Overview

• Nearly 80% of German hospitals are operating in the red, with total deficits exceeding €14 billion, according to the German Hospital Association.
• The reform aims to improve care quality and reduce economic pressures but lacks transitional funding until full implementation in 2027, leading to unplanned closures.
• Small, rural hospitals with fewer than 300 beds are particularly vulnerable, with many reporting pessimistic outlooks and increasing closures.
• Critics, including hospital leaders and unions, cite excessive bureaucracy and inflation-related cost pressures as exacerbating the crisis.
• The reforms, approved in November, include a shift toward specialization and fewer hospital locations but have sparked concerns over reduced local healthcare access and longer patient wait times.