During the coronavirus pandemic, hospitals received a premium for treating COVID-19 patients in addition to the regular remuneration. The Federal Government paid €3.1 billion even though the payment did not rely on valid workload data.
COVID-19 treatment premium for hospitals not appropriate
Corona-Versorgungsaufschlag in Konkurrenz mit weiteren Unterstützungsleistungen für Krankenhäuser
In addition to other payments worth billions of euros, hospitals were granted a COVID-19 treatment premium from November 2021 to June 2022. This premium was expected to ensure hospitals’ financial security and provide incentives to treat patients. The Federal Government spent €3.1 billion to that end.
The Federal Ministry of Health (the Ministry) calculated the amount of the premium without determining the actual costs incurred by hospitals for treating COVID-19 patients. The Ministry also did not take into account to what extent revenues lost because of the pandemic had already been compensated by other public payments.
This means that hospitals could claim a premium of up to about €9,500 for each case. Hospitals received this premium in addition to the regular remuneration of the treatment and irrespective of the severity of a disease and the type and duration of the treatment. There was only one condition: Patients had tested positive for the coronavirus.
Public payments require monitoring and impact assessments
The federal states were authorised to request evidence for the care premiums claimed by the hospitals. However, they lacked binding guidelines and verification standards. This means that comprehensive national verifications conducted by the state governments responsible could not be ensured.
Public payments require impact assessments. These assessments are in particular required if there was an urgent need for action and money was deliberately paid without bureaucratic obstacles. The data required for an evaluation must be provided.
Consistently pursue hospital reform – federal states need to take more responsibility
For years, hospital care in Germany has suffered from inefficient structures and lacking specialisation. Poor investment cost funding of the federal states has contributed to this situation: The annual gap amounts to a minimum of €3 billion to €4 billion. The hospital reform which started with the Hospital Care Improvement Act therefore needs to be pursued consistently. Financial support needs to be limited to hospitals in need and must not be spread evenly across all hospitals.
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Please note: the report is only available in German.
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Corona-Versorgungsaufschlag in Konkurrenz mit weiteren Unterstützungsleistungen für Krankenhäuser PDF, 995 KB Download