Analyses

In November 2023, the government presented a comprehensive healthcare reform package for the period 2024–2028. Under the slogan “digital before outpatient before inpatient”, the reform aims to establish a primary entry point (without gatekeeping) to the health system via the expansion of digital services, further alleviating the strain on the inpatient sector by strengthening ambulatory settings.

Through the reform a total of EUR 14 billion will be available for the health and long-term care sectors. This is the result of long financial equalization negotiations between the federal government, federal states, municipalities and the sickness funds (negotiations usually take place over the course of five years according to the Financial Equalization Act). As a result, the federal states as well as the sickness funds have agreed to take on new tasks as well as implement and support reforms. The main points of the reform can be summarized as follows:

1. Expansion and strengthening of digital health services (EUR 51 million per year)
• Connection of the existing health hotline 1450 to an appointment service centre
• Strengthening ehealth services as first, non-binding contact, points (for example, video consultations)
• Obligation of all ambulatory providers (including private doctors) to use electronic health records (ELGA) and to code diagnosis
• A platform for the secondary use of healthcare data
2. Strengthening the ambulatory sector (EUR 300 million per year)
• Hundreds of additional positions for contracted physicians in ambulatory and especially in primary care are planned. This is now possible, in part, because the Austrian Medical Chamber’s former veto power in determining and creating new positions for physicians has been revoked, and because the Regional Structural Plans for Healthcare will become binding and replace negotiations with the Austrian Medical Chamber on the number of new positions created.
• An overdue standardization of the contract¹ between SHI funds and the Medical Association will ensue. This initiative will address the persistent regional differences within the same insurance framework thereby ensuring equitable and standardized provisions across the country.
3. Structural reforms in hospitals (EUR 600 million per year)
• Hospitals will undergo structural reforms and receive more funding specifically earmarked for the expansion of day clinics and specialized outpatient hospital departments with the aim to build stronger networks of specialized care and supra-regional structures as well as offer more care possibilities for rural areas.
4. Improving medicine supply (EUR 3 million per year) and vaccination programme (EUR 90 million)
• The use of new, costly drugs will no longer be part of bilateral negotiations between individual hospital operators and the pharmaceutical industry. Rather, these will be reviewed by an independent evaluation board that will provide recommendations based on objective and scientific criteria.
• The implementation of a comprehensive, publicly funded vaccination programme emphasizing collaboration as opposed to fragmented responsibilities and isolated solutions will be implemented.
5. Nursing and Long-Term Care (EUR 1.7 billion per year)
• For the implementation of the care and long-term care reform, adopted in 2022 (link), an additional EUR 1.7 billion were secured during negotiations designated for long-term care.
6. Health Promotion and Prevention (EUR 60 million per year)
• An additional EUR 60 million per year will go into health promotion and prevention programmes, in particular early childhood interventions programme such as “Frühe Hilfen” for pregnant women and young parents, which will be rolled out across the country.