Beginning in 2025, the German Federal Ministry of Health plans to change the compensation for hybrid-DRG cases without overnight stays, aligning them with the Einheitlicher Bewertungsmaßstab to cut statutory health insurance expenditures by 235 million euros in 2027, aerzteblatt.de reported.
Shifting One-Day Cases to Outpatient Scales
The Federal Ministry of Health expects to achieve savings of 235 million euros in 2027 by altering how hybrid diagnostic-related groups are billed. A ministry spokesperson explained to aerzteblatt.de that this fiscal adjustment primarily stems from reducing the compensation for single-day procedures down to the level of the Einheitlicher Bewertungsmaßstab, commonly known as the EBM.
Hybrid-DRGs originally launched at the start of 2024. The framework aimed to incentivize the shift of medical treatments and surgeries into outpatient settings by ensuring hospitals and outpatient practices received identical reimbursement rates for specific procedures. Yet, the financial reality diverged from initial projections.
Outpatient Surgery Growth Conflicts with Incomplete Data
Data regarding the actual extent of outpatient migration under the hybrid-DRG system remains incomplete. The statutory evaluation report is not due until December 31, 2026. Prior tracking shows that contract-physician outpatient surgeries grew by 7.5 percent between 2023 and 2025. Hospital outpatient procedures rose by 22 percent during the same window, though that figure includes many treatments previously classified under standard inpatient DRGs.
At the same time, conflicting financial analyses have defined the debate. The Ministry of Health pointed to an evaluation by the Wissenschaftliches Institut der AOK, which calculated that hybrid-DRGs generated approximately 360 million euros in extra expenditures for statutory health insurance funds in 2025, rather than producing savings.
Phasing Out Hybrid Frameworks for Short-Term Bundles
The restructuring will not stop with the EBM alignment. The ministry intends to abolish hybrid-DRGs entirely by 2028, replacing them with newly designed short-term case flat rates. These incoming flat rates are slated to cover suitable patient groups and inpatient treatments lasting up to three calendar days with a maximum of two overnight stays.
The legal framework for these short-term rates was established through the GKV-Beitragsstabilisierungsgesetz in July. Exact savings figures remain undetermined because self-administration partners must still finalize the precise calculation agreements.
Health Ministry Projects Billion Euro Savings by 2030
Annual adjustments and developments are scheduled to follow their implementation.
Looking ahead to 2030, the health ministry projects that shortening the average length of stay for an estimated five million potentially affected statutory insurance cases could yield roughly 1.0 billion euros in reduced expenditures.
Opposition and Support Across the Healthcare Sector
The planned rollback and structural overhaul have triggered friction among medical associations. The German Medical Association characterized the policy shift as ambulatory care moving in reverse gear. Meanwhile, the Federation of German Specialists anticipates an increase in hospital overnight stays to the detriment of patients, alongside substantial additional costs for the statutory insurance system. Conversely, health insurance funds have voiced their support for the measures.
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