Following an Institute for Quality and Efficiency in Healthcare evaluation that found a relationship between the quality of care of very premature babies and a hospital's volume of neonatal cases, the German Federal Joint Committee ruled that hospitals will only get reimbursed for neonatal intensive care if they care for more than 30 babies a year weighing less than 2.76 pounds each. The ruling by the committee—which is the organizational body that sets policy for and regulates sickness funds and providers—has since been lifted temporarily to allow for more discussion.
The committee's ruling, which was scheduled in go into effect on January 1, 2011, would limit the care of very low-birthweight babies to 70 German hospitals. This decision to restrict care to a smaller network of neonatal centers was welcomed by parents' groups, neonatologists, and health insurance companies. The German Medical Association and the German Hospital Association opposed the ruling, arguing that extra travel time could put premature babies and mothers at risk, and that hospitals might change admission practices in order to reach the yearly threshold. After the ruling, several German states allotted special allowances to 14 hospitals that fell below the threshold.
The Joint Committee temporarily lifted the ban on small hospitals on December 16, 2010. To date, a final decision is pending.
Sources:
http://www.bmj.com/content/341/bmj.c6881.full (subscription required)
http://www.bmj.com/content/342/bmj.d156.full (subscription required