Congress Overview

More than 200 experts from politics, the healthcare industry, and clinical practice discussed, among other things, the NRW hospital planning, the federal healthcare reform, requirements for civil protection and defense capability, as well as the opportunities of increased outpatient care through the Hospital Reform Adjustment Act (KHAG). The congress was again chaired by Dr. Nils Brüggemann (Chairman of the Board of the Franziskus Foundation), Dr. Christian Heitmann (Partner and Head of Management Consulting at Curacon), and Prof. Dr. Peter Wigge (Specialist Lawyer for Medical Law).

GKV Savings Plans: Cost Containment vs. Security of Care

On the opening day, planned savings measures in statutory health insurance (GKV) were the focus—and thus the politically sensitive fundamental question of how contribution rate stability can be achieved without undermining the hospitals' ability to provide care.

The Chairman of the German Hospital Association (DKG), Dr. Gerald Gaß, warned of immediate consequences for the economic stability of many hospitals. "With this austerity law, you are depriving hospitals of their livelihood. Turn back and let us talk about measures to increase efficiency that benefit everyone. Comprehensive and high-quality hospital care must not be put at risk. And also take responsibility where you as the federal government are obliged to ensure fair refinancing for citizens receiving basic income," said Gaß.

Prof. Dr. Gregor Thüsing, member of the Health Finance Commission of the Federal Minister of Health, countered and emphasized the pressure to act on the financing side of the GKV. "Everyone agrees: bold legislative steps are needed to prevent an unchecked increase in contributions to statutory health insurance. This can only succeed if all areas contribute. The Health Finance Commission has made socially balanced proposals. Most of these have been taken up by politicians. The initiative must not be talked to death in the legislative process. System responsibility must come before client politics!" said Thüsing.

The debate thus revealed a conflict of objectives that shapes reform communication: the GKV is to be relieved, while at the same time expectations are rising that hospitals remain locally accessible, quality-assured, and capable around the clock. For clinics, this means: savings requirements do not meet an "oversupply," but often structures already working under staff shortages, investment backlogs, and high standby costs.

NRW Hospital Planning: Service Mandate Instead of Bed Logic

A second focus was hospital planning in North Rhine-Westphalia. The state was described as a pioneer; full implementation is planned for January 1, 2026. In Münster, there was discussion about whether this approach holds up under the strained financial conditions of the GKV—and which elements could be transferred to other federal states. Flexibility and regional networking were highlighted as particular strengths.

The core of the NRW planning is that control is increasingly based on service groups and thus on the question of which treatments a hospital should permanently offer, at what quality, and with what staffing and technical equipment. This is where the political dynamite lies: service groups are not just a planning tool, but a filter for future care mandates and thus for revenues, cooperation, and concentration processes. Where service groups are bundled, specialization and quality requirements arise—at the same time, the pressure grows in affected regions to organize transitions, consider emergency routes, and expand outpatient alternatives.

Whether NRW will actually become a nationwide model remained open. However, it became clear: other states are watching to see how robust this system is in practice—especially when federal laws are simultaneously changing financing and the division of labor between outpatient and inpatient care.

Federal Reform and KHAG: Outpatient Care as a Structural and Business Model Issue

The federal healthcare reform was described as having an immediate impact on hospital operators—in metropolitan areas as well as in rural regions. The perspective of health insurers, who increasingly link cost pressure and quality requirements, also flowed into the discussion.

Particular attention was paid to the Hospital Reform Adjustment Act (KHAG), which is intended to quickly implement the hospital reform. The goals cited were increased outpatient care and cooperative structures between hospitals and office-based physicians to secure service groups (Federal Ministry of Health).

For hospitals, outpatient care is less an abstract guiding principle than a business and organizational adjustment: services that can be safely provided outside of inpatient stays are to be increasingly shifted to outpatient or cross-sector settings. This changes personnel planning, OR and bed management, revenue logic, and interfaces—and it shifts risks. Clinics must make processes more efficient without simply "eliminating" standby capacity for emergencies and complex cases. In Münster, the question was therefore also raised as to whether KHVVG and KHAG actually enable concentration, better division of labor, cooperation, and an exit from inpatient volume dynamics—or whether new friction losses arise between sectors.

Mergers, Alliances, and Crisis Preparedness: Management Tasks Instead of State of Emergency

Economic pressure and upcoming state planning are driving merger and alliance efforts in Germany. In Münster, this was not treated as a marginal topic, but as a concrete management field—including best-practice examples of mergers and viable alliance structures.

The panel on post-merger processes focused on practice after the signature: what holds a hospital alliance together when IT, culture, medical strategy, and personnel issues have to be brought together? Clear objectives, transparent communication, and the involvement of all stakeholders were cited as decisive. The discussion made it clear that consolidation is not just a financing issue, but an organizational project with risks for care, employees, and regional acceptance.

In addition, a topic that was long considered a specialist debate visibly gained weight: crisis preparedness. In view of an increasingly real threat of war, civil protection and defense capability in the healthcare sector are moving more into focus. In Münster, the requirements that the Bundeswehr, states, and politicians place on hospitals in the event of defense, and what organizational and structural preparations are already necessary today, were examined. As a concrete example, a new construction project for a crisis-resilient hospital in Husum was presented, which is based on an experimental clause from the state of Schleswig-Holstein.

NRW as a Stress Test for the Reform Promise

The "Managing Healthcare Economy" congress has been held in Münster for more than ten years and is considered an established platform for supraregional exchange. This year, one message in particular crystallized there: the hospital sector is to manage several restructurings at the same time—under increasingly tight financial constraints.

Whether this succeeds will not be decided by laws alone, but by implementation on the ground: by the allocation of service groups, by functioning cooperation between outpatient and inpatient care, by viable alliances—and by whether reforms reliably stabilize care instead of overstretching it in a transitional phase. NRW thus becomes a test case that will show how resilient the reform promise is in everyday life.