Financing and Reimbursement of Hospital-Substituting Acute Somatic Care in Switzerland

Hospital-substituting acute somatic care is gaining importance in Switzerland, but current pilot models operate within fragmented reimbursement structures and often depend on temporary or non-scalable funding arrangements.

This policy brief examines how such models could be sustainably integrated into routine care in Switzerland. Drawing on an international comparison, stakeholder perspectives, and Swiss hospital data, it identifies four priority areas for action: a national definition and indication framework, an episode-capable reimbursement pathway with integrated coordination payment, visibility of relevant episodes in routine data, and safeguards against unintended financial or regional barriers for patients. The brief also points to the upcoming EFAS reform as a potential policy window for more coherent cross-sector financing and accountability arrangements.