Hybrid-DRGs drive up German healthcare costs

The introduction of Hybrid-DRGs, a system of flat-rate payments designed to shift medical treatments from inpatient to outpatient settings, has led to a significant increase in costs for German statutory health insurance (GKV).

An analysis by the Scientific Institute of the AOK (WIdO) reveals that in 2025, the number of treated cases rose by 17 percent, resulting in an inflation-adjusted expenditure increase of 14 percent. This equates to approximately 360 million euros in additional costs. The growth was particularly pronounced among contracted physicians, where case numbers jumped by 65 percent, from 219,000 to 363,000 cases.

In contrast, hospital-based cases saw a more moderate increase of 6 percent. For the first quarter of 2026, the WIdO reported a 5 percent increase in volume and a 7 percent rise in spending, totaling roughly 160 million euros. The institute predicts that total additional expenditures for 2026 could reach approximately 640 million euros.

AOK Chairwoman Carola Reimann has criticized the current implementation, suggesting that while the policy goals are well-intentioned, the execution has led to unintended financial consequences.