Caterna | Updates

By Michael Scherrer

Caterna acquires the 19th health insurance partner

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Dear Companists,

Great news: BKK24 is the 19th health insurance company to cover the costs of the Caterna therapy and the costs of medical therapy support for its members.

 

Complexity of the health system

Statutory health insurance companies may only cover the costs for treatments that are not standard benefits in very specific cases. These cases are defined in the Social Security Code. One of these cases is integrated care contracts (selective contracts). There are precise regulatory requirements for these contracts and the negotiation process for such a contract is long and arduous. For this reason, not many startups have concluded such contracts in the primary healthcare market yet.

With the Caterna therapy, we were not only pioneers with the first selective contract (first "App on prescription") but are still at the forefront of reimbursement for "Serious Health" products with more than 19 health insurance company partners. This is great because it allows parents not to pay for the Caterna therapy themselves. The physician is reimbursed EUR 145 for accompanying the therapy within the scope of these contracts. This looks very easy at first glance, of course, but it is not as simple, which the following example of our new BKK24 health insurance company shows.

BKK24 is a medium-sized one of the approximately 120 German health insurance companies. It is an public health insurance company operating nationwide. BKK24 was created through the voluntary association of the company health insurances Nürnberger BKK (2003), BKK Nienburger Glas (2002), BKK Heye (1999) and BKK Svedala (1999). Most recently, it merged with BKK advita on 1 October 2017. (Source: Wikipedia https://de.wikipedia.org/wiki/BKK24). BKK24 has approx. 130,000 members.

 

Caterna - Reimbursement

 

Patient potential

If one assumes that the number of children insured by the BKK24 reflects the percentage of the total population, the BKK24 should cover approximately 11,000 children between the ages of 4 and 12 as members. Based on a prevalence of amblyopia of 6%, 660 children insured by the BKK24 alone would be affected by amblyopia.

In order to leverage this great potential, the parents of these 660 children now need to be informed that their health insurance company will cover the costs of the Caterna therapy. Of course, one avenue is the BKK24's website or customer magazine, but we have found that our target group does not regularly read customer magazines.

If we look at the overall picture, you can see that we have now signed selective contracts with 19 health insurance companies. These 19 insurances cover 21% of all 72 million legally insured persons. Considering this as a whole, there are 14.8 million people insured with companies with whom we have a contract. Statistically, 1.25 million of these are children between the ages of 4 and 12. An amblyopia prevalence of 6% results in a potential of 74,739 amblyopic children who are insured by one of the health insurance companies that reimburse the Caterna therapy.

 

Caterna - Patient potential

 

Unfortunately, the problem is that health insurance companies only advertise Caterna to their members very moderately. Most parents of these 74,739 children probably do not even know that they will be reimbursed for the Caterna therapy.

Using online marketing tools is our chance to target parents whose children suffer from amblyopia and are insured with BKK24. This is the goal of our Companisto campaign. Help us to provide these children access to the Caterna therapy.

 

Best greetings,

Michael Scherrer



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