German health insurance data usage and prevention

Under the Health Data Usage Act, which has been in effect since March 2024, German statutory health insurance companies are permitted to analyze billing data to identify individual health risks without explicit consent. This analysis utilizes diagnoses, treatments, and medications to detect issues such as rare diseases, cancer, and potential needs for long-term care. If a risk is identified, insurers must inform the member in writing and recommend medical consultation.

While the GKV-Spitzenverband reports that approximately 1.5 million people have been targeted for individual care through these methods, a survey by Forsa for the Federation of German Consumer Organisations revealed that 71 percent of statutory insured individuals are unaware of this regulation.

Building on these capabilities, the Betriebskrankenkassen (BKK) have launched specific screening initiatives. One program focuses on identifying allergy risks in children and adolescents, noting that one-third of participants in a large-scale screening showed risk factors. Another pilot project, ‘Mein Nierenkompass’, employs machine learning to detect chronic kidney disease earlier. This project uses a prognosis model to identify high-risk individuals, providing them with further diagnostics and lifestyle counseling to prevent the progression to dialysis.