Case study: Healthy Kinzigtal, Germany

Healthy Kinzigtal (Gesundes Kinzigtal) is a comprehensive population-based integrated programme that aims to improve the experience of care for people with chronic diseases and reduce costs.

Case study: Healthy Kinzigtal, Germany

What does the programme involve?

Healthy Kinzigtal includes fragility fracture prevention as part of a wider programme delivering chronic disease care through multidisciplinary teams. The teams collaborate with non-medical services such as gyms and workplace health providers to support people with chronic diseases in self-management through close collaboration with their chosen ‘physician of trust’. Regular ‘geronto-pharmaceutical consultations’ support physicians in managing the complex needs of people with multiple conditions, including those with osteoporosis.

Healthy Kinzigtal applies an innovative payment model to incentivise the delivery of best-practice care. In addition to fee-for-service payments, physicians are reimbursed for services providing additional value such as physical training in long-term care settings to prevent falls. Service providers also receive a share of the company’s revenue.

What has the programme achieved?

Initial assessments suggest that this programme is effective in improving osteoporosis care:1

  • The number of people who experienced fragility fractures has been 10% lower than among those who received routine care.
  • The project has been able to improve patient satisfaction and demonstrate cost savings each year, with savings of US$38.2 million between 2007 and 2014.

What lessons can be learnt from this programme?

The programme highlights the impact of a wide cross-sectoral partnership on fragility fracture prevention and cost savings. It presents a feasible and cost-effective approach to provide tailored care for people with chronic conditions, including osteoporosis, while improving patient outcomes and satisfaction.


The information in this case study is based on research conducted for the 2020 publication Osteoporosis and fragility fractures: a policy toolkit.
Date of preparation: October 2020.
References +
  1. Pimperl A, Hildebrandt H, Groene O, et al. 2017. Case Study: Gesundes Kinzigtal, Germany – Accountable Care in Practice: Global Perspectives. Durham: Duke University