Hospital Reform 2026: Status and What Patients Can Expect

The hospital reform in Germany has taken a significant legal step with the Hospital Reform Adjustment Act (Krankenhausreformanpassungsgesetz, KHAG). For patients, the key question is how care in local hospitals changes and what that means for treatment and co-payments.

The Key Points at a Glance

• The Bundestag passed the KHAG on 6 March 2026.
• The Bundesrat approved it in its second passage on 27 March 2026.
• According to the BMG law page, the act enters into force on 15 April 2026.
• Hospital planning is the responsibility of the federal states. The regional planning shows what arrives in your area.
• How much you pay yourself in hospital is covered in the article on hospital co-payments (in German).

What Did the Bundestag Decide on 6 March 2026?

The KHAG is a law that adjusts the hospital reform. According to the ministry’s law page, the first reading in the Bundestag took place on 12 November 2025, and the first passage in the Bundesrat on 21 November 2025. The second and third readings in the Bundestag followed on 6 March 2026, and the second passage in the Bundesrat on 27 March 2026.

When Does the New Law Apply?

The stages of the procedure can be taken from the ministry’s law page. The table lists the dates in the order of the procedure.

The page does not give a separate promulgation date. If you need the exact wording, the Federal Law Gazette (Bundesgesetzblatt) holds the authoritative version.

What Does This Mean for Patients?

The law is aimed primarily at hospitals, the federal states and health insurers. Patients therefore notice changes mainly where treatments are concentrated or where responsibilities shift between sites. Whether your hospital still offers a particular procedure, you will learn from the hospital itself or from the regional planning authority.

What Are Service Groups?

A central element of the hospital reform is service groups (Leistungsgruppen), that is, groups of medical services to which hospitals are assigned. For patients, this matters when you want to know whether a hospital may offer a specific treatment. The federal states decide when and where this assignment takes effect. We cover the details of this concept in a separate article (in German).

Which Hospital Is Right for My Treatment?

There is no general answer, because it depends on the diagnosis, how urgent the treatment is and what the hospital offers. For planned procedures, it is worth asking about experience and the range of services. In an emergency, other rules apply, and the emergency department is the relevant point of contact.

What You Can Do as a Patient

1. Read the law text if you want to know which rule applies.
2. For a planned treatment, ask about the hospital’s service range and experience.
3. For a planned procedure, get a second opinion if the procedure provides for one.
4. For questions about regional planning, contact the state ministry of health responsible.

How to Compare Hospitals

A comparison is most useful for planned treatments. Hospitals publish information about their services, and you can set these details side by side. A fixed order helps you avoid deciding only on the impression of a single visit.

• Service range: Is exactly the treatment you need offered, and at which site?
• Quality reports: Hospitals publish reports on quality and treatment numbers that are publicly accessible.
• Accessibility: How long does it take to reach the hospital, and what does aftercare look like locally?
• Questions for the medical team: How often is the procedure carried out in this hospital, and what alternatives exist?

In the end, the decision rests on the treatment you discuss with your doctor. A hospital is not automatically the right one just because it is close to home. For larger procedures, it is worth discussing these details with your family doctor, who knows the course of your care.

Emergency Department or Hospital: Where to Go With Acute Symptoms?

The reform changes structures, but the question in an acute case stays the same: which is the right point of contact? For life-threatening symptoms, the emergency number 112 is the right route. For non-life-threatening symptoms outside surgery hours, the medical on-call service can be reached on 116117. An overview of the differences is in the article When to call 112 and when 116117.

The emergency department of a hospital is meant for emergencies. Anyone who turns up there without a pressing reason must expect longer waiting times and may take up capacity needed by people with acute symptoms. If you are unsure, a first telephone assessment via 116117 is a sensible first step before you set off.

What Patients Should Know About Hospital Payments

Co-payments are due in hospital, and their amount follows the Social Code Book V (SGB V). The details on amounts and exemptions are in the article on hospital co-payments, which is available in German.

Frequently Asked Questions

Does the KHAG already apply?

Yes. According to the ministry’s law page, the act enters into force on 15 April 2026. How it affects daily care depends on how the federal states and hospitals implement the requirements.

Where can I find information about my hospital?

The hospital provides information about its service range on its website and on request. For regional planning, the state ministry of health responsible is the right authority.

Do I have to pay more in hospital?

Co-payments in hospital are due, and their amount follows the Social Code Book V. The details on amount and exemptions are in the linked article on hospital co-payments (in German). Before a planned stay, it is worth checking with your health insurer which documents are needed for admission and for the cost coverage.

Is the reform an improvement for patients?

That is a political assessment. Supporters and critics see different consequences, for example for hospitals in rural regions. If you want to follow the debate, the positions of the associations are set out in their statements on the law.

What to Do Now

1. Check the wording in the Federal Law Gazette or on the ministry’s law page.
2. When a treatment is planned, ask about service range and experience.
3. For a planned procedure, get a second opinion if the procedure allows it.
4. For questions about regional planning, contact the state ministry of health responsible.

Related Articles

• Health system reform: all topics at a glance (hub, in German)
• Pharmacy reform 2026: what changes for patients
• Second opinion before surgery from 2027: entitlement and process
• Hospital co-payment 2027: what a stay costs patients
• Integrated emergency centres: what lies behind them

Sources: Hospital Reform Adjustment Act (KHAG), law page of the Federal Ministry of Health (status as stated on the page, in German).

Last updated: November 2026. This guide is general information, not individual advice.