The financial situation and current challenges of Swiss hospitals and clinics

EBITDA margins increased more strongly in 2024 than had been forecast last year, reaching 3.4%, slightly above the five-year average. 62% of the healthcare institutions analyzed improved their EBITDA margin, and 65% of the CFOs surveyed expect margins to continue rising slightly in 2025 and 2026.

Despite significant increases in revenue and tariffs compared to the previous year, more than half of the healthcare providers analyzed report negative operating results after depreciation. KPMG estimates that the cumulative deficits of loss-making providers in the Swiss hospital sector could still amount to as much as CHF 750 million in 2024.

Compared to previous years, 2024 saw a significant cumulative revenue increase of +4.9%, against the backdrop of an average tariff increase of around 1.5% in the inpatient sector. At the same time, cost growth continued - driven in particular by medical supplies and materials (+4.9%).

Ongoing investment needs and the pressure to refinance existing financial liabilities through new debt and equity capital, combined with strained financial ratios, underscore the financial instability of many institutions.

Fundamentally weak credit metrics and the sector’s ongoing challenges mean that many clinics are no longer considered creditworthy on a standalone basis from a cash flow perspective. As a result, explicit and implicit guarantees - as well as other forms of public sector support - are becoming increasingly important in practice.

Market perception of hospital bonds has continued to deteriorate, primarily due to rising expectations of credit default risk. This is increasingly having a negative impact on the issuers’ ability to access capital markets.