Schon während der Verhandlungen um die Reform des 2009 eingeführten morbiditätsorientierten Risikostrukturausgleichs (Morbi-RSA) zwischen den Krankenkassen hatten die Ortskrankenkassen immer wieder darauf hingewiesen, dass sie mehr vulnerable Patienten als andere Kassenarten haben und dass ihnen deshalb zu Recht höhere Zuweisungen aus dem Ausgleich zustünden als den Ersatz-, Betriebs- und Innungskassen.
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