Social insurance funds collectively negotiate with regional Medical Chambers and other health professions regarding health care provision in the areas of ambulatory (or outpatient) and rehabilitative care and pharmaceuticals. Efforts were made over a number of years to achieve more joint planning, governance and financing by bringing together the federal and regional levels and coordinating these with social insurance funds. The 2013 health reform was an important step in this direction, introducing a federal and nine regional commissions on health system governance involving all relevant actors (see Section S.3).