Hospital association raises alarm: One-third of clinics at risk of insolvency - Germany's hospitals face collapse as insolvency risks surge and reforms stall
Germany's hospital system is under severe financial strain, with over a third of facilities at risk of insolvency. A new report reveals that 16% face high risk, while another 21% remain vulnerable. Meanwhile, industry leaders and local authorities are pushing back against recent reform plans. The crisis deepens as 80% of hospitals now operate at a loss. Rural areas, particularly Schleswig-Holstein, Saxony-Anhalt, and Mecklenburg-Vorpommern, have seen steep declines in services—Schleswig-Holstein alone lost 61% of its maternity units since 1991. North Rhine-Westphalia has also experienced a 14.6% drop in gynaecology and obstetrics departments since 2018.
The German Hospital Association (DKG) and the German Association of Districts have issued warnings about potential collapses. DKG Chairman Gerald Gaß proposed raising daily patient co-payments from €10 to €15 to ease financial pressure. Achim Brötel, president of the districts' association, called for fixed standby payments instead of the current case-dependent reimbursement model.
At the centre of the dispute is the hospital reform, championed by former Health Minister Karl Lauterbach. The plan aims to increase medical specialisation but faces resistance from statutory health insurers, who insist on keeping the approved changes. The Bundesrat is set to vote on the reform on March 27.
Adding urgency, a state compensation payment introduced in November 2025 to stabilise hospital finances will expire this November. Without further support, more closures could follow. The financial instability threatens widespread service reductions, particularly in rural and underserved regions. With the reform vote approaching, hospitals and local authorities are demanding immediate revisions to prevent further closures. The outcome of the Bundesrat's decision will determine whether struggling facilities receive the relief they need.
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