Healthcare Reform 2024: Key Changes at a Glance

The 2024 healthcare reform introduces major changes to Germany’s healthcare system. It aims to improve patient care and reorganize hospital financing, with the goal of enhancing treatment quality in hospitals.

A key aspect is the introduction of base funding payments to ensure the stability of hospitals. This shift focuses on transitioning care from quantity to quality. A transformation fund of €50 billion will support this restructuring.

The reform intends to ensure that patients receive only necessary and high-quality treatments. A transparency initiative will launch in 2024 to make hospital services and quality clearer. These steps aim to make the healthcare system more efficient and patient-friendly.

Key Points of the Healthcare Reform

The 2024 healthcare reform introduces extensive changes for hospitals and patients, aiming to make medical care better and more efficient.

New Hospital Financing Models

A central component is the introduction of base funding payments, partially replacing the old per-case payments. Going forward, 60% of compensation will come from base funding payments, while per-case payments will be reduced to 40%.

This change aims to relieve financial pressure on hospitals and improve treatment quality.

Specialization of Medical Care

The reform defines 65 medical service groups to encourage specialization among hospitals. Each hospital must meet specific quality criteria to be authorized to offer services within a group.

The goal is to improve care quality by focusing on core competencies.

Transformation Fund of €50 Billion

To support the transition, the reform introduces a €50 billion transformation fund, financed over 10 years by the federal and state governments. This funding will help hospitals adapt to new structures and optimize their services.

Changes in the Hospital Landscape

The 2024 healthcare reform brings significant structural changes to hospitals across Germany. Hospitals will be categorized into three types: local basic care, standard and specialized care, and maximum care. The aim is to improve medical care everywhere and encourage specialization.

Quality Criteria for Hospitals

Hospitals must meet certain quality criteria to offer specific services. Medical services will assess compliance with these criteria, ensuring high treatment quality without excessive administrative burdens on hospitals.

Service Groups and Specialization

The reform introduces service groups based on hospital facilities. Smaller hospitals in rural areas can become healthcare centers that also offer outpatient services, strengthening medical care in these areas.

Accessibility of Hospitals

A primary goal of the reform is to ensure hospital accessibility. For internal medicine and surgery, travel time should be no more than 30 minutes. There are also additional payments for essential areas like pediatrics and emergency care to ensure comprehensive coverage.

New Hospital Compensation System

Hospital financing will change, with hospitals required to cover 60% of their costs through base funding payments. The remaining 40% will be billed through per-case payments.

This change is designed to reduce pressure on hospitals, allowing them to treat fewer patients if necessary.

Key areas like pediatrics, obstetrics, and intensive care will receive additional funding. A €50 billion transformation fund will be available over 10 years to support this transition.

The GKV-Spitzenverband criticizes the financing from the healthcare fund, calling for more state support. Private health insurers also express concerns.

Health Minister Lauterbach aims to “de-economize” the hospital sector, though many challenges remain, as about 30% of hospitals are currently unprofitable.

The reform is intended to improve care quality and strengthen hospital finances. Its implementation will be closely monitored.

Impact on Rural Care

The 2024 healthcare reform will bring significant changes, especially in rural areas. A major goal is to secure basic care in remote regions, which is challenging due to a shortage of doctors.

Securing Basic Care

To ensure rural care, so-called basic care hospitals will be established. These facilities are not required to meet high quality standards. A travel time of up to 30 minutes to the nearest hospital is considered acceptable.

It is expected that approximately 20% of hospitals will close.

Integration of Outpatient Specialist Care

Small hospitals are now allowed to offer outpatient treatments to compensate for the shortage of general practitioners. In Germany, 34% of general practitioners are over 60, meaning around 8,000 new GPs will be needed.

Cross-Sectoral Healthcare Facilities

A new approach is cross-sectoral facilities that combine inpatient and outpatient services. Pilot projects, such as in Schwarzwald-Baar-Heuberg, show this works well, with local engagement playing a key role.

Structural Changes in the Healthcare System

The 2024 healthcare reform brings substantial changes, with the introduction of 65 service groups being a central element to improve medical care and encourage hospital specialization.

Each service group has its own quality criteria, which hospitals must meet to offer specific treatments. States determine which hospitals can offer which services. This could improve treatment quality but may also result in longer travel distances for patients.

The German Hospital Association views the changes critically, expressing concerns about patient care. However, international examples show that reforms can be beneficial. In Sweden, similar steps led to better healthcare services and shorter waiting lists.

The reform also promotes digital solutions. As in Norway, digital patient records could enhance care, while artificial intelligence and innovative technologies, like in South Korea, could improve healthcare delivery.

Implementation and Timeline of the Reform

The 2024 healthcare reform will be implemented soon. A total of 373 members of parliament voted in favor of the amended bill. The reform is set to take effect on January 1, 2025.

A €50 billion transformation fund will be established to improve medical care. The reform aims to save over 20,000 life years annually.

The Federal Council plays an important role in the reform. Although the reform does not require their approval, some federal states may express concerns, particularly about the impact on rural care and financing.

North Rhine-Westphalia is seen as a model for the reform. Its hospital planning will start on January 1, 2025, aiming to ensure good basic care and easy access to hospitals.

FAQ

What are the main goals of the 2024 healthcare reform?

The reform aims to improve treatment quality and ensure everyone has access to healthcare services. It also seeks to make the system simpler and more efficient.

Another focus is redesigning hospital financing with new models.

What does the new hospital compensation system look like?

Hospitals will cover 60% of their costs through base funding payments and 40% through per-case payments. This aims to reduce pressure on hospitals and improve quality.

What is the transformation fund, and how is it financed?

The transformation fund is a €50 billion program financed over 10 years with support from the federal and state governments. The goal is to restructure the healthcare system.

How will the service groups affect the hospital landscape?

Sixty-five medical service groups will be defined. Hospitals must meet specific quality criteria to encourage specialization and improve quality.

However, this may lead to longer travel distances for patients.

How will rural healthcare be ensured?

Smaller hospitals can be converted into healthcare centers offering outpatient specialist care. Basic care hospitals will ensure that essential services are available.

When will the healthcare reform take effect, and how long will implementation take?

The reform is set to start on January 1, 2025, with implementation expected to take ten years.

What are the criticisms of the planned reform?

The GKV-Spitzenverband criticizes financing from the healthcare fund and calls for state funding. Private insurers question the constitutionality of their involvement.

Some federal states have concerns about the impact on rural healthcare and financing.

How will hospital accessibility be ensured?

The reform stipulates that hospitals with internal medicine and surgery departments should be accessible within 30 minutes, ensuring basic care across the country.