KHVVG · Hospital Transformation Fund

Turning funding into care

MDR Class IIa certified network infrastructure for telemedicine networks (Category 3) and university centres for complex conditions (Category 4). Application-ready and operational in weeks, not years.

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Class IIa medical device (MDR) Can be used for any indication No installation, get started right away
Executive Summary

Two funding categories, one infrastructure

One regulated platform serving telemedicine networks (Category 3) and university centres for complex conditions (Category 4). One project, two routes to funding.

Two categories, one infrastructure

One regulated platform serving telemedicine networks (Category 3) and university centres for complex conditions (Category 4). One project, two routes to funding.

Category 3 + 4on a single regulated platform

Regulated and application-ready

As a Class IIa medical device under the MDR with KIM and FHIR, myoncare meets the statutory criteria and the forthcoming ministry requirements. Operational in 8–12 weeks instead of 12–18 months.

8–12 weeksto operational readiness, instead of 12–18 months

Investment funded, operation to be financed

The one-off investment is eligible for federal and state funding; ongoing operation is not. It is carried by hospital usage fees, in time by a selective contract or a disease management programme.

85–100%of the eligible investment is carried by federal and state funds

Funding rates under § 12b KHG as amended by the KHAG: from 2026 to 2029 the federal government carries up to 70 per cent of eligible costs. The states provide co-financing of at least 30 per cent and may pass on no more than half of that to hospital operators. The hospital's own contribution therefore lies between 0 and 15 per cent and is handled differently in each state; from 2030 the combined state and operator share is at least 50 per cent. A selective contract requires an agreement with a statutory health insurer and is not a commitment.

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The moment is now

A narrow window. Those who use it well, win

The bottleneck is not capital. It is projects that are ready to apply and able to prove their effect.

from 01 Jul 2025

Cut-off date for project start

Projects that began before 1 July 2025 are excluded. For everything after that date, the quality of the project description decides.

State level

The decisive gatekeeper

Hospitals do not apply to the federal government. The states review, prioritise and file the collective application with the Federal Social Insurance Office. The state level decides.

30 Sep 2026

Nationwide minimum requirements

By this date the Federal Ministry of Health will set binding minimum requirements for telemedicine network structures. Until they exist, the Federal Social Insurance Office approves no Category 3 application, including none of the 78 already filed. Those who are prepared start the moment it opens.

For clinical decision makers

Pay once, benefit every year

A patient who is prepared, guided and followed up leaves earlier, cancels less often and returns less often. The hospital pays its share once; the effect recurs every year. What a saved bed day is worth depends on whether the bed is filled again. That is why we count additional cases, not bed days.

Length of stay, total knee replacement, DRG I43B (catalogue value)
Today8.3 days
With myoncare6.8 days

Lower length-of-stay threshold: 3 days. The model stays above it. Within the threshold range the case rate does not change, so the effect does not come from the revenue of the saved day. It comes from the additional case that moves into the freed bed. What matters is your own length of stay, not the catalogue value.

€0Contribution margin released per year with 500 elective cases in the pathway, at steady state
Phase 1 · Before admission

Informed, not cancelled

Consent, history taking and results check happen before the patient travels.

1.5 percentage points fewer cancellations
Phase 2 · Admission & surgery

A theatre list that holds

Complete records, and the schedule survives the day.

Around 11 theatre hours saved per year
Phase 3 · Inpatient

Shorter, better managed stays

Pathway control and early mobilisation. Criteria-led discharge.

1.5 bed days per case, around 750 a year
Phase 4 · After discharge

No revolving door

Monitoring and a defined escalation path. Complications stay outpatient.

1 to 2 wound infections avoided
Your model calculation
€211kContribution margin released per year
€421per case in the pathway
1.7 ×savings per euro of total cost, five years
Model calculation. Not a commitment and not a revenue promise.
Run it with your own numbersFive years, adjusted for realisation, using your own contribution rather than the total project volume.

Your hospital

Elective cases in the pathway per yeariScheduled procedures only, and only those that run through the pathway. Emergencies and conservatively treated cases are excluded.
Length of stay todayiYour own length of stay, not the catalogue value of 8.3 days. Many arthroplasty units are already below it in 2026, and what has been realised cannot be saved twice.
Hospitals in the joint projectiCategory 3 is a network project. The volume is shared across all participating hospitals, while the benefit arises in each hospital separately.

Effect on the process

Reduction in length of stayiThe documented 3.5 days come from a colorectal ERAS cohort and do not transfer to arthroplasty. The figure here applies to the full pathway programme; myoncare supplies the digital layer of it.
Contribution margin per additional caseiThe most sensitive figure in the whole calculation. Not case revenue, but the margin over variable costs. This number should come from your own controlling department.
Utilisation of the freed capacityiFreed beds are only worth something if a waiting list exists and theatre capacity can absorb the additional cases.
Additional cases agreed in the budget fromiUntil the additional volume is written into the budget agreement, excess revenue is clawed back at 65 per cent under § 4 (3) KHEntgG. Until then the calculator counts it at 35 per cent only.
Reduction in day-of-surgery cancellationsiIn the reference literature the day-of-surgery cancellation rate is 1.23 per cent, falling to 0.48 per cent with structured preoperative assessment. Values above two percentage points assume a baseline well above five per cent.
Cancelled theatre slots left unfillediA cancelled patient is rebooked. What is lost is not the case but the theatre time, and only to the extent that it stays empty. Valued at €16.63 per theatre minute.
Reduction in wound infectionsiThe infection rate after primary knee arthroplasty in Germany is below one per cent. The largest randomised trial of digital wound monitoring showed no lower rate, but markedly earlier detection. The benefit lies in cheaper treatment.
Uncovered cost per wound infectioniOnly the share that generates no revenue. A readmission within the upper length-of-stay threshold is merged with the original case under § 2 FPV.

Project and own contribution

Total project volumeiThe volume of the whole joint project, not one hospital's share. Derived from 35 Category 3 applications in Hesse at €1.8m to €2.1m per project. We deliberately calculate at the lower end.
Hospital's own contributioniFrom 2026 to 2029 the federal government carries up to 70 per cent and the states at least 30 per cent, of which they may pass on no more than half to hospital operators. The hospital share therefore lies between 0 and 15 per cent, depending on the state.
Annual usage feesiLicence, hosting and monitoring as a service. Ongoing operating costs are never eligible under the transformation fund.
Include VAT as a costiHospitals are largely unable to reclaim input VAT. It is then a real cost, charged on ongoing operation with no refund.
Assumptions, sources and legal notes

How it is calculated. Five years with a ramp-up: in year one 60 per cent of the target volume runs through the pathway, in year two 90 per cent. Within the length-of-stay threshold range the case rate does not change, so a saved bed day produces no revenue on its own. What is valued is the additional case that moves into the freed bed, counted at 35 per cent only until the next budget agreement, in line with § 4 (3) KHEntgG. Cancelled theatre time counts at €16.63 per minute, and only where the slot stays empty. Wound infections count at their uncovered cost, not in bed days.

Real, but left out. Preparation and documentation time saved, coding and case-mix effects, fewer audits by the medical review board, and revenue from a selective contract or a disease management programme. These items are real, but cannot be quantified credibly.

Sources. Length of stay and lower threshold for DRG I43B: reimbursement.INFO based on InEK data · Revenue per theatre minute €16.63: Waeschle et al., Der Anaesthesist, 2016 · Day-of-surgery cancellation rate: published cohort of 14,893 elective patients · Prehabilitation and complication rate: meta-analysis, odds ratio 0.74 · Digital wound monitoring, earlier detection without a lower infection rate: randomised controlled trial · Project volume derived from 35 Category 3 applications in Hesse: Federal Social Insurance Office, statistics under § 8 (3) KHTFV, as at 31 July 2026 · Funding rates: § 12b KHG as amended by the KHAG, and the KHTFV.

Important. The cited reduction of 3.5 days comes from a colorectal ERAS cohort and does not transfer to arthroplasty. It demonstrates the effect of a complete pathway programme, not of myoncare. Until the Federal Ministry of Health has set the nationwide minimum requirements, the Federal Social Insurance Office approves no Category 3 applications.

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The solution with myoncare

Not a one-off IT project. A regulated network infrastructure

In this project myoncare is not a patient portal. It is regulated digital process and control infrastructure for monitoring, pathway management and cross-sector escalation, run as a service for a hospital group.

Class IIa medical device
under the MDR. Regulated, not just software.
IaaS + MaaS
Infrastructure and monitoring as a service for the whole group.
Natively interoperable
KIM and FHIR R4, ready for the national TI.
A building block of transformation
with measurable KPIs. Not a one-off IT project.
For municipal owners and supervisory boards

One platform for the hospital, one care structure for the whole district

  • Care without breaks
    Practice, hospital and follow-up on one axis.
  • Relief for the district budget
    66% of German hospitals ran a deficit in 2024.
  • Free for practices and care homes
    They connect without a project and without a budget of their own.
  • Build once, use many times
    Further hospitals join as a module.
Patientenübersicht in myoncare: Liste von Patientinnen und Patienten mit farblich markierten Messwerten.
GPs
University hospital (teleconsult)
Specialists & clinics
Rehab and follow-up
Care services & homes
Patients
Connected via KIM or browser

Funding rates under § 12b KHG as amended by the KHAG: federal government up to 70 per cent, states at least 30 per cent, of which no more than half may be passed on to operators. Hospital own contribution 0 to 15 per cent · 66% of hospitals with an annual deficit in 2024: DKI Krankenhaus-Barometer, 2025.

The legal basis

Categories 3 and 4, combinable on one basis

The two categories can be combined: a network application under Category 3 and a parallel centre application under Category 4, on the same technical basis.

Category 3

Telemedicine network structures

No. 3 · between hospitals · including robot-assisted telesurgery · university hospitals included

Building networks that make one hospital's particular expertise available to others: teleconsults, monitoring, pathway management.

  • myoncare is the network infrastructure itself

  • Several hospitals apply jointly

  • Meets the nationwide interoperability requirements

Skizze: mehrere gleichrangige Krankenhäuser, über eine digitale Ebene miteinander vernetzt.

Category 4

Centres for complex conditions

No. 4 · rare, complex or severe conditions · university hospital and non-university hospitals together

Concentrating treatment expertise at a university centre. myoncare is the digital hub-and-spoke layer between the centre and the periphery.

  • Connects the university centre with peripheral hospitals

  • Teleconsults and pathway management across sector boundaries

  • Extendable by indication, with no new infrastructure

Skizze: ein großes Zentrum mit vier angebundenen peripheren Häusern über eine digitale Ebene.

Wording per § 12b (1) sentence 4 nos. 3 and 4 KHG, set out in detail in § 3 KHTFV.

The difference

A conventional IT project vs. myoncare as a service

Conventional model

  • HIS integration

    Deep · 12–18 months

  • Monitoring

    Per hospital, manual

  • Connecting practices

    Fragmented, laborious

  • Change management

    Heavy

  • Further indications

    A new project

  • Refinancing

    Unresolved

myoncare

  • HIS integration

    Lean · 8–12 weeks

  • Monitoring

    Central, as a service

  • Connecting practices

    KIM or browser, no setup

  • Change management

    Little to none

  • Further indications

    A module on existing infrastructure

  • Refinancing

    Selective contract, DMP or cost savings

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myoncare Careplan Manager: Patientenübersicht mit farblich markierten Messwerten.
App & Platform

Powerful back end, intuitive front end

A content management system for clinical teams and content creators, delivered to a native app or a progressive web app. Editable in real time, with no app update.

Careplan Manager (CMS)

Straightforward creation of clinical content and linking to pathways, now with AI support.

Patient management (PMS)

Dashboard with heat maps and triage filters, detail view with trends and progress curves.

Real-time alerts

Whenever predefined thresholds are crossed in either direction.

Certified telemedicine module

For direct patient communication and virtual case conferences.

Financing & Refinancing

The investment is funded. The operation is refinanced

Eligible for funding is the one-off investment: setup, configuration, initial KIM and FHIR integration, and implementation coordination. Ongoing operation (licence, hosting, monitoring as a service) is not eligible, but can be refinanced along three routes.

Funding of the one-off investment 85% federal & State(1)
Federal government (transformation fund via the BAS) State Hospital contribution (0–15%, depending on the state)
Prospect

Selective contract · § 140a SGB V

A care fee per patient per quarter. Requires an agreement with a statutory health insurer.

Baseline

Hospital usage fees

€50k to €80k per year per hospital, within normal digitalisation budgets.

Scale

DMP integration · § 137f SGB V

Parkinson's and MS are disease management programme indications. Statutory reimbursement applies without a separate contract.

(1) Funding rates under § 12b KHG as amended by the KHAG: federal government up to 70 per cent from 2026 to 2029, states at least 30 per cent, of which no more than half may be passed on to operators. Hospital contribution 0 to 15 per cent, rising to up to 25 per cent from 2030. Procurement at full market price and compliant with German public procurement law, with no discount and no special state-aid construction.

Implementation

Using the transformation fund. How we proceed together

We work with established consultancies and implementation partners to deliver projects professionally and quickly.

  1. 01

    Analysis

    We map the relevant service groups, the basis of your corporate and clinical strategy.

  2. 02

    Identification

    We assess your funding potential, then define and prioritise suitable projects against your state's deadlines.

  3. 03

    Application

    We guide the two-stage process: registration with the state ministry, transparent costing, and every deadline met.

  4. 04

    Implementation and training

    Seamless integration of myoncare into your operation, including training for your staff.

The states decide on funding applications. Hospital operators register projects with the responsible state ministry. For telemedicine network structures the Federal Social Insurance Office will only approve once the Federal Ministry of Health has set the nationwide minimum requirements.

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Good to know

Your questions,answered

Hospitals do not apply to the federal government. The states review, prioritise and file the collective application with the Federal Social Insurance Office. An early, well-prepared outline sent to the state creates an advantage.

Yes. As a Class IIa medical device under the MDR with KIM and FHIR R4, myoncare is the network infrastructure itself (Category 3) and the digital hub-and-spoke layer between centre and periphery (Category 4). Anchored in § 12b (1) sentence 4 nos. 3 and 4 KHG.

Eligible is the one-off investment: setup, configuration, initial KIM and FHIR integration, and internal project costs, at 85 to 100 per cent through federal and state funds. Ongoing operating costs are expressly not eligible. Operation is carried by hospital usage fees, in time by a selective contract (§ 140a SGB V) or a disease management programme (§ 137f SGB V). Both require agreement with the payers.

In 8–12 weeks instead of 12–18 months. Run as a service, with minimal HIS integration and practices connecting via KIM or a browser, with no elaborate on-site setup.

Procurement takes place at full market price and in line with German public procurement law, with no discount and no special state-aid construction. The project therefore stays clean under both procurement and state-aid law.

Let us make your projectapplication-ready

Your next network or centre project: regulatory sound, technically ready, economically viable.

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