Timelines for submission of suggestions for DRG change in Switzerland

In December 2023, the Swiss parliament adopted the uniform financing of outpatient and inpatient services (EFAS). Currently, inpatient benefits are financed jointly by health insurers and the cantons, whereas outpatient services are entirely funded by the insured. The EFAS will come into force in January 2028 and bring a uniform way of financing inpatient and outpatient services; the healthcare system is expected to be integrated into this system four years later.

On January 3, 2024, the entity managing the DRG system in Switzerland, SwissDRG, announced that they will be accepting applications for changes in the DRG system from June 3, 2024, until July 15, 2024. The results of the DRG applications made in 2024 will be reflected in the 2026 version of SwissDRG.

In mid-November, the Federal Office of Public Health released an overview of the Swiss HTA program in a presentation “Bridging the Gap: How to Align HTA and Health Care Decision Making in Switzerland”.

On November 29, 2023, the Swiss Federal Office of Public Health published the changes that will occur to the Services Ordinance (KLV/OPre), which determines coverage of medical services in Switzerland. The updates will enter into force on January 1 or July 1, 2024, and they relate to the list of explicitly evaluated services (Annex 1 of KLV/OPre), outpatient-before-hospital services (Annex 1a), List of Tools and Equipment (Annex 2), and List of Analyses (Annex 3).

On November 22, 2023, the Swiss Federal Council approved the digital transformation program in the healthcare system to accelerate the implementation of the Swiss health data space. To implement the program over ten years (2025 – 2034), the Federal Council is applying to Parliament for a commitment loan of 392 million francs.