteria referred to in articles 3 and 4 of the agreement in accordance with article 15a B-VG on the Organization and financing of health care in the currently valid version 11 planning large-scale intra and extramural 12 issues of the drug Commission 13 specifications for the transparent representation of full budgeting, and the accounts of hospitals or hospital associations and of guidelines for the transparent presentation of estimates and accounts of social security for the extramural area of 14 development projects for health promotion 15 evaluation of tasks that is perceived by the target federal control Commission 16 principles and objectives for the use of funds to strengthen health promotion according to article 23 (5) the Federal Commission in the control of the target is a reciprocal information and consultation on the substantive and strategic commitments of the targeting and the control mechanisms that use federal, State and social security within the area of effect.

Subsection B)

Decision-making structures and organization at the country level

Article 13

Organization of the National Health Fund (in accordance with article 18 of the agreement in accordance with section 15a B-VG on the Organization and financing of health care in the currently valid version)

(1) in the national health fund, following organs are set up: 1 Health Platform 2. country target control Commission may provide a Bureau consisting of (2) to prepare the meetings of the health platform and the country target control Commission consisting of representatives/representatives of the country and the social security system.

(3) also can be set up each a health Conference to advise the national health fund, in which the main actors/stakeholders of health care are represented.

(4) in order to fulfil the tasks of the country target control Commission is based on an equal co-ordinator / an equal co-ordinator from the land and the social order, which are responsible exclusively the co Chairman of country destination control Commission and are responsible for all matters referred to in article 15. The regulation of the management of the Land Fund is the country.


(5) the Parties shall ensure that the National Health Fund on request receive the data required to carry out their tasks in accordingly prepared and comprehensible form. Furthermore ensures that is informed in the institutions of the National Health Fund on all relevant measures with regard to intra - and extramural.

(6) in the case of the tasks the country health fund in particular have to ensure that a high-quality, effective and efficient, freely accessible and equal health care in Austria all especially by targeting health ensures and secured the financial viability of the Austrian health care in accordance with the financial framework contracts is.

(7) in the case of unregulated with the Contracting Parties, the national health fund will help with to avoid serious consequences for the population. This is also a scheme for the fees for additional services to meet. The social security system has to make payments to the extent of the comparable savings medical costs to the national health fund.

(8) a member of the provincial government ordered the country chaired the health platform. The first Deputy / the first Deputy of the Chairperson is the Chairwoman / Chairman of the locally competent regional health insurance fund. A member of the provincial government ordered the country leads in the country target control Commission on an equal footing with the Chairwoman / Chairman of the locally competent regional health insurance fund (co Chair). The rules of procedure has to regulate that the meetings are to prepare together (agenda and documentation) and to invite.

Article 14

Health platform at the country level

(1) the health platform include: 1 vote: five representatives of the country and five representatives of carriers of social security as well as a / a representative/representatives of the Federal Government; Alternate members accordance with any landesgesetzlicher provisions, 2. non-voting: the main Association of Austrian social insurance institutions and 3. in any case, representatives of the Medical Council, the representatives of towns and municipalities, the patient representatives and the legal entity of the hospitals that are settled through the national health fund, which landesgesetzlich a right to vote can be granted.

(2) in the case of the representation of social security is to pay attention to the rights of the self-government he flowing.

(3) in respect of decision making in the health platform, the following shall apply: 1. in matters referred to in paragraph 5 is Z 1 - subject to the para 9 - a majority of the country.

2. in matters referred to in paragraph 5, Z 2 is no. 1 required a majority vote and the approval of at least three quarters of the representatives referred to in paragraph 1.

3. the Federal Government has against applicable law, the existing agreements in accordance with article 15a B-VG, the federal target control contract or decisions of the organs of the Federal Health Agency right of veto against decisions that violate.

(4) the health platform at the country level has tasks in compliance with the provisions in the Federal Health Agency, in the federal target control contract, to perceive in the respective country target control contract and in the respective country target control Commission, and taking into account macroeconomic effects to the planning, management and financing of health care in the country field.

(5) in the health platform determinations (decisions) are carried out at the following points: 1. in matters of the country health fund as the Fund: a) specific country loft of the defined benefit hospital financing system force in the Federal State of; Compensation for the performance of the Fund hospitals; Implementation of performance-based remuneration systems; Granting of funds for investment projects; Granting of financial aid for projects, planning and hospital-relieving measures b) estimates and accounts of the State Health Fund c) tasks that transferred the Land Fund by the national legislation of the jurisdiction of the country 2 on general health matters: a) (further) develop of the health objectives (including strategies to implement) at country level b) principles of the implementation of quality standards for the provision of intra - and extramural health services c) principles of the implementation of guidelines for the joint management of d) participation in the establishment and development of relevant health information and communication technologies (such as ELGA, eCard, telehealth, telecare) at the country level e) implementation of projects to promote health f) evaluation of tasks (6) perceived health platform at the country level in the health platform information and consultations are carried out at the following points: 1 resource planning in the health care sector 2. report on commitments the country target control Commission (7) the estimates and accounts are immediately its decision to submit the Federal Health Agency.

(8) the provincial legislature may provide that individual tasks of health platform, if in agreement between the country and the social security system, can be transferred to the country target control Commission.

(9) a corresponding to the number of people in each country share of EUR 15 million of the grants for hospital-relieving measures gem. § 5 No. 1 lit. a is separately annually in the years 2013 to 2022 in the estimate. The allocation of these funds will be decided in consultation between land and social security in the health platform.

Article 15

Country target control Commission

(1) the Curia of the country with five representatives/officials, the Curia of the institution of social security with five representatives/officials, as well as a representative / a representative of the Federal Government are the country target control Commission. The representation of social security's respect from self-government rights to ensure betriebsgesellschaft.

(2) with regard to decision-making in the country target control Commission, the following shall apply: 1 within the respective Curia is a decision on their vote to bring about. Decision making is to regulate for the Curia of the country landesgesetzlich and for the Curia of the institution of social security in social security law.

2. for decision-making, consensus between the Curia of the country and of the Curia of the social insurance institution is required.

3. the representative / the representative of the Federal Government has against applicable law, the existing agreements in accordance with article 15a B-VG, the federal target control contract or decisions of the organs of the Federal Health Agency right of veto against decisions that violate. In case of the incapacitation of the Federation at the meeting attended this can bring in writing and justified his veto right within one week.

(3) in the respective country target control Commission is the design for the country target control contract to advise and recommend for decision in the competent bodies of the social health insurance and the country by mutual agreement. This agreement constitutes the basis and the framework for the tasks referred to in paragraph 4 and 5.

(4) in the country target control Commission determinations (decisions) are carried out at the following points: 1 coordination, polls, and specifications of all from the country target control contract including financial agreement resulting tasks 2. annual work programmes for measures at national level to the concrete implementation of the country destination control treaty 3. participation in the nationwide monitoring and treatment of the Commission pursuant to section 7 4 perception of agendas cross-sector financing to howsoever 8 5. implementation of the provisions for contractual and jointly by social security and countries to the sanction in accordance with section and allocation mechanisms at the country level (E.g. hospital clinics , Group practices and established physicians/specialists, clinical day care, innovative forms of care etc.); Implementation of agreed innovative models for cross-sectoral financing of the outpatient area 6 Affairs of the regional structure plan health in accordance with articles 3 and 4 of the agreement in accordance with article 15a B-VG on the Organization and financing of health care in the current version 7 issues of large-scale intra and extramural 8 strategy for health promotion 9 issues of the health promotion fund in accordance with article of 23 10 participation in the implementation of quality standards for the provision of intra - and extramural health services 11 implementation of guidelines for the joint management of 12.
Evaluation of Commission's tasks perceived by the target country Control Commission (5) in the country target control is a reciprocal and timely information and consultation on commitments to significant operational and financial matters of the provision in the health sector by country and social security.

5. section

Concrete expression of partnership targeting health

Article 16

Orientation of targeting health


(1) on the basis of the principles presented in section 2 and objectives of targeting health, as well as in the agreement in accordance with section 15a B-VG on the Organization and financing of health care in the amended provisions formulated the targeting health in the following four areas of control is 1 result orientation, 2. supply structures, 3. to concretise supply processes and 4th financial targets in accordance with section 6.

(2) for all target agreements covered by the areas of control in the context of targeting health measures and target values to define are.

(3) Federal, State and social security federal or land and social security at the national level responsible for the conclusion of the contract, the implementation and adherence of targeting health together and each other. This includes a mutual information and consultation about intended measures which are taken in the respective area of effect and can affect the other utilities sector. To implement the agreed binding targets Federal have comprehensive and mutually support each other countries and social security. In conflict situations, the respective target control Commission is in any case to deal.

(4) the federal target control treaty partners have to ensure that the existing target control systems in the field of public health do not contradict the federal target control contract or the country target control contracts.

Article 17

Control Panel results-oriented

(1) in the Control Panel results-oriented federal target control agreements must include in particular the following regulations: 1. national frameworks for results-oriented supply and effect-oriented health objectives derived from the framework health objectives 2. documentation requirements (data basis: cross-sectoral common diagnostics and performance documentation;) Use of pseudonyms) for a nationwide monitoring of the health and care objectives 3. nationwide uniform measures and target values are set for the measures in the control areas of supply structures and processes These are meant for international comparisons and be suitable 4. uniform guidelines on cost benefit reviews and evidence based (HTA) of diagnostic and treatment methods performance measurements (including health promotion, screening and vaccination programmes) 5. coupling of measures of health promotion and prevention on action-oriented health goals including mandatory evaluation (2) in the country target control treaties regional health and care objectives must be set, so that the nationwide targets for the results-oriented supply and effect-oriented health objectives can be achieved.

Article 18

Control Panel supply structures

(1) in the control panel supply structures the federal target control agreements must include in particular the following regulations in the form of bandwidth: 1-demand supply and power density in the acute inpatient and outpatient (intra - and extramural) area (development of power density in direction power density for all areas) 2. share of the day clinical performance or outpatient services for specified selected services 3. discharge of the full inpatient area in the acute hospitals by medical and economy as a whole justified shift of services in the day or in the ambulant field (hospital outpatient clinics , independent outpatient clinics and outpatient clinics area) taking account of article 5 para 3 Z 4 1, 2, and 3. portion of the ambulatory care structure with opening day and week end times and share of interdisciplinary care models to the ambulatory care structure 5. strengthening primary care ("primary health care") in the established field 6 frameworks for any affected joints 7 framework for the roles, responsibilities, and supply jobs of outpatient care 8 cross-border cooperation (2) within the framework of the period-related country control contracts and agreements are the set forth prior tasks in accordance with para 1 outbound to be more specific regional needs and to set targets for the respective observation period by mutual agreement. Also specifications about the action implementation both in qualitative and in quantitative terms, being in these contracts to meet, in particular the following measures concerning supply structures, bring about the significant impact on service provision in the other sector, taking into account: 1 capacity adjustments in acute sick institutions, insb. setting structural measures such as converting (dislocated) week or day clinics and base hospitals or creating networks of hospitals and hospitals with multiple locations (functional areas selected including specifications for the joint operation) 2. capacity adjustments by extramuraler performance provision (insb. interdisciplinary care models such as such as an independent outpatient clinics, group practices or to establish new innovative forms of care, extended opening hours), taking into account the to set regional supply contracts (especially in new contracts) 3 establishing interdisciplinary central reception and primary care units and outpatient primary care units 4. planning of hospital outpatient clinics in connection with the established specialists of physicians/5. adaptation of the clinical day and outpatient structures starting from the agreed target output volumes per area 6 setting of the roles, responsibilities and supply orders per outpatient care level and mandatory cross-sectoral planning through the regional structure plans health (incl. redemption possibility of upright permits at dismantling of parallel structures) 7 set of "best points of service" by means of regional supply orders differentiated according to supply level and introduction of integrated care models 8 taking into account of the "Date time" and "Supply effectiveness" per providers in regional capacity planning in primary care () RSG) article 19

Control Panel supply processes

(1) in the control area of supply processes the federal target control agreements must include in particular the following regulations as targets for optimization of treatment processes: 1. defining the implementation of eHealth concepts (electronic health record, cross-sectoral common diagnostic and performance documentation, eMedikation, etc.)

2. reduction of avoidable double and multiple findings requirements, particularly for elective surgery through the implementation of the Federal quality guideline preoperative diagnosis 3. comprehensive definition and implementation of quality standards (E.g. Federal quality guideline recording and release management) 4th offer on disease management programmes and concepts for integrated care 5. operational measures for the implementation of article 24 para 2 third and fourth set KAKuG (the existing instruments for the implementation of an economic way of prescribing are authentic record.)

6 a common "medicine Commission" will be set up as part of targeting health measures for the effective and efficient use of medicines (2) at the federal level for the intra - and extramural area in particular for specialized and high-priced medicines and their uses. Where: 1 the "Medicine Commission" challenge, at the request of a State or of the main Association of Austrian social insurance institutions of federal target control Commission recommendations to submit, what high-priced and specialized drugs are used in the utilities sector and what reimbursement system or which utilities sector assumes the costs thereby incurred. Their recommendations have making "best point of service" on the and in particular on medical and therapeutic, health economic and supply aspects to be based to ensure the highest quality of service.

2 three representatives of the social security and the countries include common "medicine Commission" for the intra - and extramural area. A representative / a representative of the Association shall preside. The Federal Minister of health sent three scientific experts/experts of the pharmaceutical industry in the Commission. All members are eligible to vote. She meets the recommendations by a three-quarters majority, where the minority opinion requested document is.

3. the federal target control Commission has to decide on the recommendations of the common "medicine Commission" for the intra - and extramural area.

4. the cure-Evaluation Commission the main Association of Austrian social security institutions established will prepare still the decisions of self-government in the procedures relating to the reimbursement code, where she record the federal target control Commission at least has in their recommendations to the main Association of Austrian social insurance institutions.


(3) in the country target control contracts measures to optimize the treatment processes must be provided through improved organization and communication processes between all service providers. Such measures are in particular considering: 1. implementation of eHealth concepts (electronic health records, sektorenüber cross common diagnostic and performance documentation, eMedikation, etc.)

2. implementation (cross-sectoral) guidelines and standards (E.g., recording and release management, pre-operative diagnosis) for treatment and care for chronic and common diseases 3. patient control to the "best point of service" 4. implement evidence-based and quality-assured disease management programs, as well as integrated care concepts article 20

Specifications and content of the country target control treaties the country target control treaties may not contradict the federal target control contract. You need to starting from the regional demand closer clarify in particular the requirements under the federal target control agreement in the areas of control "Result orientation", "Power structures", "Supply processes" and "Financial targets" and include the appropriate measures to implement.

Article 21

Annual work programmes that are taken down and measures "Result orientation", "Power structures", "Supply processes" and the financial target control (section 6) in the target control treaties in the areas of control to operationalize in regard to their timely implementation. There are annual programmes to create for this purpose.

6 article

Defining the financial target control

Article 22

Financial target management - general provisions

(1) the Contracting Parties agree to complement the control areas upstream in the 5th section with a financial target control as an integral part of the targeting health. The financial target control is in financial contracts at federal and State level, which are part of period-related federal and State control contracts, to be more specific.

(2) basis of financial target control is an output attenuation path across sectors to be agreed. This output attenuation path includes a forecast of health care spending without intervention, the agreed nominal expenditure ceilings for public health expenditure (excluding long term care) and the resulting attenuation effects in output growth (output damping effects). This ceiling on expenditure and output damping effects are to represent for the field of social security and the competence of the Länder at federal as well as country-level and country-level cross-sectoral expenditure ceiling and output attenuation effects merge.

(3) the Contracting Parties constitute a package of measures based on financially weighted and verifiable assumptions which is suitable in sum, actually achieving the agreed expenditure ceiling and the resulting output damping effects. The final objectives finally focused on the respect of the applicable expenditure ceilings.

(4) following are criteria at the federal level for the definition of the output damping path: 1. is the increase in public health spending gradually as far as steaming, that the annual increase in output does not exceed a value of 3.6 percent (average development of the nominal gross domestic product in accordance with the medium-term forecast for the Federal Finance frame law) in 2016 in the first period of targeting health from 2012 to 2016. In other periods, the annual output increase in the average development of gross domestic product in accordance with the medium-term forecast for the Federal Finance frame law in amended remains coupled.

2. in 2016 is to achieve an output damping effect of €1.3 billion, so a maximum spending limit for public health expenditure arises in the year 2016 total of 25,563 billion euros.

3. for the first period of targeting health from 2012 to 2016, cumulative output damping effects of a total of 3.43 billion euros are to achieve.

(5) in subsequent periods are, especially for the period up to 2020, in the federal target control contract to set binding values for in par. 4 Z 1-3 listed sizes and the possible change in the methodology for determining these values. The agreement in accordance with article 15a B-VG on the Organization and financing of health care in the current version should be noted.

(6) compliance with the output attenuation path at federal and land level is imperative to ensure through partnership agreed measures in the context of targeting health.

(7) the determination of defined for the financial target control as target control relevant health issues in the countries and social security has to be transparent and comprehensive. The methodology of the Austria-wide representation and the output numbers for the first period of targeting health are laid down in the articles 26 and 27. They are mutually disclosed for the identification of public health expenditure and data works required for the subsequent monitoring and the corresponding data origins are to expel.

(8) health spending from the pension insurance, accident insurance, health care institution and the Federal Government, as well as investment are be presented separately.

(9) the financial target control refers to the use of the funds. Targeting health shall be without prejudice to the relevant provisions to the source of the funds, in particular the provisions in the agreement in accordance with article 15a B-VG on the Organization and financing of health care in the current version.

(10) in the implementation of the financial target control is in any case to ensure that the social health insurance to seek an income-oriented spending has.

Article 23

Strengthening of health promotion

(1) in order to strengthen health promotion and Prevention Fund with its own billing circle as a so-called "health promotion fund" are in all country health fund without legal personality.

(2) throughout Austria are allocated to this health promotion fund for 10 years (2013 to 2022) with a total of 150 million euros, where social 130 million euros and in equal annual tranches of EUR 20 million to introduce by the countries. The social security funds will be after the insured key, the resources of the countries be applied according to the number of people and distributed in this way on the Länder.

(3) the decision on the use of funds from the health promotion fund in the country target control Commission in the agreement between the country and social security takes place at the country level.

(4) funds not used in the financial year are to strike the health promotion resources available the following year.

(5) the federal target control Commission has to use this funding to adopt principles and objectives, which is in particular to ensure that health promotion projects do not contradict the fundamental objectives of the federal target control treaty and the country control contracts.

Article 24

Content and subject to the financial framework contracts

(1) the financial framework contracts set the expenditure ceiling and the output damping effects derived from federal and land level. These include that of the Contracting Parties in the context of targeting health to control health expenditure, which in future are subject to a joint financial responsibility of countries and social security with regard to the use of funds, as set out in article 22.

(2) at the federal level, the financial framework contracts for the respective period of targeting health have to include at least the following content: 1 for the nationwide cross-sectoral output attenuation path of public health care spending without long-term care: a) the output value for the first year of the relevant period b) the evolution of expenditure in the period without intervention c) the annual expenditure ceiling and the result to be derived from d) annual and accumulated over the period of the output damping effects, as well as e) the allocation key for the output damping effects on the two sectors 2.
For the nationwide sectoral output damping paths of public health expenditure for controlling financial target ongoing relevant: a) the output values for the first year of the relevant period b) the evolution of expenditure in the period without intervention c) the annual expenditure ceiling and the result to be derived from d) annual and accumulated over the period output damping effects in accordance with subpara 1 lit. d and e separately for countries and social security 3.
The Division of lit in no. 2. c and expenditure ceilings shown in d and output attenuation effects derived from a) on the b's nine federal States) on all carriers of social health insurance, as well as the c) State-way merging lit. Separately to represent b 4 are: a) investments b) health spending of pension insurance (in particular rehabilitation) c) health expenditures of the accident insurance d) health spending of Krankenfürsorgeanstalt e)

5 federal health spending.
The specific design of the differentiated output representation for the extra - and intramural field, as well as the generation of the necessary data bases shall be agreed in the first federal target control contract.

6 Furthermore the content are in the first federal target control contract nationwide framework regulations for the country level according to para 3 No. 7 of to financing and clearing mechanisms for agreed cross-sectoral shifts in performance.

(3) at the country level, the financial framework contracts for the respective period of targeting health for all nine provinces have to include at least the following content: 1 representation of the output damping path of for controlling financial target running relevant public health spending of the country: a) if the output value for the first year of the relevant period b) the evolution of expenditure in the period without intervention c) the annual expenditure ceiling and the result to be derived from d) annual and accumulated over the period output damping effects pursuant to par. 2 No. 3 lit. : â 2. representation of the output damping path of for controlling financial target running relevant public health expenditure of social security in the country) the output value for the first year of the relevant period b) the evolution of expenditure in the period without intervention c) the annual expenditure ceiling of social security and the result to be derived from d) annual and accumulated over the period output damping effects pursuant to par. 2 No. 3 lit. (c) 3.
The appearance of the merged output damping path in accordance with no. 1 and no. 2 for the respective State 4.
Attributable to the respective Federal State investment distribution by country and social security 5.
The expenditure of both sectors are displayed according to a functional outline due to a nationwide report template: a differentiated presentation of expenditure according to the existing functional structure is to make for the extramural area. A differentiated presentation of essential financial positions of the national health fund and the countries/communities is to make for the intramural field. In addition, it is for the intramural sector on the basis of the estimates and accounts of the hospital institution and starting from the uniform data bases for hospitals cost accounting one according to material and functional aspects differentiated from these computing works to define derived expenditure or cost display (expenses/costs for staff, medical and non-medical health and consumer goods including a separate presentation of the remedy for the purchase of medical and non-medical services and investment) and to supplement. A differentiated appearance is functional and technical areas to strive for.

The measures agreed in the country target control treaties are 6 to represent in budgetary terms, as follows: a) overall assessment of the measures in accordance with article 17 para. 2, art. 18 para. 2 and art. 19 para. 3 and b) whose impact on the intra - and extramural area.

7 binding rules for cross-sectoral funding and allocations pursuant to par. 2 No. 6 of performance shifts caused by targeting health or newly established forms of care article 25

Definition of the output damping path for the first period on the federal level

(1) public expenditure on health are the basis for the determination of the nominal expenditure ceilings including output damping effects at the federal level, as well as for the definition of sectoral and regional expenditure ceilings for the first period from 2012 to 2016 2010 in their respective expression by making selections in analogy to the approaches of Statistics Austria on the basis of "System of health accounts (SHA)".

(2) the output attenuation effects arise from the difference between of the forecast of public health care spending without intervention and the expenditure ceilings to get closer to the path of GDP.

(3) on the basis of public health spending without long-term care (öGA) 2010 in height from 20,262 million euros an increase in public health spending for the year 2011 with 3.3% will be applied. This results in an output value for 2011 in the amount of 20.931 million euro.

(4) for the forecast of health care spending without intervention, an annual value of increase in is taken for the years 2012 to 2015 of 5.22% and for the year 2016 by 4.65%.

(5) from the gradual rapprochement with the Z 1 predicted GDP path in accordance with art. 22 par. 4, the following output attenuation path is apparent for the years 2012 to 2016:



In million euro



2012



2013



2014



2015



2016



Output development public expenditure on health without intervention



22.024



23.175



24.386



25.660



26.853



Expenditure ceilings



21.873



22.813



23.748



24.675



25.563



annual output attenuation effects (rounded)



150



360



640



980



1,300 article 26

Definition of the output damping path for the first period in the range of countries

(1) the countries undertake to achieve until 2016 cumulative output damping effects of public health expenditure amounting to 2.058 million euro in the first period.

(2) on this basis, up 2016 following to output damping effects of public health expenditure for the countries arise for the first period:



2012



EUR 90 million



2013



EUR 126 million



(accumulated: EUR 216 million)



2014



168 million euro



(cumulative: 384 million euro)



2015



EUR 204 million



(cumulative: 588 million euro)



2016



192 million euro



(cumulative: 780 million euro)



Cumulative output damping percentage of countries by 2016:



2.058 million euro (3) that set output damping effects are in para 2 to achieve from the countries on the basis of the ongoing health-care-related expenditure of the country health fund financed hospitals (FKA). The target control relevant output values are from the accounts of the Land Fund and the countries and to derive municipalities as follows (cf. annex): expenses for Fund hospitals (FKA) less subsidies according to accounts (RA) the National Health Fund (LGF) (incl. budget according to health and social aid Act (GSBG)). Capital expenditure (incl. debt for investment) less subsidies. Structural funds less subsidies. Operating outlet cover designated via LGF less subsidies. foreign guest patients less subsidies. results in other charges: Zielsteuerungsrelevante plus expenses for FKA pursuant to RA of the LGF. Operating outlet cover shown in the RA of the owner or public. Carrier (insb. Plus countries and communities). Operation finish covers of the municipalities (if relevant) less subsidies. Operating outlet cover/operating grants for nursing homes (if relevant) plus. Social assistance (if not included in RA National Health Fund) gives: Zielsteuerungsrelevante health care expenditure in the area of the countries (4) issues of the country health fund for Central according to health and social aid Act (GSBG) are included in the target control-specific baseline. This output position is to undergo a separate analysis in the context of the Finanzzielsteuerungs monitoring anyway. Resulting changes in GSBG due to changed regards in particular in staff allocations between local authorities and hospitals societies remain at best in establishing implementing expenditure ceilings out of consideration.

(5) a modification of the appearance of financial statements of the national health fund and other existing underlying computing works of a country, unless for targeting health relevance, are transparent to the partners of targeting health. A time series continuity at the positions relevant to the financial target management is anyway to make sure any changes is to establish agreement to ensure this continuity with the Contracting Parties of the Federal Commission in the control of the target

(6) for the countries, an output value for the year 2010 is defined by 9,320 million euro as target control-related health issues; for 2011, a value of 9.627 million arises thus taking into account the underlying increase of 3.3%.

(7) in the first period until 2016 following expenditure ceilings including output damping effects, being the implementation of the targets in the period in the foreground will be so for the countries:



Year



Defined output values of the countries for financial target control, without output damping (nationwide)



Sum of the output damping the countries



Expenditure ceilings of countries (nationwide)



2012



10.130 million €



€90 million



€10.040



2013



10.659 million €



€216 million



10.443 million €



2014



11.215 million €



€384 million



10.831 million €



2015



11.801 million €



€588 million



11.213 million €



2016



12.349 million €



€780 million



11.569 million € Übererfüllungen the output damping effects of countries in one year can be applied to subsequent years, provided complied with the annual expenditure ceilings set.


(8) the distribution of the expenditure ceiling including the output damping effects to be achieved within countries is done by the countries and document (decision of the country financial officer Conference from October 2, 2012) in the Federal and respective country target control contracts.

Article 27

Definition of the output damping path for the first period in the field of social security

(1) the Federal Government shall ensure that the social security institutions in the first period to achieve until 2016 cumulative output damping effects of public health expenditure in the amount of EUR 1,372 million.

(2) on this basis, up 2016 following to output damping effects of public health expenditure for social security arises for the first period:



2012



EUR 60 million



2013



84 million euro



(cumulative: 144 million euro)



2014



EUR 112 million



(accumulated: EUR 256 million)



2015



EUR 136 million



(accumulated: EUR 392 million)



2016



EUR 128 million



(cumulative: 520 million euro)



Cumulative output loss share of social security by 2016:



1,372 million euro (3) that set output damping effects are in para 2 to achieve the social security on the basis of the current expenditure. The accounts of the social security institution to form the basis for the target control relevant expenditure of social security, with following issue shares to determine the relevant output values to the withdrawal are (see appendix): 1 transfers to the national health fund 2. remittances for the private hospitals Financing Fund (PRIKRAF), accident and other hospitals as well as Hanuschkrankenhaus hospital 3. inpatient rehabilitation 4 health strengthening and prevention of disease (spas) 5. cash benefits (sickness benefit, maternity benefit, funeral expenses grant) 6 depreciation 7 financial expenses 8 transfers to the compensation fund of 9 other extraordinary expenses 10 assignment reserves (4) modifications of the appearance the accounts of social security, as far as they are relevant to the target control health, are transparent. A time series continuity at the positions relevant to the financial target management is anyway to make sure any changes is to establish agreement to ensure this continuity with the Contracting Parties of the Federal Commission in the control of the target

(5) for social security, a baseline for 2010 is defined by 8.146 million euro as target control-related health issues; for the year 2011 produce a value of 8.415 million thus taking into account the underlying increase of 3.3%.

(6) in the first period until 2016 following expenditure ceilings including output damping effects, being the implementation of the targets in the period in the foreground will be thus for social security:



Year



Defined output values of the SV for the financial target control, without output attenuation (nationwide)



Sum of the output damping the SV



Expenditure ceilings of the SV (nationwide)



2012



8.854 million €



€60 million



8,794 million €



2013



9.316 million €



€144 million



9,172 million €



2014



9.802 million €



256 million €



9.546 million €



2015



10.314 million €



€392 million



€9.922 million



2016



10.794 million €



520 million €



€10.274 million as document, the distribution of the expenditure ceiling including the target output damping effects within the social security institutions as well as you are mapping the ceiling on expenditure and output attenuation effects country to carry out the social and in the Federal and respective country target management contracts (7).

Article 28

Virtual budget

(1) refers to the agreed financial framework contracts referred to in article 24 the joint financial responsibility at the country level within the framework of the virtual budget and includes: 1 the output damping effects and the expenditure ceilings, and 2. the measures pursuant Article 22 § 3.

(2) the content referred to in paragraph 1 are no. 1 in art. 22 para. 3 and art. 24 par. 3 regulated Nos. 1, 2 and 3.

(3) the content referred to in paragraph 1 Z 2 are in art. 22 para. 3 and art. 24 para 3 Z 6 and 7 regulated.

(4) land and social security responsible for paragraph 3 within the meaning of article 16 together the realisation of the objectives agreed in the financial framework contracts, being regulated by the corresponding procedure in the not achievement of objectives and for breaches of the financial framework contracts in articles 34 and 35.

7 section

Provisions for monitoring and reporting

Article 29

Implementation of a monitoring and reporting system

(1) in the target control system health are that a constant monitoring of clearly defined measures and target values is possible at federal and State level to define the agreed targets. Where a uniform rating scheme for assessing the degree of target achievement is to make sure.

(2) the partners of targeting health have to implement an Austria-wide monitoring differentiated according to sectors and regions and reporting at the national level. This reporting must meet the following requirements: 1. monitoring of the adequate objectives of targeting health on the basis of measures and target values contracted 2. creation of transparency and comparability 3. structured public reports (3) Federation and Länder ensure that timely provided data required for the monitoring and the evaluation of based available. The countries agree, that in accordance with section 17, paragraph 2, of the Federal Statistics Act 2000 for Health Federal Ministry responsible for the purposes of monitoring all his data used by Statistik Austria for calculating permanently are provided which according to the system of health accounts (SHA) by Statistics Austria directly.

Article 30

Process steps the monitoring and reporting system has to be carried out following clearly distinct process steps: 1 the monitoring (data collection, processing and evaluation) is done by the Gesundheit Österreich GmbH. The data processing and evaluation are to submit to the respective country target control Commission for an opinion.

2. the respective country target control Commission has Act preliminary recommendations to develop.

3. the acceptance of the Commission including the senior action recommendations is carried out taking into account the comments by the federal target control Commission.

4. the federal target control Commission has to send the monitoring report, including the senior action recommendations and opinions to the country target control commissions.

Article 31

Financing of the monitoring and reporting the financing of monitoring to be implemented at the federal level targeting health and reporting is done by the Federal Government.

Article 32

Detailed rules for monitoring and reporting

(1) the detailed arrangements for monitoring and evaluating based on it, in particular as regards the necessary data, their form and data sources, are binding to agree in the first federal target control contract. These regulations are the requirements arising from the targeting health to adjust particularly in terms of ensuring data availability regularly. These detailed regulations is to ensure that 1 the handling of monitoring and evaluating based on it is simple and no-hassle, routine documentation primarily existing 2 and data reporting tracks be used, 3. nationwide not consistent metrics are used and 4 a high topicality is guaranteed anyway.

(2) the periodicity of monitoring and evaluating based on it is in terms of key measures and target values to the supply (according to the areas of control in section 5) and to regulate the financial target management (in accordance with section 6) in the federal target control contract.

8 section

Regulations of the sanction mechanism

Article 33

General information

(1) Federal and State Governments agree to set a sanction mechanism for the following cases: 1 not achieve identified In the course of monitoring of targets that are set in this agreement, in the federal target control contract, or in the country target control treaties 2. breach of this agreement, the federal target control contract or the country target control treaties 3. non-consummation of the federal target control treaty or the country control contracts and agreements (2) the penalties laid down in other agreements in accordance with article 15a B-VG remain unaffected by the provisions in this section. Financial penalties for not meeting financial goals are subject to only the agreement of the Federal, the State and communities on an Austrian stability pact in 2012, Federal Law Gazette I no. 30/2013.

Article 34

Rules for non-achievement of objectives determined in the course of monitoring by the federal target control Commission, not achieving the targets that are set in this agreement, in the federal target control contract, or in the country target control contracts, the following applies: 1.

The respective country destination control Commission, in whose country the target was not reached to submit a written report within eight weeks after finding non-achieving the objectives of the federal target control Commission has in not achievement of the common objectives set forth in the federal target control agreement at national level. Not reached relates to the Bund, the reporting obligation on the federal target control Commission meets the Federal.

2. for failure to reach the common objectives laid down in the country target control contracts, the respective country target control Commission within eight weeks after finding non-achieving the objectives of the federal target control Commission has to submit a written report.

3. the reports referred to in Nos. 1 and 2 have in any case, the reasons for the failure to reach of the set objectives and to measures to contain that securing the attainment of the objectives at the time of ehestmöglichen.

4. the federal target control Commission has to authorize under Z 1 and 2 referred to reports in particular as regards the measures proposed and the proposed timetable for achieving the goal. If not approval, revised reports to submit.

5. According to no. 4 by the federal target control Commission approved or non-approved reports are to publish the respective stakeholders with appropriate commentary on the federal target control Commission and opinion.

Article 35

Regulations for violations of this agreement, the Federal Government target control contract or the country control contracts

(1) a violation of this agreement or against the federal target control contract exists from the perspective of a contractual partner of targeting health, this violation by this Contracting Party in the federal target control Commission is in writing and justified to show. The listed offences are to treat the Federal Commission in the control of the target and measures of organisation of action to restore the State of vereinbarungs - or contractual provisions, discontinue in to initiate are promptly identified violations by the federal target control Commission.

(2) a violation against this country target control contract exists from the perspective of a Contracting Party of a country destination control contract, this violation by this Contracting Party in the country target control Commission is in writing and justified to show. The identified violations must be treated in the country target control Commission and measures of organisation of action to restore the State of contractual provisions, discontinue in to initiate are promptly identified violations by the country target control Commission.

(3) can be 2 months the Federal Commission in the control of the target or the country destination control Commission in no consensus here, whether a violation exists or on the measures to be taken, can initiate the party displayed on the violation of the conciliation procedure referred to in article 37.

(4) if additional expenses resulting from a violation identified in the conciliation procedure the federal target control contract or the country control contracts, these shall be borne by the defaulting partner. The resulting overspending are slamming the financial target control-specific editions of the defaulting partner.

Article 36

Regulations in non-realization of the federal target control treaty or the country control contracts

(1) is up to the in section 3 (art. 8 para 4 No. 3) this agreement set time no unterfertigter country destination control treaty before, may be admitted upon a reasoned request of the respective country target control Commission a reasonable grace period for the submission of the advice country target control contract by the Federal. Moreover, the federal target control Commission is to inform.

(2) no unterfertigter country destination control contract is concluded within the granted period continues, the following applies: 1 in the country-destination control Commission are to determine the consensus and dissent points and submit the federal target control Commission.

2. the federal target control Commission has Act preliminary requirements in terms of the existing points of dissent or if necessary from the federal target control contract is to lead missing points to set.

3. the federal target control Commission has to make a report on Nos. 1 and 2 by publishing transparent. The opinions of the parties are to incorporate it fully.

(3) is up to the in section 3 (art. 8 para 3 Z 3) this agreement set time no unterfertigter federal target control contract above applies after unsuccessful smearing of a grace period of two months the following: 1 the Federal Commission in the control of the target are to determine the consensus and dissent points and to make transparent by publishing.

2. no federal target control contract is concluded within three months after publication, the Federal Minister for health has temporary action preliminary requirements in terms of the existing points of dissent or any missing points to set for one year. The agreement with the Federal Minister of finance is to produce financial effects. In these provisions, the Federal Minister for health of the existing preparatory work and the senior action guidelines, which are suitable to achieve the main objectives, to be has.

Article 37

Arbitration for disputes arising from the federal target control contract or the country target control treaties in the context of targeting health

(1) a conciliation board is set up at the Federal Ministry of health in connection with the targeting health for disputes arising from the federal target control contract or the country target control contracts.

(2) the Arbitration Board include the following four years ordered members to: 1 a / a designated/recognized and independent/independent health expert/health expert from the federal target control Commission appointed/appointed as Chairman 2. two members delegated by the Federal Government 3 two members delegated by the countries together 4 two members delegated by the main Association of Austrian social security institutions for decisions of the Arbitration Board is the simple majority required, where ever a voice to all members , in decisions on disputes from the country target control contracts, the members delegated by the Federal Government have no voting rights.

(3) it has the Arbitration Board called by a Contracting Party, in consultation with the affected parties in the case to decide and to make transparent the decision through publication. This decision must be accepted by concerned parties. The conciliation body has this decision 1 the affected parties, and 2. the federal target control Commission, as well as 3 of the concerned country target control Commission in disputes from the country target control contract to bring.

9 section

Key points for legislation for the establishment of targeting health at federal as well as at the country level

Article 38

Legislation at the federal level

(1) to ensure the establishment and the implementation of partnership targeting health, the Federal Government has in particular the following regulations to provide for: 1. commitment of social security to comply with the principles, objectives and fields of action targeting health that are laid down in sections 5 and 6 in particular 2. obligation social security together with federal and State digital information systems from the eHealth area to strengthen the health literacy of the population to use 3. anchoring the mandatory signing of the federal target control contract by the Hauptverband after decision of the carrier Conference 4. regulations for Financing and accounting mechanisms as well as for projects on the basis of objective control contracts in particular for cross-sectoral financing of the outpatient area 5. codification of the modified organs (composition, Beschlussmodalitäten and task allocation) of the Federal Health Agency and rules for posting of representatives/agents of social security in the institutions at the Federal and State level and regulations to the internal decision-making process within social security 6 obligation of the Federal Government, the countries, the country health fund , social security and the health care providers, to document all the targeting health including monitoring required data and creating the legal basis for the nationwide monitoring and evaluating based on 8 specification for the sanctions mechanism (2) the Federal Government committed partners of targeting health in accordingly prepared and comprehensible form to provide 7 to undertake, the legal provisions referred to in paragraph 1 as well as the necessary other federal adjustments in a timely manner.

Article 39

Legislation at national level

(1) to ensure the establishment and the implementation of partnership targeting health, the countries have the following legal regulations to provide for: 1. commitment of the country health fund to comply with the principles, objectives and fields of action targeting health, set in particular in sections 5 and 6 are 2.

To insert commitment to improving the health literacy of the population together with federal and social security digital information systems in the field of eHealth 3. codification of the modified organs (composition, Beschlussmodalitäten and task allocation) of the national health fund 4. specifics of the sanctions mechanism (2) the countries undertake, the legal provisions referred to in paragraph 1 as well as the required other Laender in time to make adjustments.

10 section

Other provisions

Article 40

Special provisions in case of natural disasters or extraordinary emergencies In the event of natural disasters or exceptional emergency situations which are beyond the control of the State and adversely affect the financing of health care, are to agree on compensatory financing mechanisms.

Article 41

Support mandatory of Federal significant additional expenses (in analog application of the agreement in accordance with article 15a B-VG a consultation mechanism, Federal Law Gazette I no. 35/1999) the countries due to legal requirements on the part of the Federal Government be measured separately and remain in determining compliance of the expenditure ceilings for the affected countries out of consideration.

11 Chapter

Duration and final provisions

Article 42

Entry into force this agreement into force after receipt of messages of all parties in the Federal Ministry of health, that you are met necessary conditions for the entry into force according to the Federal Constitution and the constitutions of the country, with January 1, 2013.

Article 43

Implementation of the agreement

(1) the Federal and State rules necessary for the implementation of this agreement include retroactively with in force January 1, 2013.

(2) the Contracting Parties agree to provide also the following related to the transformation of this agreement provisions: 1 ordered is a member of I no. 101/2007, decorated Federal Health Commission with the KAKuG Act, Federal Law Gazette so long to be implemented on the basis of this Agreement Federal Health Commissioner, another Member is appointed to for this.

2. decisions of the Federal Health Commission established this amendment to KAKuG and derived rights and liabilities remain upright, unless it decides otherwise on the basis of this agreement to set Federal Health Commission or federal target control Commission.

3. on a recourse of the federal health agency/country health fund against members of the Federal Health Committee/national health platforms and members of the federal target control Commission/country destination control commissions the services employees Liability Act is (BGBl. No. 80/1965 i.d.F. Federal Law Gazette No. 169/1983) apply mutatis mutandis.

Article 44

Period of validity, expiry

(1) this Agreement indefinitely. The parties waive their right to terminate the agreement until 31 December 2014.

(2) after December 31, 2014, this agreement may be terminated by the Federal Government or at least six countries at the end of the year in compliance with a nine-month period of notice.

(3) the agreement shall cease to be force if the agreement in accordance with article 15a B-VG on the Organization and financing of health care without succession arrangement accepted by the Federal Government and the laender override occurs 1 or 2 enters the agreement in accordance with article 15a B-VG between the Federal, the State and communities about an Austrian SGP 2012 without succession arrangement accepted by the Federal Government and the laender override.

(4) the agreement partners undertake to open negotiations about adapting this agreement to revised EU legislation in time, with the aim of a timely entry into force of the amended agreement and any complementary federal and national regulations.

Article 45

The Federal Ministry of health has messages immediately to inform the parties, once all notices under article 42 have arrived.

Article 46

Original of this agreement is issued in a single original. The original is deposited with the Ministry of health. This has to transmit certified copies of the agreement to all Contracting Parties.

 

The agreement entered into force in accordance with article 42 with 1 January 2013.

Faymann