Transfer pricing for anaesthesia services - Chances and risks for a department of anaesthesia

Internal transfer pricing of services is a relatively new economic tool used in the hospital sector. It aims to improve economic steering of internally delivered services within a hospital. Basic principle is that all organizational units who use services of other organizational units have to pay for this service on the basis of a predefined internal billing system. The introduction of a transfer pricing system for anaesthesia services is of great importance for a department of anaesthesia since the majority of anaesthesias are performed for patients of other departments. In this article we discuss aims, principles and basic requirements of an internal transfer pricing system. Different base units for transfer pricing of anaesthesia services are described and their influence on economic steering is discussed. Using cost data from our own department we analyze to which extent a transfer pricing system can reflect real costs. The effect of a transfer pricing system on efficiency of an anaesthesia department is analysed using anaesthesia process times of within our department from the last 6 years. Other important questions regarding the introduction of a transfer pricing system for anaesthesia services, like the initial price setting and budgetary implications, are also discussed in detail. Special considerations are given to the problem of dynamic adjustment of the pricing system because of cost or structural changes.