Bundestag Adopts Amendments to Abolish Hybrid DRGs from 2028 in Germany

On October 15, 2026, the German Federal Ministry of Health (BMG) announced that the Bundestag had passed amendments to the Statutory Health Insurance (SHI) Contribution Rate Stabilization Act.

One of the key developments is the planned abolition of the Hybrid DRG reimbursement mechanism from 2028, accompanied by changes to reimbursement arrangements for outpatient and short-stay inpatient procedures starting in 2027.

The amendments establish a two-stage transition:

• From 2027: Services currently covered by Hybrid DRGs that are performed without an overnight stay will be reimbursed according to the regular outpatient physician reimbursement framework, regardless of whether they are provided by SHI-accredited physicians or hospitals. Procedures involving an overnight stay will continue to be reimbursed under the agreed Hybrid DRG tariffs.
• From 2028: The Hybrid DRG reimbursement system will be completely abolished, alongside the introduction of new short-stay case-based payments (Kurzzeitfallpauschalen) for inpatient cases.

The amendments also introduce other changes to healthcare financing and reimbursement. These include €550 million in additional annual financial support for hospitals, comprising €100 million for university hospitals and €450 million for non-university hospitals. Further changes concern the medical aids sector, Digital Health Applications (DiGA) and a potential expansion of the mandate of the Institute for Quality and Efficiency in Health Care (IQWiG), which could enable it to initiate health technology assessments independently.

What does it mean for the industry?

The planned abolition of Hybrid DRGs represents a significant change in the reimbursement framework for outpatient and short-stay inpatient procedures in Germany. Hybrid DRGs have had varying implications for medical device manufacturers, depending on the type of technology (e.g., implants versus invasive non-implantable devices), device costs, and other reimbursement-related factors.

The transition to new payment mechanisms may change reimbursement opportunities for technologies currently affected by Hybrid DRGs, including innovations previously disadvantaged by the existing framework. However, the impact will depend on the structure and reimbursement levels of the replacement mechanisms.

Manufacturers should reassess the implications for their specific products and procedures, including potential changes to reimbursement conditions, and consider whether adjustments to their market access strategies will be necessary as the new arrangements are implemented.

This news is just one of about 300 market access news and updates collected by our team in the premium subscription service MTRC Access Intelligence every week from more than 80 organizations. Access our paid service to stay on top of all developments, specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, six-week, no-obligation trial.