German healthcare reimbursement reform controversy

Medical professional organizations in Germany have expressed concern regarding proposed changes to the hybrid-DRG reimbursement system scheduled for 2027.

The Association of Specialist Physicians (SpiFa) warned that the new regulations might incentivize hospitals to keep patients overnight rather than discharging them after outpatient procedures. SpiFa noted that under the proposal, services without an overnight stay would be reimbursed via the fee schedule for contract physicians, while inpatient treatments would maintain the hybrid-DRG flat rate. This shift could potentially increase costs and strain hospital resources by discouraging ambulatory care.

Following these concerns, the German Medical Association (Bundesärztekammer) also cautioned against the reforms during a Bundestag Health Committee hearing. President Dr. Klaus Reinhardt described the potential termination of hybrid diagnoses for outpatient doctors as a ‘serious mistake’ that would undermine the transition toward ambulatory care. Experts warned that reducing compensation could decouple outpatient doctors from the healthcare transformation process and create incentives for unnecessary inpatient treatments.