Conversion fund for clinics to be set up

 A multi-billion support fund for the reorganization of the clinic network in Germany is taking shape. A series of projects aimed at concentrating capacities and increasing specialization will be eligible for funding, according to a draft regulation from the Federal Ministry of Health. Department head Karl Lauterbach (SPD) told the German Press Agency: "We are now investing a lot of money in the necessary restructuring." In the long term, however, this will save costs and significantly improve treatment outcomes, particularly for cancer.

Fund of up to 25 billion euros

The "transformation fund" is part of a major hospital reform that was agreed after the coalition government's traffic light coalition agreement. Up to 25 billion euros are to be made available from 2026 to 2035 to support the transformation, provided that the federal states contribute the same amount to the projects. The money is to come from the statutory health insurance funds and – in line with their share of treatments – also from private health insurance companies.

The fund is to be set up at the Federal Office for Social Security. The ordinance is intended to more precisely regulate the conditions under which projects can receive support. Lauterbach said the reform must start now. "Many hospitals, even very good ones, will only survive if applications for transformation can be submitted as early as the summer." The regulation should therefore now be submitted to the Bundesrat as quickly as possible. It still requires the approval of the chamber of federal states.

Support also for certain closures

According to the draft, the restructuring of hospital locations and the formation of regional alliances to reduce duplicate structures, among other things, should be eligible for funding. Money should also be available for the development of networks for telemedicine and centers for rare and complex diseases. Hospital closures should also be eligible for funding, particularly in areas with a high density of clinics – but not if a closure would significantly worsen the care of the population.

According to the draft, the decisive factor should be "that existing structures are not predominantly preserved". Therefore, investments that would be required anyway for the renovation of buildings or the replacement of outdated and worn-out equipment will not be eligible for funding. "Rather, the project must serve to improve hospital structures as a whole." Furthermore, the projects must be new and their implementation must begin after July 1.

The federal states should be able to submit funding applications to the Federal Office for Social Security, which manages the fund, via an online portal. The ministry explained that the authority plans to publish monthly updates on the internet to make changes and the funding process more transparent.

The Federal Council cleared the way for the controversial hospital reform in November. It is now to be implemented in stages by 2029. The network of 1,700 hospitals is likely to become smaller as a result.

Reform aims to ease pressure from rising case numbers

The goal is to ease the financial pressure on hospitals. To this end, the reimbursement system is to be changed with flat rates for treatment cases, and a large portion paid just for providing certain services. The basis for financing by the health insurance funds is to be new "service groups". They are intended to describe hospital treatments more precisely and to enforce uniform quality standards, for example with regard to personnel or treatment experience.

Many hospitals have been struggling with financial difficulties, unoccupied beds and staff shortages for some time. The federal states and the hospital industry had therefore called for interim financing until the reform was fully in place.

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