Mit dem morbiditätsorientierten Risikostrukturausgleich (Morbi-RSA) wurde 2009 der Finanzausgleich zwischen den Krankenkassen auf völlig neue Füße gestellt. Erstmals gab es aus dem Gesundheitsfonds auch Geld auf der Basis von Durchschnittsausgaben für Krankheiten. Schnell zeigte sich die Anfälligkeit des neuen Ausgleichssystems für Manipulationen vor allem bei den ambulanten ärztlichen Diagnosen.
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