As part of the reform partnership, the federal government, provinces, and municipalities aim to significantly reorganize responsibilities in health care, energy, education, and public administration by the end of 2026. Pressure is particularly high in the health sector due to tight budgets and clear gaps in public services. Talks are being conducted intensively, the Federal Chancellery said in response to an APA inquiry. A political agreement is to be reached by June 2026.
Numerous proposals are under discussion. Last fall, Salzburg Governor Karoline Edtstadler (ÖVP) drew attention with her proposal to transfer all health matters—including hospitals—to federal responsibility, while shifting education to the provinces. Her party colleagues in Tyrol and Vorarlberg, Anton Mattle and Markus Wallner, advocated partial centralization in health care or “central legislation in hospital matters,” while maintaining provincial involvement.
The longstanding “guest patient” dispute, particularly between Vienna and Lower Austria, is also to be resolved. A nationwide uniform contract for physicians is planned, and doctors are to be integrated more strongly into the public system. Patients are to see shorter waiting times for appointments and surgeries. On the SPÖ side, there are calls to address deficits stemming from the previous conservative–Freedom Party health insurance merger and to limit private medicine.
Uniform Patient Steering System
At a summit in December, it was announced that a nationwide uniform patient steering system should be introduced starting in 2027. “It should lead to shorter waiting times, faster diagnoses, and quicker surgery appointments,” said Federal Chancellor Christian Stocker (ÖVP). He is aiming for financing, management, and planning from a single source. However, the question of which structure would be most efficient will only be decided at the end. Earlier, Health Minister Korinna Schumann (SPÖ) had contradicted Stocker when he suggested that agreement had already been reached.
Following the summit at the end of last year, it was announced that an expert group would develop three options for bundling funding streams as well as structural and capacity planning, integrating outpatient, inpatient, and ambulatory sectors. After a steering group meeting last week, officials stated that a “further important step in the ongoing coordination and negotiation process” had been achieved.
“A Good Distance Covered”
During Holy Week, federal actors have not disclosed which issues have already been finalized. The Chancellery stated that “a good portion of the path has already been covered,” and that cooperation remains constructive and goal-oriented. There is agreement on the direction: modern, patient-oriented care, clearer responsibilities, and better coordination across the system—following the principle “digital before outpatient before inpatient” and the guiding concept “money follows performance.”
Negotiations continue intensively, and officials remain confident that the timetable can be maintained and a political agreement reached by June 2026, with the aim of initiating the necessary legislation later in the year.
Tyrol Governor Mattle, who currently chairs the Conference of Provincial Governors, expressed cautious optimism. He said he would contribute during the first half of the year, particularly in health care, to achieve progress. However, the originally planned 18-month timeframe of the reform partnership—through the end of this year—will likely be necessary. Vorarlberg will assume the chairmanship in the second half of the year. The Conference of Health Ministers will address the health reform in Innsbruck on May 22.
Mattle reiterated that the provinces are “ready for reform” and referred to a joint position paper published with Governor Wallner earlier this year. In line with the principle “money follows performance,” responsibilities must be clearly defined, transparent, and as close to citizens as possible. While there is agreement on patient steering, discussions continue on bundling financing, planning, and service responsibilities, as well as on a model of unified financing. However, Mattle emphasized a “red line”: “I will not allow a hospital to be closed from Vienna—on the contrary, we are investing €174 million in the district hospital in Kufstein.”
Upcoming key dates include the Finance Ministers’ Conference in Tyrol on April 10, the Provincial Governors’ Conference in Innsbruck on June 19 to formulate the provinces’ position, and the reform partnership meeting at the end of June under Tyrolean chairmanship.
