Students from Osnabrück University of Applied Sciences visiting the VKD stand. Front right: Professor Dr Julia Oswald – recently awarded Professor of the Year in the Economics/Law category by the UNICUM Foundation – alongside Dr Jens-Uwe Schreck.
Warken: Insurer Deficits Will Continue to Rise – With Consequences Extending Beyond Hospitals
“A Fresh Start for Hospital Policy – The Courage to Change” was the guiding theme of the 48th German Hospital Congress, which concluded yesterday in Düsseldorf. Given the current pressures facing the system, many participants likely interpreted the motto quite differently from its original intention. From 17 to 20 November, hospital professionals from all disciplines discussed the issues most critical to them – challenges that have grown significantly more acute in recent months.
As in previous years, the Congress took place alongside MEDICA, the world’s largest medical trade fair, and COMPAMED, its specialist supplier event. This proximity offered hospital representatives first-hand insight into emerging research, new technologies, and industry developments, while enabling direct engagement with exhibitors.
VKD Sets Out Clear Warnings on Hospital Finances and the KHAG
For the Verband der Krankenhausdirektoren Deutschlands (VKD) – the Association of German Hospital Directors – the four days provided repeated opportunities to articulate their position on the state of hospitals, the ongoing hospital reform, and the Krankenhausreform-Anpassungsgesetz (KHAG) – the Hospital Reform Adjustment Act. VKD President Dirk Köcher addressed both the financial situation and its direct consequences for patient care, warning during the opening press conference and the subsequent panel discussion that service security is at risk.
Dr Gerald Gaß, Congress President and Chair of the Deutsche Krankenhausgesellschaft (DKG) – the German Hospital Federation – used his opening keynote, delivered in the presence of Federal Health Minister Nina Warken, to set out hospitals’ concerns, criticisms and demands. Drawing on the current Hospital Index of the Deutsches Krankenhausinstitut (DKI) – the German Hospital Institute – he illustrated the likely impact of the worsening economic situation on patients. At the time of the survey, the latest austerity proposal had not yet emerged, and expectations still rested on €4 billion in promised relief from the immediate transformation fund. Even so, one third of hospitals anticipated staff cuts or service reductions, and 17% foresaw delays to elective operations or temporary ward closures.
Minister Warken Defends Savings – No Indication of Further Concessions
Minister Warken later attempted to justify decisions such as the required hospital contribution to stabilise statutory health insurance finances. She pointed to improvements in the KHAG and declared both the reform law and the adjustment act to be fundamentally sound.
Her remarks indicated no intention to revise the flawed standby funding (Vorhaltefinanzierung) mechanism, which fails to achieve its stated purpose, nor the Hybrid-DRGs, which effectively force the outpatient shift of services traditionally provided on an inpatient basis, resulting in significant revenue losses for hospitals. Whether Parliament will manage to secure any meaningful amendments is uncertain.
Regarding the €1.8 billion in savings imposed on hospitals to shore up insurer finances, Warken suggested this would not be the final round. Further cost reductions – likely in the double-digit billions – are expected next year, though not solely in the hospital sector. The overarching objective is to stabilise 2026 insurance contribution rates, which she argued is essential to safeguard Germany’s economic trajectory amid rising social expenditures.
VKD President Köcher had already emphasised that hospital leaders found it incomprehensible why, despite their fragile financial state, hospitals were being asked to carry the heaviest burden.
Pressure on Municipal Hospitals – and Local Budgets
North Rhine-Westphalia’s Health Minister Karl-Josef Laumann expressed some understanding, noting that he also serves as State Minister for Labour. The NRW government will decide today whether to support Thuringia’s request to refer the savings package to the Mediation Committee.
VKD President Köcher illustrated the impact on municipal hospitals: missing funds will need to be covered by local authorities. Of the €1.8 billion shortfall, municipalities would have to absorb more than one third – around €600 million in 2026 – diverting resources from other essential public responsibilities. He also warned that not-for-profit hospitals, which do not benefit from municipal backing, will face even greater pressure. The overall impression was that warnings from practice are not resonating sufficiently within political decision-making.
Nursing and Medical Leadership Highlight Risks to Care Quality
Dr Sabine Berninger, Chair of the Deutscher Berufsverband für Pflegeberufe (DBfK) Südost – the German Professional Association for Nursing Professions, Southeast – warned that the new financing system, with standby remuneration as an additional pillar, will not meaningfully simplify the situation. She stressed that professional nursing care and nursing quality are not luxuries but the foundation of safe patient care. Nursing, she argued, “must be rethought”.
PD Dr Michael A. Weber, President of the Verband leitender Krankenhausärztinnen und -ärzte (VLK) – the Association of Senior Hospital Physicians – noted that the KHAG draft falls far short of necessary improvements. He criticised the complete lack of clarity around medical training and continuing education within a rapidly transforming hospital environment.
Day Two Focus: Artificial Intelligence and Crisis Resilience
The second day of the Congress centred on two strategically important topics: Artificial Intelligence (AI) and crisis resilience.
PD Dr Weber, introducing the AI discussion, described it as a potential “game-changer”, while questioning how much oversight will be needed and the degree to which AI will genuinely reduce clinical workload.
PD Dr Peter Bobbert, Board Member of the Marburger Bund, cautioned against adhering to outdated professional roles. AI, he argued, is likely to transform medicine fundamentally and disrupt routine medical practice.
Introducing the topic of resilience, VKD President Köcher highlighted the substantial backlog of investment, even for basic refurbishments, suggesting that a federal infrastructure programme may be necessary. Past crises have shown hospitals can react flexibly, he said, but the question remains whether this will be enough for future emergencies. In a defence or alliance scenario, hospitals must be prepared to treat 1,000 casualties per day, including 250 severely injured. Currently, hospitals treat around 85 severely injured patients daily.
Strong Engagement at the VKD Stand
VKD Managing Director Dr Jens-Uwe Schreck reported exceptionally strong engagement at the VKD stand near the Congress venues. He, Anke Kraft, and honorary member Peter Förster with Christine Förster welcomed almost 190 visitors across the four days. Delegates included VKD members, partner associations, industry representatives, international guests, and a large group of students from the Health Business Management programme at Osnabrück University of Applied Sciences. Visitors exchanged views, discussed current challenges, and learned about VKD positions, publications and forthcoming initiatives.
MEDICA 2025: Strong International Presence and Positive Momentum
MEDICA and COMPAMED once again proved to be reliable platforms for high-quality professional exchange. According to Messe Düsseldorf, three-quarters of the 78,000 trade visitors belonged to the top management of their organisations. 75% of attendees came from 160 countries, including international buyer delegations from the Gulf States, Africa and the United Kingdom.
More than 5,300 exhibitors from 70 nations showcased the full spectrum of solutions for modern inpatient and outpatient care, including a wide array of high-tech supplier innovations.
“With numerous programmatic changes and our new guiding theme ‘Meet Health. Future. People.’, this year’s MEDICA marks the starting point of a change process that reflects the transformation of the international healthcare sector and underscores our ambition to actively shape this shift with forward-looking concepts. We will continue on this path with further innovations in 2026,” said Marius Berlemann, Managing Director of Messe Düsseldorf.
Original Press Release: This is a translated version of the original German press release. To view the original text, Click Here (German).
Image Credit: VKD
