AOK warns of rising statutory health insurance costs

The AOK Federal Association is calling for legislative improvements following a decision by the expanded assessment committee regarding the future reimbursement of Hybrid-DRGs (sector-independent flat rates). Dr. Carola Reimann, Chairwoman of the AOK Federal Association, warned that the current decision will not resolve the rising costs within statutory health insurance (GKV).

The committee's decision applies a very minor reduction in reimbursement rates and excludes a large portion of Hybrid-DRGs from these cuts. According to the AOK Scientific Institute (WIdO), the introduction of Hybrid-DRGs led to additional expenditures of approximately 360 million euros for statutory health insurance in 2025 alone.

Reimann noted that by excluding many services from price reductions, the incentives for ambulantization are actually decreased. This maintains high prices that place a financial burden on contributors. The AOK is urging lawmakers to refine regulations to ensure the legal goal of reducing reimbursement levels to the Unified Assessment Standard (EBM) by 2030 can be met.