Styria as Pilot Region for Specialist Medical Centers from 2030

Kornhäusl addressed the offer directly to federal policymakers: "I am very concretely offering that we become the pilot region for the specialist medical centers". The concepts are on the table and well advanced. At the same time, he expects the promised funding to hold – "also in the next financial equalization scheme". The specialist medical centers are to bundle several medical disciplines under one roof and thereby strengthen outpatient care in the regions.

Cross-Border Cooperation

Parallel to the major projects, Styrian health policy is working on concrete cooperations. In October, a cross-state collaboration between the hospitals of Schladming (Styria) and Schwarzach (Salzburg) in the area of obstetric care is set to begin. In Schladming, fewer than 100 births per year are now recorded, Kornhäusl explained as the reason for the restructuring. He considers it "inexplicable why one would still maintain that there". Nevertheless, a midwife support point is to remain in Schladming. The costs for Styria in this cooperation amount to around one million euros.

A cooperation with Upper Austria around the locations of Bad Ischl and Bad Aussee has already been running since April. According to information from Kornhäusl's office, this is the first direct financing agreement between two Austrian federal states. The costs for Styria are just under 3.8 million euros. KAGES chairman Gerhard Stark explained regarding the step: "But we didn't do this because we wanted to save money, but because we wanted to improve quality". At the Bad Aussee location, "there had not even been 500 operations recently".

Primary Care and Statutory Health Insurance Care

Styria is also pressing ahead with its plans for primary care units (PVEs). So far, the state and the Austrian Health Insurance Fund (ÖGK) have jointly created 26 PVEs; by 2030 this is to rise to 40, with 30 being the next milestone. Strategic partners such as Diakonie and Barmherzige Brüder are involved in the locations. Regarding the expansion of contractual physician posts, Kornhäusl sees the biggest challenge: "What comes up most frequently on my desk is the problem of unfilled contractual physician posts".

How great the pressure is, is shown by the example of Deutschlandsberg. Because no contractual pediatric specialists were available in the district, KAGES established a pediatric outpatient clinic at the regional hospital. This offers specialist medical services paid for by the ÖGK, it was said. Cooperations for statutory health insurance care have also been developed with Hartberg, Rottenmann, and Liezen. Kornhäusl summarizes his strategy in the sentence: "Cooperate rather than compete".

Service Development Since 2017

Politically, the health councillor presents himself as conciliatory. "Fear is not a care concept. Those who try to freeze locations endanger them; those who develop them further secure them à la longue," he said with a view to resistance against hospital reforms. The question of blame for why something is not going well is "the worst of all questions". "The only question is: Who is working with whom" – and what comes out of it.

That reforms work is evidenced by the latest performance figures. Since 2017, Styria has recorded a 70 percent increase in day-clinic services, 40 percent in the outpatient sector, and around 20 percent fewer fully inpatient patients. This shift toward outpatient and day-clinic care is what the RSG aims to structurally reflect through the specialist medical centers and PVEs. Kornhäusl considers Styria well positioned for this – provided the federal government and the states pull together on financing.

Whether Styria actually becomes a pilot region now depends on the response of federal policymakers. Kornhäusl has made the offer, the RSG provides the basis, the reform partnership provides the framework. What remains is the question of whether Vienna will commit the corresponding funds for the next financial equalization scheme.

Schladming, Bad Aussee, Deutschlandsberg – the examples show that care in rural areas can be secured even when contractual physician posts are lacking or birth numbers are declining. The specialist medical centers are to systematize this approach while at the same time shortening the journeys for patients. Kornhäusl considers Styria particularly suitable as a "pilot region" for this – as the first model area for a form of care that bundles several disciplines, prioritizes cooperation over competition, and does not cement locations but develops them further.