[Current health economic and policy issues in intensive care and emergency medicine]

In 2025, intensive care and emergency medicine in Germany face profound structural and political transformation. The new Hospital Care Improvement Act (KHVVG) introduces a three-pillar financing model consisting of standby budgets, nursing reimbursement, and residual DRGs, aiming to reduce economic incentives and strengthen quality, safety, and specialization. At the same time, workforce shortages in medicine and nursing, as well as the integration of new roles such as Advanced Practice Nurses and Physician Assistants, pose major challenges. Structural reforms, regionalization, and the establishment of specialized centers are designed to ensure efficient resource allocation. Digitalization, telemedicine, and artificial intelligence offer opportunities for process optimization, cost management, and improved care quality, but require standardized frameworks and effective change management. In addition, sustainability initiatives, outpatient shifts, and quality-oriented payment models are gaining relevance. Overall, these developments mark a paradigm shift intended to secure high-quality, safe, and sustainable care for critically ill and emergency patients.