DFSI analysis challenges German health insurance merger plans

An analysis by the Deutsches Finanz-Service Institut (DFSI) suggests that mandatory mergers of statutory health insurance funds in Germany may not resolve administrative cost issues. The study of 44 health insurance providers for 2025 found no reliable correlation between the size of a fund and its net administrative costs per insured person.

While Federal Health Minister Carsten Linnemann has advocated for reducing the number of health insurance funds from 93 to a maximum of 20, the DFSI data indicates that larger scale does not automatically equate to lower costs. For instance, among funds with over one million members, average costs were 181.78 euros per insured person, whereas the Techniker Krankenkasse reported costs of 107.63 euros.

The findings are supported by the Health Finance Commission of the Federal Ministry of Health, which also found no clear empirical link between fund size and administrative spending. The commission noted that in Austria, administrative expenses increased significantly following the merger of regional health insurance funds between 2020 and 2024.