With the Hospital Care Improvement Act (Krankenhausversorgungsverbesserungsgesetz, see policy analysis “The Hospital Care Improvement Act came into force on 1 January 2025” from 31 January 2025), a so-called transformation fund with €50 billion for hospitals has been introduced. Between 2026 and 2035, hospitals can apply for investment funding to support structural reforms and adapt to the changes initiated by the Hospital Care Improvement Act.
On 21 March 2025, the Federal Assembly of Germany’s 16 federal states adopted the Regulation on the Administration of the Transformation Fund in the Hospital Sector (Krankenhaustransformationsfonds-Verordnung). The regulation defines which types of projects are eligible for funding, including [1, 2]:
- Concentration of acute inpatient care capacities
- Restructuring of an existing hospital site into an intersectoral care facility (a hospital combining basic inpatient care, short-term nursing care, and outpatient physician care)
- Development of telemedical networks
- Establishment of centres for the treatment of rare, complex, or serious diseases
- Formation of regional hospital networks
- Creation of integrated emergency centres (combining inpatient emergency rooms and outpatient emergency practices; see country update “Establishment of Integrated Emergency Centres as part of an emergency care reform” from 30 October 2024)
- Closure of hospitals or departments
- Expansion of additional training capacities for health professionals
The fund will be jointly financed by the federal states and the sickness funds on a 50/50 basis.