Up to €50 billion is available through 2035 to restructure the hospital landscape. Yet many hospital providers do not have a clear understanding of what is specifically eligible for funding, how the process works and how tight the deadlines actually are.
The Hospital Transformation Fund (KHTF) makes funding of up to €50 billion available to hospital providers over the period from 2026 to 2035, financed in equal shares by the Federal Government and the federal states. This amounts arithmetically to around €5 billion per year. Unlike the former Hospital Future Fund, its focus is not only on digitalisation in the narrower sense, but specifically on structural reform, specialisation and professional synergies in line with hospital reform. Despite this volume, practice shows that many providers know neither their own funding opportunities nor the deadlines that are decisive for submitting applications.
What is generally eligible for funding
Eligibility is governed by eight statutory funding categories, including the cross-site concentration of acute inpatient capacity, the establishment of cross-sector care facilities and the creation of telemedicine network structures, including robot-assisted remote surgery. Explicitly ineligible, by contrast, are projects that primarily serve to preserve existing structures, projects started before 1 July 2025, and measures already funded elsewhere or where, in the event of the provider’s impending insolvency, there is no prospect of economic sustainability.
How the process actually works
A central, often underestimated point is that hospital providers cannot apply directly to the Federal Government. The procedure has two stages. First, providers notify their requirements to the responsible state ministry, in some cases through an informal expression of interest that does not yet constitute a binding application. Only when the federal state classifies a project as eligible for funding and prioritises it does it submit the formal application through an electronic administrative portal to the Federal Office for Social Security (BAS).
- Applications by the federal states for a funding year must generally be submitted to the BAS by 30 September of the preceding year, with a limited extension until 31 December under certain conditions.
- Federal funding is allocated among the federal states according to the Königsteiner key – North Rhine-Westphalia, for example, can arithmetically expect around one fifth of the annual volume, with smaller states receiving correspondingly less.
- State-specific deadlines, forms and points of contact sometimes differ considerably; an approach that works in one federal state cannot automatically be transferred to another.
- For several funding categories, approval also depends on the allocation of service groups, whose nationwide completion is only expected by the end of 2026.
Why many providers miss out on funding
In practice, recurring obstacles emerge: projects are notified too late or without the required cost breakdown, the distinction from project components already funded elsewhere remains unclear, or procurement-law requirements for the use of funds are only considered at a late stage. Since the federal states independently assess eligibility in individual cases, the quality of the application documents often determines whether a project that is eligible in principle is actually considered.
How we support you
We support hospital providers from classifying a project within the appropriate funding categories, through compiling the application documents, to coordinating with the responsible state authorities. The aim is to identify funding opportunities early, actively manage deadlines and prepare applications so that they stand up to the federal states’ assessment process. Contact us if you would like to clarify which projects at your site are generally eligible for funding and which steps now make sense.
Conclusion: Funding is not unlocked automatically
The Transformation Fund offers a historically large funding volume for restructuring the hospital landscape. Whether a hospital benefits from it, however, does not depend on the volume of the fund, but on how early and systematically its own funding needs are identified, justified and submitted to the responsible federal state.