KOF forecast: care costs at record levels
Healthcare costs in Switzerland are rising steadily – in part due to care services. This is shown by the health cost forecast of the Swiss Economic Institute (KOF), financed by Comparis.
18.11.2025
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1. Health expenditure continues to rise
Healthcare expenditure in Switzerland is expected to increase by 3.6% in 2026. This is what the KOF Institute of ETH Zurich predicts in the health cost forecast financed by Comparis.
In the Comparis press release (only available in German) on the KOF forecast, Comparis health insurance expert Felix Schneuwly puts the results into perspective.
In 2027, health expenditure will even rise to over 12,000 Swiss francs per person.
The increase is, according to Comparis health insurance expert Felix Schneuwly, manageable. It is important that economic growth continues and that the share of health expenditure remains between 11 and 12% of gross domestic product (GDP).
Good to know: Switzerland has the fourth-highest share of GDP of all OECD countries in health costs – after the USA, Germany and Austria. The graph shows how much all OECD countries spent on healthcare in 2024.
About the KOF forecast
Comparis finances the KOF forecasts of health expenditure. Since the Federal Statistical Office only publishes health expenditure with a two-year delay, the KOF forecast data are particularly valuable for monitoring the development of health insurance premiums.
2. Care by relatives faces challenges
According to Comparis health insurance expert Felix Schneuwly, long-term care is facing a particular challenge. More and more people are receiving care and support at home. The positive aspect is that the less expensive outpatient care is growing faster than inpatient care.
Many elderly people want to spend their retirement in familiar surroundings.
However, according to Schneuwly, paid care by relatives is not sufficiently regulated. In principle, health insurers, cantons and municipalities are obliged to cover basic somatic and psychiatric care. This includes help
getting dressed
eating
personal hygiene
structuring everyday life
The prerequisite is that relatives are employed. However, according to Felix Schneuwly many ambiguities in practice: «Spitex organisations, health insurance companies and authorities interpret the requirements differently.»
Scope and costs of family care
Exact figures on the scope and costs of family care are lacking. This is because the work of relatives is not recorded separately.
The Federal Council estimates that the turnover of family care between 2019 and 2024 grown strongly. In 2019, it generated about 18 million francs in turnover, five years later it was already 100 million francs.
3. Private Spitex organisations hire more relatives
According to Comparis health insurance expert Felix Schneuwly have non-profit Spitex organisations the importance of family care «overslept». As a result, the market for private care companies that employ family caregivers is growing.
Both private and non-profit Spitex organisations recorded not only more care costs in 2024, but also higher employment than in the previous year. However, both values have risen significantly more for profit-oriented care companies than for non-profit organisations, as the following graph shows.
Care costs at record levels
According to the FSO, Spitex services provided about 25.6 million hours of care. That is a good 10% more than in 2023 – the strongest increase since 2011.
This is also reflected in the development of care costs since 2011, which you can see in the graph.
The care costs of 15.82 billion francs corresponded to 16% of total health expenditure. At 12.16 billion francs, the majority of this was attributable to retirement and nursing homes. Outpatient care services amounted to only 3.66 billion francs.
4. Financing of family care must be regulated pragmatically
From 2026, the financing of healthcare costs will be switched – from the current Tarmed to the Tardoc and outpatient flat rates. From 2032, this will also affect care services. The cantons will then pay 73.1% of the care costs, and the health insurance companies 26.9%.
Until then, the financing of family care must be defined more precisely. Comparis health insurance expert Felix Schneuwly warns against solving the existing uncertainties with too much bureaucracy, or not at all.
Lean and pragmatic solutions are needed. This is the only way to clearly regulate the extent to which family care is financed and at what rates – without a new planned economy.
Schneuwly also calls for the federal government and the cantons clarify key issues. These include:
Rules on who is allowed bill for care services
what training is required to bill for care services
the maximum amount that billed for care services can be
clear guidelines on the duty to mitigate damage. In other words, when is unpaid family care reasonable – and when is it not?
According to Felix Schneuwly must also care and support services be clearly separated from each other. This is especially true for psychiatric care provided by relatives. There is also a need for uniform criteria throughout Switzerland for the public financing of the remaining costs and the quality of the services provided.
This article was first published on 07.11.2023
