SBK Reform and Stability Package: Strengthening Patient Orientation, Securing Contributions

15.09.2025 18:17

The parliamentary summer recess in Berlin ended on September 8th. Now, the groundwork is being laid for urgently needed healthcare reforms. The SBK Siemens company health insurance fund has compiled eight concrete proposals for stabilizing and further developing healthcare in Germany.

It combines acute relief measures with long-term structural reforms for patient-oriented and future-proof care.

„The statutory health insurance system (GKV) is facing massive challenges: rising expenditures, structural imbalances, and only mediocre quality of care,“ explains Dr. Gertrud Demmler, board member of SBK Siemens-Betriebskrankenkasse. „The coalition agreement stipulates that a commission of experts and social partners will develop proposals for the financial and structural reform of the GKV by 2027. A loan is intended to provide support until then. But that is not enough: insured individuals and employers cannot wait that long. The loan doesn't even begin to cover the cost increases. The federal government must therefore intervene immediately: we need a return to a reliable, revenue-oriented spending policy.“

Short-term financial stabilization measures

The SBK therefore calls for a return to a revenue-oriented spending policy. The GKV has already published a concrete proposal to this effect and demanded that Section 71 of the German Social Code, Book V (SGB V) be reinstated. The specifics of this demand for the most important spending areas are as follows:

Drug supply

In 2023, the manufacturer's discount for pharmaceuticals was increased to relieve the financial burden on the health fund. However, the resulting savings of €1.3 billion were lost again from 2024 onwards due to political reasons. If this measure were revisited and further developed – for example, by increasing the manufacturer's discount for patented drugs – it would be beneficial.
Reducing the cost of medications from 7 to 17 percent would save around €2 billion per year (calculation based on SBK figures).

Hospital care

Since 2020, health insurance funds have covered 100% of nursing care costs in hospitals. As a result, expenditures in this area have risen significantly faster than in others. This change alone accounted for approximately €2.5 billion in 2023. With the full refinancing of collectively agreed wages by statutory health insurance, decided in December 2024, expenditures will increase by a further €1.5 billion. Therefore, above-average cost increases are expected to continue in the future. The SBK (Swiss Association of Statutory Health Insurance Physicians) is therefore calling for the dynamics of expenditures to be linked to the basic wage rate again and for collectively agreed wage refinancing mechanisms to be fundamentally limited once more.

Contract physicians

In addition to general price increases, office-based physicians have received further surcharges in recent years. Special bonuses for appointment referrals and the abolition of budget constraints alone have resulted in additional expenditures of approximately €1.5 billion. This demonstrates the importance of proactive planning to ensure stable costs. Such regulations are not sustainable in the long term. The practice of creating new sources of funding must be stopped immediately.

Other healthcare professions

Last year, SBK's expenditures for services provided by additional healthcare professionals rose significantly faster than general price increases and the wages and salaries of those with statutory health insurance. Had the level of expenditure remained in line with general societal developments, savings of approximately €2 billion could have been achieved across the entire statutory health insurance system. To prevent such overspending in the future, SBK is calling for a consistent return to linking basic wages to health insurance contributions. However, a fair, revenue-oriented spending policy also requires the state to fulfill its payment obligations to the insured community.

Federal government's payment obligation

The federal government has sensibly transferred the administration of healthcare for recipients of basic income support to the statutory health insurance funds. However, the resulting non-insurance-related services are currently only partially reimbursed by the federal government, leaving those with statutory health insurance to bear the remaining costs. The SBK (Social Insurance Fund for the Self-Employed) is calling for this practice to be rectified and for the statutory health insurance system to receive the necessary funding.
to provide approximately €10 billion per year.

These first five measures will temporarily stabilize the financial situation of the statutory health insurance system and create room to initiate fundamental changes.

Long-term structural reforms: Patient orientation at the center

Beyond short-term stabilization, a genuine fundamental reform is needed. The SBK demands:

Creating the conditions for genuine patient-centered care

• Care pathways that effectively link analog and digital services and guide patients in choosing the right option significantly relieve the burden on the system. Especially at the beginning of the "patient journey," digital services such as symptom checkers or video consultations can be the first point of contact, thus conserving the limited time resources of doctors and practice staff, as many issues can be resolved without a physical visit.
• Patient-centered care pathways also mean well-organized co-treatment by specialists or in inpatient facilities. This includes coordinated appointment scheduling that ensures urgent matters are prioritized and prevents unnecessary examinations. It also means ending discriminatory practices regarding access to specialist appointments and inpatient care.
• „"Quantity over quality" must no longer be the motto. Currently, our system often rewards those who bill for a large number of services, regardless of whether the result is higher quality care. The crucial question, however, is: Does the treatment help people? To find out, transparency regarding services and care provision must be enshrined in law as a fundamental principle for all stakeholders in the system. Patient feedback must also be integrated as a standard practice (a learning system).

Facilitating care support

• Immediate access to supply data and seamless communication options (e.g. e-prescription) between all actors involved in the supply.
• Replace the existing confusion of individual consents for (health insurance) advice and data use with a general objection solution.

Using data effectively

• Establish real-time data exchange (in the ePA) as a standard.
• Establish digital processes and the "once-and-only" principle as the standard for administrative processes.
• International standards ensure data quality and enable networking within the European healthcare area.
• Increase acceptance of the ePA through a self-reliant and tiered security concept.

With its reform and stability package, the SBK delivers eight key proposals that will reduce the contribution rate while simultaneously setting the course for sustainable healthcare.

About SBK

SBK Siemens-Betriebskrankenkasse is the largest company health insurance fund in Germany and one of the 20 largest statutory health insurance funds. As an open, nationwide health insurance fund, it insures more than one million people and serves over 100,000 corporate clients in Germany – with around 1,800 employees in 80 SBK branches.

For over 100 years, SBK has been personally and actively committed to representing the interests of its members. It positions itself as a pioneer for genuine quality competition within the statutory health insurance system. From SBK's perspective, this requires greater transparency for its members – regarding relevant financial indicators, but also concerning the commitment, advice, and service quality of health insurance funds. Furthermore, in the best interests of its members, SBK combines the best of both the personal and digital worlds and actively drives digitalization in the healthcare sector.