Market Access Strategy for Medical Devices in Europe
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Bundestag adopts Hospital Reform Adjustment Act in Germany
On March 6, 2026, the German Bundestag adopted amendments to the hospital reform. The core objectives of the reform remain unchanged: consolidating services, increasing specialization, and thereby improving the quality of healthcare delivery. The adjustments primarily aim to ensure the practical implementation of the measures, with a particular focus on maintaining inpatient care, especially standard and emergency care, in rural areas.
Some of the key elements of the Hospital Reform Adjustment Act are provided below:
- Transformation Fund financing: The statutory health insurance system (GKV) will be relieved financially. Its originally planned €25 billion contribution to the Transformation Fund (2026-2035) will now be financed from the federal special fund for infrastructure and climate neutrality;
- Introduction of upfront payment/reserve financing (Vorhaltevergütung): The introduction of upfront payment/reserve financing will be postponed by one year, meaning its full financial impact will occur only from 2030;
- Definition of service groups (Leistungsgruppen): The service groups introduced by the Hospital Care Improvement Act (KHVVG) will be aligned with the 60 service groups defined in North Rhine-Westphalia (pilot federal land), with the addition of a “Special trauma care” service group;
- Hybrid DRGs: Starting in 2027, Hybrid DRGs may once again include children and people with disabilities. The exclusion introduced under the KHVVG will therefore be removed.
The full details in German can be found here and here.
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