Overview

• The cabinet-approved adjustments shift the statutory insurers’ share of the €50 billion Transformation Fund to the federal “Infrastructure and Climate Neutrality” special fund, with the federal government also providing €1 billion annually to states for the first four years.
• States may grant smaller hospitals three-year exemptions from strict staffing and quality thresholds to preserve local access, and the package allows more inter-clinic cooperation and trims performance groups from 65 to 61.
• Core goals remain stronger specialization and concentrating complex procedures in certified centers, with Health Minister Nina Warken acknowledging fewer hospitals, mergers and closures and warning some patients will travel farther for specialized care.
• Key financing instruments, including standby payments, new surcharges and funding contributions, will start one year later than planned.
• Statutory insurers GKV and AOK criticized loosened standards as a threat to uniform patient safety, the hospital federation warned of waitlists and restricted services, and the bill still requires Bundestag approval.