28 luglio 2025

In its decision C-4147/2021 and C-4177/2021 of 15 July 2025, the Federal Administrative Court partially upheld two appeals on the same decision, one filed by St. Claraspital AG and one by tarifsuisse AG regarding the determination of the SwissDRG-base rate for acute inpatient services. A collective agreement had been in place between the parties for inpatient services until 31 December 2018. The point of contention was the setting of the SwissDRG base rate for acute inpatient services from 1 January 2019.

The court held that, since the Federal Council as well as the legislator had not chosen to specify the efficiency benchmark, the tariff partners as well as the cantons had a considerable scope for assessment and discretion. They were thus able to take account of the circumstances, to consider any negative effects of a decision at an early stage and to decide on the necessary corrective measures.

Furthermore, the court stated that in its previous jurisdiction it had always been critical of benchmarking differentiated according to hospital categories but had allowed such benchmarking in individual cases in the implementation phase. However, birthing centres would not fall into any hospital categories, but rather into a distinguishable category of service providers for which completely different regulatory requirements and obligations applied.

Consequently, since the birthing centres were to be excluded from benchmarking, a new benchmarking as well as a new determination of the appropriate measure of efficiency would have to be established. However, the court referred this procedure back to the Government Council of the Canton of Basel-Stadt.

Regarding the inflation surcharge, the court held that the weighted inflation rate from the base year (X-2) to the previous year (X-1) was decisive, whereby the nominal wage index was to be used for personnel expenses weighted at 70% and the national consumer prices index (Landesindex der Konsumentenpreise, LIK) for material expenses weighted at 30%.

Lastly, the court stated that the mere fact that a hospital provides more complex services or services in highly specialised medicine (Hochspezialisierte Medizin, HSM) would not justify setting a higher base rate.

The two appeals were upheld in the sense that the contested decision was overturned and the case was referred back to the Government Council of the Canton of Basel Stadt so that it could re-determine the base rate in accordance with the considerations.

For more information, see here.