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Model projects of a regional budget or a model project according to § 64b SGB V have been for more than 18 years. The structural, economic, and therapeutic long-term effects are described in this paper. The model project in the Steinburg district (Schleswig-Holstein) describes the developments between 2002 (index year) and 2020 that have developed through the regional budget. The article describes the situation and its specific changes in the first german model region. There is no comparable control group. In the observed period, the

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