Health policy: CSS's position

Quality, transparency, cost targets and appropriate tariff structures: we are keen to play a part in shaping the future of healthcare in these and other areas. After all, as a health insurer, we have responsibility for the issues that concern the people who pay our premiums.

The CSS Group’s position on health policy issues

This page gives you an overview of where the CSS Group stands on current health policy matters. As a leading health insurer, CSS Insurance also aims to contribute to advancing the Swiss healthcare system with its “im dialog” publication.

Health policy CSS's position

Supervision by FINMA

The Swiss Financial Market Supervisory Authority (FINMA) is responsible for supervising the providers of supplementary insurance in accordance with the Insurance Contract Act (VVG). CSS calls for sensible and appropriate levels of supervision.

Single (cantonal) health insurance scheme

CSS opposes single health insurance schemes at both the national and cantonal levels.

Promoting personal responsibility

Self-responsibility is an important component of mandatory health insurance that helps stem the rising tide of healthcare costs. CSS actively supports developments that encourage people to take responsibility for their health.

Integrated care

CSS views integrated care as a key instrument in promoting quality and cost efficiency in the Swiss healthcare system.

Medication

In a highly regulated market for medication, CSS champions the introduction of market mechanisms in pricing and in the insurers' right to appeal against the prices set by the Federal Office of Public Health.

Financing of care

CSS supports a sustainable care financing arrangement, which spreads the costs between the mandatory healthcare insurance (OKP), the insured persons and the cantons.

Mandatory services/benefits (HTA)

By law, mandatory healthcare insurance only pays for those services that are effective, appropriate and economical. Health technology assessments (HTAs) guarantee a systematic review of such services. That is why CSS supports the establishment of HTAs.

Prevention

CSS recognises the considerable importance of prevention in healthcare provision. Like all other benefits under basic insurance, preventive measures covered by basic insurance should meet the criteria of effectiveness, appropriateness and cost-effectiveness.

Quality

Quality and transparency are imperative conditions for establishing sustainable competition that makes economic sense. CSS call for medical services and benefits to be disclosed transparently and subject to quality reviews.

Risk compensation

A functioning system of risk compensation is the fundamental requirement for competition that makes economic sense. CSS therefore advocates refining the risk compensation system.

Hospital planning

CSS is calling for the wording of the KVG to be amended in such a way that it would oblige the cantons to coordinate their hospital planning on the basis of a sensible number of catchment regions.

Hospital financing

CSS is calling for the wording of the KVG to be amended in such a way that it would oblige the cantons to coordinate their hospital planning on the basis of a sensible number of catchment regions.

Accreditation / steering of outpatient services

CSS welcomes a long-term approach to the recognition of outpatient service providers as a contribution to both quality and cost containment.

Tariff structures

The vast majority of medical services are provided via a variety of tariff structures (incl. TARMED, SwissDRG, LOA, Physiotherapy). CSS champions the further development of tariff structures in a manner that is fit for purpose.

TARMED revision

The revision of the tariff structure for outpatient medical services is under way. CSS champions the further development of this tariff structure in a manner that is fit for purpose.

Territoriality principle

CSS position statement on mandatory benefits under the KVG which could be provided across borders. The issue of quality is at the heart of this proposal.

Digitalisation

Position statement on technological development and the associated impact on the healthcare system.

Cost targets and cost containment measures

Per capita healthcare costs continue to rise at rates that by far outstrip the cost of living and wage growth. CSS therefore considers effective cost containment measures to be necessary.

Data protection

Data protection has been a central concern of CSS for decades. We take the most advanced security precautions to protect the sensitive data of those insured with us.

Outpatient case rates

CSS is generally in favour of flat rate compensation for individual services and procedures. However, it is essential for outpatient case rates to be calculated on the basis of outpatient data, and they must apply to the entire spectrum of outpatient service provision.

Shift from inpatient to outpatient

The great advances made in medical services in recent years means that CSS welcomes the discussion on a greater shift away from inpatient towards outpatient treatment.

Brokers’ commissions

CSS supports self-regulation within the industry as a means of promoting high quality and cost-effective advice, which is an important objective.

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«im dialog» publication

Find out more about the CSS Group’s position on health policy issues.

Read now (in German)

Any questions?