The Austrian Health Insurance Fund (ÖGK) plans to eliminate its deficit by 2026, aiming for a balanced budget or “black zero” next year. On Tuesday, the ÖGK supervisory board and general assembly approved a comprehensive cost-saving package. Alongside internal cuts like not replacing retiring staff, patients will also face changes: MRI and CT scans will once again require prior approval, and transportation services will no longer be free.
ÖGK chairman Peter McDonald told APA he inherited the fund a few months ago with a projected deficit of 900 million euros. He attributed the shortfall largely to factors beyond the fund’s control—such as the aging baby boomer population, rising medical costs, and a shift in treatment from hospitals to outpatient care, which is more heavily funded by the ÖGK. Additionally, the ongoing recession has impacted revenues.
Deficit to Shrink from 900 to 250 Million in 2025
McDonald emphasized the goal is to maintain top-quality healthcare via the e-card system without placing too much additional burden on the insured. With this new package, the deficit is expected to fall from 900 million to 250 million euros this year. A balanced budget is targeted for 2026, with the goal of rebuilding reserves afterward, as demographic challenges persist.
In addition to long-term structural reforms, the focus is currently on urgent short-term measures. Government efforts, like raising health insurance contributions for pensioners, are expected to help. Further relief may come through additional political decisions, though McDonald declined to speculate.
Internal Cuts and Operational Savings
Internally, the ÖGK plans to leave every second retiring position unfilled this year—equivalent to 86 full-time jobs, bringing the total reduction to 200 since the 2020 fund merger. They also plan to reduce the use of leased staff and give up 10 percent of office space in administrative buildings. Investment delays are being evaluated as well.
MRI Scans to Require Approval Again
Patients will also notice changes. To reduce overuse and shorten waiting times, MRI and CT scans will again need authorization. An electronic approval system is expected to be in place by the end of the year, with a simpler process than the previous “chief physician” model. A similar system may be introduced for physiotherapy. Additionally, patient co-payments for orthopedic shoes will increase, and the ÖGK is discussing whether vitamin D testing without a medical reason should remain covered.
Due to a 10 percent rise in medical transport usage, the ÖGK will begin charging. A standard ambulance trip will cost the usual prescription fee (7.55 euros), while taxi rides will cost double. The aim is to prevent transport prescriptions being used purely for convenience.
Doctors and Regions to Share Responsibility
The ÖGK also intends to negotiate with doctors to help reduce costs. McDonald stated that the tough years of 2025 and 2026 require everyone to contribute fairly. From now on, doctors’ fees should not grow faster than insurance contributions—which are currently capped at 4 percent, above inflation. McDonald called this plan reasonable and said he hopes to reach agreement through negotiations.
Talks are also planned with Austria’s federal states to explore co-financing specific areas like diabetes and pain clinics.
