As part of the hospital reform, the Hessian Ministry of Health decided in a first step which clinic in the state is likely to be able to offer which treatments. The ministry said there were no changes in the number of emergency locations and no changes in obstetrics or pediatric and adolescent medicine.
“People can continue to rely on receiving medical help quickly in an emergency,” explained Health Minister Diana Stolz (CDU) in Wiesbaden. At the same time, the quality of planned interventions by specialists will be increased. “As a result, for the majority of Hessian hospitals, there are only minimal changes apart from the expansion or concentration on certain service groups, i.e. the definition of medical priorities.”
The clinics will now receive their provisional allocations digitally, and the list will then be made available to everyone online, the ministry added. The hospitals can comment on this list at a hearing. Final allocation is scheduled for December. By 2027 it will be clear which medical treatments can be carried out where.
What does the hospital reform regulate?
The reform pushed through by the traffic light coalition at the end of 2024 against protests is intended to reduce financial pressure for more and more treatment cases and bring about more specialization in complicated procedures. The then minister Karl Lauterbach (SPD) even spoke of a “revolution”. The central instrument is newly defined “service groups” for treatments with uniform specifications for equipment and specialists. Only clinics that meet them can offer the service group and bill the statutory health insurance companies. This is intended to ensure that cancer surgeries, for example, are carried out in clinics with specialist knowledge.
How did the new list of Hessian hospitals come about?
The Hessian Ministry of Health has assessed and approved around 1,800 applications from hospitals according to the nationwide service groups and after examination by the Hesse Medical Service. A separate application had to be submitted for each desired service group for each individual hospital location - regardless of whether the service had already been provided there.
“It’s about ensuring that treatment is provided where the necessary conditions, experience and quality for the treatment are available,” explained Stolz. At the same time, reliable basic and emergency care remains of central importance in all regions - from Bad Karlshafen as the northernmost to Neckarsteinach as the southernmost municipality in Hesse.
On what basis is hospital planning carried out?
Needs-based hospital planning must take into account how many treatments are likely to be needed in the future, as the ministry explained. The need for care is determined according to a uniform procedure and defined in the 260-page Hessian hospital plan. Developments that change future treatment needs were also taken into account - in particular demographic change and the increasing shift of previously inpatient treatment to the outpatient area.
The state then compares the forecast demand with the hospitals’ verified offerings. This makes it clear for each performance group whether supply and demand match.
What are the effects of specialization?
“Greater specialization and concentration in highly complex treatments is important,” explains the Ministry of Health. A hospital that performs complex procedures more frequently has greater medical experience and greater routine. The specialization ensures greater patient safety.
Examples for specific patient groups:
Pancreatic procedures (pancreatic procedures): 23 hospitals in Hesse currently offer these highly complex operations. In the future, the same service will be provided nationwide by 15 specialized and most suitable hospitals.
Ovarian cancer (ovarian carcinoma) has so far been treated by 28 different clinics. In the future this will be taken over by 15.
Artificial knee joint (endoprosthetics): 66 hospitals in Hesse currently offer operations. In the future, 50 clinics should be able to offer this.
Breast cancer (senology): The implementation of the hospital reform provides for a specialization from 29 to 24 breast cancer clinics.
