Table 1.

Overview of important changes in the hospital payment system since 2005

Year	Change
2005	Introduction of DTC product classification system (>40,000 DTCs)
	Introduction of prices per DTC instead of hospital per diem rates
	Introduction of freely negotiable prices for on average 10% of hospital revenue
2008	Expansion of free pricing segment to on average 20% of hospital revenue
2008–2017	Phasing out retrospective capital cost compensations
2009	Expansion of free pricing segment to on average 34% of hospital revenue
2012	Profound revision (DOT) of DTC product classification system (4400 DTCs)
	Expansion of free pricing segment to on average 70% of hospital revenue
2012–2014	Phasing out global hospital budgeting system (transition model)
2012–2018	General agreements about macro budget total hospital expenses
	Insurers and hospitals negotiate about lumpsum payments and DTC prices
2015	Integration of medical specialist remuneration in DTC prices
	Reduction of maximum duration of DTCs from 365 to 120 days