Care in Germany is becoming more and more expensive. By 2050, annual spending could almost triple – from around 110 to 305 billion euros. This emerges from the new study “Nursing finances under pressure” by the management consultancy Deloitte, which is available to Handelsblatt. The consultants expect 145 billion euros as early as 2030 and 208 billion euros in 2040. Rising wages and prices are also included in the forecast.
But the authors also see opportunities to slow the rise in costs. In the best case scenario, artificial intelligence (AI), robotics and better preparedness could reduce expected spending by a quarter in 2050. That would correspond to around 76 billion euros per year. However, Deloitte sometimes relies on technologies that are not yet fully developed. And even then, care would cost around 229 billion euros in 2050.
How much could be saved depends on which technologies become established and how much they change everyday care. Deloitte has calculated three scenarios for this. If care facilities and outpatient services make greater use of existing technology, spending could be three percent lower in 2050. If Germany also adopts successful approaches from other countries, the figure could be eleven percent.
To achieve savings of 25 percent, technologies that are not yet fully developed would have to be used. These include AI systems that complete tasks independently and robots that can be used for various tasks. Some of these machines are still in development. But even in the most far-reaching scenario, according to Deloitte, the savings are not enough to stabilize long-term care finances.
Some applications already exist today. Sensors can detect falls or indicate changes in health. This could help older people live independently at home for longer. AI can support nurses in writing reports and planning trips for outpatient services. Robots can take on heavy transport or help with lifting and repositioning.
“Financial stabilization could be successful, but the financial problems of care as a whole remain,” says Gregor-Konstantin Elbel, health expert and partner at Deloitte. The rising costs then placed a particular burden on those in need of care and municipalities.
In the best scenario, ten percentage points of the possible savings come from precautions and digital aids. AI and less administrative work should bring another five percentage points, and robotics and other digital technologies should bring ten percentage points.
This could also have financial consequences for those in need of care. In this scenario, your average annual contribution for inpatient care in 2050 would be around 47,900 euros. According to Deloitte, without additional technology effects it would be around 66,500 euros.
Nursing scientist Michael Isfort from the German Institute for Applied Nursing Research does not consider savings of this magnitude to be fundamentally out of the question. “I don’t think it’s completely made out of thin air,” he tells the Handelsblatt. Nursing staff could save time, especially when it comes to documentation and route planning. However, whether this would also make it possible to save personnel is “the huge question”. In nursing homes, employees increasingly cared for people with dementia or at the end of life. They would need a lot of personal attention.
Isfort doubts that robots can replace nursing staff. “There are neither the sensors nor the haptics nor the mobility to specifically replace nursing staff,” he says. Deloitte also assumes that the technology will primarily relieve the burden on employees and limit the need for additional personnel.
Added to this are the costs. Many institutions can hardly afford digital aids today, says Isfort. If they passed the expenses on to the residents, care for them would initially become more expensive. He is therefore calling for government funding.
Christine Vogler, President of the German Nursing Council, sees another problem. Many digital systems lacked common interfaces and uniform standards for care data. Therefore they could not communicate with each other. “They can create additional documentation and bureaucracy rather than ease the burden of care,” she warns. Financing and data protection issues have not yet been clarified.
The Deloitte study shows what such help can look like using examples from abroad. In the Belgian region of Wallonia, around 120 apartments were initially equipped with digital assistance systems in 2023. Sensors are supposed to detect changes in everyday life and trigger an alarm if necessary. The region planned to deploy 15,000 devices by 2026. Japan uses robots, among other things, to support nursing staff with physically demanding tasks.
How much money Germany could save in this way remains to be seen. The care systems differ. In addition, not every hour of work saved leads to lower expenses. Nursing staff can also use the time gained for care. Deloitte takes this into account in its calculations for AI and administrative work and only counts half of the assumed time savings as additional staff capacity.
Meanwhile, cost pressure in the care system continues to grow. At the end of 2025, around six million people in Germany were in need of care. According to Deloitte, there could be more than eight million by 2040 if the proportion of those in need of care within the respective age groups remains the same. Depending on how the need for care develops, the number could be around a million higher or lower.
The study also examines how the planned care reform could affect financing. If the draft of the Care Reorganization Act (PNOG) approved by the Federal Cabinet in September is not continued permanently after 2030, annual spending on social care insurance could rise to around 184 billion euros by 2050. If the reform applies in the long term, it would be around 165 billion euros, according to Handelsblatt calculations based on Deloitte figures.
In order to cover the expenses, a calculated contribution rate of 4.0 percent would be necessary in 2050 if the reform is permanent. Without the reform it would be 4.5 percent. The values cannot be directly compared with today's statutory contribution rates. The general contribution rate is currently 3.6 percent, and for those without children it is 4.2 percent.
The reform would also not make care 19 billion euros cheaper. Rather, the costs are shifting: nursing care insurance would have to pay less, while private households, non-profit organizations and social assistance would have to pay more.
For its technology scenarios, Deloitte assumes that the reform applies in the long term. But even if AI and robotics bring the hoped-for savings, care costs will continue to rise. The consultants therefore believe additional reforms are necessary.
