Hospital financing and hospital planning
Since 2012, stays in Swiss hospitals have been reimbursed via diagnosis-related flat rates (DRG flat rates per case), based on the rates charged by efficient hospitals. Private and public providers must be treated equally. And to encourage competition, patients may choose any hospital in Switzerland that features on the official lists. In the long term, efficient providers that maintain high quality levels should win out.
The cantons are responsible for hospital planning, which must be geared to demand and coordinated in a way that prevents unnecessary treatment and lowers costs. However, in practice, cantons frequently fail to look beyond their own borders when drawing up their plans. This leads to surplus capacities and distorted competition. Many cantons tend to favour their own hospitals instead of implementing overarching plans that make sense in terms of healthcare policy. The cantons' multiple role as operator, supervisory and licensing body exacerbates this problem. Better regional hospital planning is required to resolve conflicts of interest.
The Federal Council harmonised the planning requirements for hospitals and nursing homes as of 1 January 2022 in order to boost quality and reduce costs. The relevant ordinance requires uniform assessments of economic efficiency and quality to be performed at institutions throughout Switzerland, and encourages greater coordination between the cantons. To prevent unnecessary volume growth, hospitals included on cantonal hospital lists may no longer pay volume-related bonuses. CSS generally welcomes these adjustments as they can help make cantonal procedures more precise and more standardised. They can also contribute to a concentration of the services on offer. Health insurance associations have had the right to appeal against hospital-planning decisions in the cantons since 1 January 2024. CSS also welcomes this. Moreover, the Council of States is sending the motion (25.3017 Strengthening hospital planning by means of intercantonal hospital lists) back to the National Council and is asking the Federal Council to amend the KVG in such a way that the cantons, in addition to their current obligation to coordinate their hospital planning with that of other cantons, will now also have to coordinate and jointly award performance mandates within catchment regions. If the cantons fail in their duties, the Federal government should be permitted to intervene on a subsidiary basis, as is already the case with highly specialised medicine.
Your health partner
As a health partner, we are committed to leading a healthy life, actively taking steps to regain one's health and developing a mindful approach to illness.
