Changes in the areas of health and long-term care in 2026
Important steps have been taken in 2025 to ensure good and universal healthcare. We will continue steadfastly on this path in 2026! The Federal Ministry of Health wishes you a healthy new year!
Since the Federal Government took office, important steps have been taken to futureproof our healthcare system, and we will continue to implement these steps consistently in 2026. The challenges could scarcely be greater, but they offer an opportunity to create structures for good and affordable healthcare and to double down on our promise of solidarity.
With the Transformation Fund, we are launching a very important mechanism to finance the structural changes in hospitals. A total of up to 50 billion euros will be available for this purpose over the next ten years, of which the Federal Government will cover 29 billion euros. This sends a strong signal to the people in our country that we are taking responsibility for modern and universal health coverage.
With the aim of sustainable financial stabilisation while maintaining good and universal healthcare, both pillars of the welfare state that fall within my remit are facing the biggest reforms in recent decades. The technical basis for the reform of long-term care has been developed by the Working Group of the Federal Government and the Laender. Meanwhile, the Health Finance Commission will present its proposals for the statutory health insurance system at the end of March, and these will be incorporated directly into the legislation. For both reforms, the clear goal is to achieve effectiveness as early as 2027.
The reform of pharmacy and emergency care is intended to strengthen the structures in the healthcare system and use them more efficiently in order to ensure continued universal access to healthcare going forward. The participation process for the planned primary care system will be initiated in January. Digitalisation will be a key component in all of these structural changes, and we are currently preparing a comprehensive legislative package to drive this development.
Regarding the specific changes:
Hospital reform
Launch of the Hospital Transformation Fund
The funding from the Hospital Transformation Fund will be made available from 1 January 2026. A total of up to 50 billion euros will be provided up until 2035 for the modernisation of hospital structures.
Digitalisation
Electronic patient file (ePA)
From 1 January, software systems must be in use that have received confirmation of conformity for use of the ePA and are therefore “ePA-ready”. Doctors who use systems that are not ePA-ready will no longer be able to bill their services (section 372 (3) of the Fifth Book of the German Social Code (SGB V)). In order to avoid cases of hardship, the National Association of Statutory Health Insurance Physicians can address such cases in an interpretative guideline. If a service provider has failed to provide proof of the ePA update during the 4th quarter, the lump sum paid for upgrading their telematics infrastructure (‘TI-Pauschale’) will be reduced.
Long-term care
Broader powers
Professional caregivers will be authorised to exercise their own responsibility in the practise of medicine, meaning that – within a certain framework – they can carry out tasks previously reserved for doctors. The services that can be provided in this way will be set out in contracts by the system of self-administration. On the basis of the changes to the law, the self-administration can conduct the contractual negotiations from 1 January 2026.
In the future, long-term care professional organisations are to be involved more closely in important decisions in the field of health and long-term care. Therefore, the participation of such organisations is regulated in a uniform manner in section 118a SGB XI-E.
Comprehensive measures to reduce bureaucracy
In order to conduct quality audits without disruption and at the same time ensure good long-term care, the Medical Service (Medizinischer Dienst, MD) will announce its audits earlier in future.
As has already been introduced for fully residential long-term care, audit intervals will be increased from one to two years for outpatient long-term care services and semi-residential long-term care facilities that are found to have a high level of quality in the quality audit.
The scope of the long-term care documentation is limited by law to the amount necessary. In addition, this principle will be explicitly enshrined in law for quality audits.
Prevention counselling
Access to preventive services for persons in need of long-term care who are cared for by friends or relatives and/or a long-term care service at home will be improved by means of targeted prevention counselling and by allowing professional caregivers to recommend a specific measure.
Implementation of the innovative “Joint pilot projects for assistance measures and structures for persons in need of long-term care in their home environment and in the local community” will be extended until the end of 2029 at no additional cost by transferring funding not used in the calendar year 2028 into 2029.
Cooperation project to make it easier to apply for benefits and services
Applications and forms for long-term care benefits and services are to be simplified. To this end, a cooperation body is being set up at the Central Federal Association of Statutory Long-Term Care Insurance Funds.
Promoting shared-living arrangements
In order to promote long-term care in innovative shared-living arrangements, new regulations will be incorporated into contract law, law relating to benefits and services and quality assurance law for long-term care insurance. This will create attractive and legally secure options for operators that allow them to map out outpatient long-term care in a variety of new forms of living. In addition, it will provide a safe space in which inpatient service providers can try out pilot projects to make their service provision more flexible.
Training
Preparing care assistant training that is standardised across Germany
Care assistant training that is standardised across Germany is set to start in 2027. Significant parts of the legislation therefore only enter into force as of 1 January 2027.
In order to be able to prepare for the start of training, however, certain regulations already had to enter into force on the day after the announcement as of 1 November 2025. These include:
- Powers to issue ordinances on the Training and Examination Ordinance (Ausbildungs- und Prüfungsverordnung – PflAPrV) and the Financing Ordinance (Finanzierungs-verordnung – PflAFinV) as well as
- Regulations for the development of a framework curriculum and a framework training plan.
- In order to prepare for the start of training, funding must also be secured. The regulations on financing in particular will therefore already enter into force as of 1 January 2026.
Supply of medicinal products
Standard contractual clauses for clinical trials
With the entry into force of the Standard Contractual Clauses Ordinance (Standardvertragsklauselverordnung – StandVKlV) on 18 December 2025, standard contractual clauses have been set out on the rights and obligations of the sponsor and the trial site in the conduct of a clinical trial. This should help to shorten the contractual negotiations between sponsors and trial sites prior to a clinical trial so that they can start more quickly overall.
Establishment of a coordination centre for BfArM and PEI
In order to harmonise the processes between the Federal Institute for Drugs and Medical Devices (BfArM) and the Paul Ehrlich Institute (PEI) and to improve cooperation, a coordinating agency will be set up at BfArM. It will respond to the ongoing development of innovative medicinal products and combination therapies as well as demands from industry to improve the administrative and technical cooperation between the higher federal authorities PEI and BfArM without affecting their independence.