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

Model calculation for a project under funding category 3 of the hospital transformation fund. All assumptions and sources are listed below the calculator.

Your model calculation
€199k €397 1.9 × Contribution margin released per year per case in the pathway savings per euro of total cost, five years
Illustrative model calculation based on average values from comparable projects and publicly available figures. Your hospital's actual values will differ. We accept no liability for accuracy or completeness, and neither a commitment as to achievable results nor a claim to funding can be derived from this calculation. In a personal conversation we factor in further figures from your hospital and calculate with your actual data.
Calculate your own savings potential Four figures about your hospital are enough. Everything else is preset.

Your hospital

Elective cases in the pathway per year iHow many scheduled procedures should run through the pathway? Emergencies and conservatively treated cases do not count, because the pathway does not apply to them.
Length of stay today iEnter your own length of stay, not the catalogue value of 8.3 days. If your unit is already below it, that part of the saving has been realised and should not be counted twice.

Effect on the process

Reduction in length of stay iAs long as you stay within the length-of-stay thresholds, the payer reimburses the same case rate. A saved day therefore brings you no extra revenue, it brings you a free bed. What is valued is the additional procedure you fit into it.
Contribution margin per additional case iWhat is left for your hospital from one additional procedure once variable costs are deducted? Not case revenue, but the contribution margin. Your controlling department knows this figure. As a rough guide for a first conversation, many hospitals use 30 to 40 per cent of average case revenue.
Utilisation of the freed capacity iA freed bed only helps you if you fill it again. Estimate what share of the freed capacity you would realistically fill with cases from your waiting list.

Cost and funding

Fixed values from comparable projects. We will quote your actual figures in a conversation.

Investment, one-off iCovers the platform licence, configuration, integration with your hospital information system via KIM and FHIR, data migration, training for your staff and project management up to go-live. The figure reflects experience with a mid-sized hospital and means your share of the network project, not its total volume.€400,000
Annual usage fees iThe running service: licence, hosting and monitoring as a service. For telemedicine network structures these costs are eligible for funding during a ramp-up phase of up to three years, under section 6.3.1 of the funding directive. From year four your hospital carries them in full.€65,000 per year
Funding rate iUntil 2029 the federal government carries up to 70 per cent of eligible costs and the states at least 30 per cent. Because states may pass on no more than half of their share to hospital operators, your share lies between 0 and 15 per cent. We calculate throughout with 70 per cent, the least favourable case for you. How your state splits its share is something we clarify together.70%
VAT iYour hospital can normally not reclaim VAT as input tax. It is therefore included as a real cost, and it also counts towards the eligible costs.19%, included
Assumptions, sources and legal notesEvery calculation step and average value in detail

Why the calculator is this simple. It asks for the figures you know yourself and that carry the result: case volume, length of stay, contribution margin and utilisation. Everything else is set to defensible average values, disclosed here. A calculation with your real numbers belongs in a conversation, not on a website.

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, from year three the full volume. Within the length-of-stay thresholds 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. Until that case is written into your budget agreement it counts at 35 per cent only, in line with § 4 (3) KHEntgG; the calculator assumes an agreement from year three.

Fixed average values. Reduction in day-of-surgery cancellations 1.5 percentage points · 90 minutes of theatre time per cancelled procedure · contribution margin €16.63 per theatre minute · 50 per cent of cancelled slots stay empty, the rest are refilled · investment €400,000 · usage fees €65,000 per year · funding rate 70 per cent · VAT 19 per cent. These values are deliberately conservative and can be replaced with your own figures in a conversation.

Deliberately excluded. Wound infections avoided. The effect is real, but depends so heavily on risk profile, type of procedure and comorbidities that a flat percentage across all patients would not be sound. Also not counted: 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. The calculator therefore comes out lower than it could.

One hospital, not the network. Funding category 3 requires a network project with at least two participants. The benefit, however, arises in each hospital separately, with its own case volume and its own length of stay. The calculator therefore models your hospital, and the investment means your share of the project, not the total volume of the network.

Eligibility of ongoing costs. As a rule, operating costs recoverable through the per-diem rate are not eligible for funding. For telemedicine network structures there is an exception: under section 6.3.1 of the funding directive issued by the Federal Social Insurance Office on 26 August 2026, the cost of using software under service and usage agreements, such as subscription models or software as a service, can be eligible as the cost of an initial ramp-up phase of up to three years. Beyond that the directive no longer assumes an initial operating phase. The calculator reflects this: usage fees in years one to three are funded, from year four you carry them in full.

Sources. Length of stay and thresholds 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, 1.23 per cent against 0.48 per cent with structured preoperative assessment · Prehabilitation and complication rate: meta-analysis, odds ratio 0.74 · Funding rates: § 12b KHG as amended by the KHAG, and the KHTFV · Eligible costs: funding directive under § 8 (1) sentence 2 KHTFV of 26 August 2026, section 6.3.1.

Important. The frequently 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 applications for telemedicine network structures. All results are model calculations, not commitments.

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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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