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50 Billion Euros Are Waiting. Those Who Act Too Late Will Pay Out of Pocket.

The hospital reform has long since become reality. On April 17, 2026, the Federal Office for Social Security approved the first grants from the Transformation Fund. 254 applications had already been submitted. Those who wait risk not only losing funding, but also their hospital's ability to act.

03.07.2026
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What's happening right now and why there's no time to lose

Three pieces of legislation have fundamentally reshaped the German hospital landscape: the KHVVG (in force since January 2025), the KHTFV Regulation (April 2025), and the KHAG (April 2026). Together, they establish a 50-billion-euro Transformation Fund, replace DRG-based case flat rates with a capacity-based reimbursement model, and make ISiK Level 3 mandatory.

The critical clause: only projects contractually initiated after July 1, 2025 are eligible for funding. Those who started earlier are excluded. Those who haven't started yet need to act now.

What this means for your hospital

The reform has direct consequences for hospital IT and presents CIOs and IT leaders with three immediate challenges:

  • ISiK Level 3 is now mandatory. Without a certified FHIR interface, your hospital cannot access funding. This is enshrined in law (§ 373 SGB V).
  • SAP IS-H has no future. With expiring maintenance, mandatory ePA 3.0, and TI 2.0, today's system landscape will no longer be viable in three years.
  • Data flow is now a budget issue. The new capacity-based reimbursement model makes documentation and coding quality directly revenue-relevant. Hospitals running fragmented systems will lose money.

The architecture question that answers itself

Many hospitals are asking: new HIS or open platform? The reform has already answered that question. A monolithic legacy system cannot structurally meet the requirements for interoperability, network logic, and cross-sector care. An open platform with native FHIR, a shared Clinical Data Repository, and the ability to modernize incrementally — without a big-bang migration — can.

This is not just a technical decision. It is the foundation for accessing funding across six of the eight eligible categories of the Transformation Fund.

What Mesalvo does differently

Around 35% of our staff bring hands-on clinical experience. We know handovers, night shifts, and fragmented system landscapes from the inside.

Mesalvo HealthCentre, our open platform, was not retrofitted for the reform. It was developed in anticipation of KHVVG, KHTFV, and KHAG — with native ISiK, a Regional Spine for hospital networks, and sovereign deployment options (Cloud + Edge + Disaster Recovery).

We support hospitals from strategic analysis through to proof-of-use documentation. This means funding application, IT transformation, and program management from a single source.

Where does your hospital stand? Find out for free.

In our free KHVVG Readiness Assessment, we analyze together how your hospital is positioned: Which funding categories are relevant for you? Where are the gaps in your IT architecture? And where is the greatest potential?

The assessment is free of charge and takes 60 minutes.

→ Request your free Readiness Assessment now: https://mesalvo.com/de/kontakt

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About Mesalvo

Mesalvo makes a significant contribution to digital transformation, quality improvement, and patient safety in healthcare. Around 460 employees work every day to support healthcare providers with tailored IT solutions and strategic expertise.

The Next Generation Healthcare Platform, Mesalvo HealthCentre, digitizes and connects all administrative and clinical processes along the patient journey. This makes the work of medical and administrative professionals more efficient and effective while enhancing the quality of patient care.

For more information, visit www.mesalvo.com.

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