Long-term care in Switzerland: the EFAS 2032 reform explained simply – strong potential, but real uncertainty
29 July 2026 | Comment(s) |
Benoît Michellod
The funding of long-term care in Switzerland (particularly the costs of care homes and home care) is set to undergo a major transformation. With the introduction of uniform funding (EFAS), which aims to simplify and better coordinate the healthcare system, the funding of long-term care will, from 2032 onwards, be provided entirely through compulsory health insurance (AOS/OKP). Though these objectives are commendable, the reform is also causing uncertainty, particularly amongst insurers and, more broadly, amongst those who pay insurance premiums.
The current system: who funds long-term care?
At present, the funding of long-term care is based on a tripartite model:
- Health insurers pay a contribution set by law (subject to a cap)
- Patients pay a limited share of the costs
- Cantons and municipalities cover the remaining balance
This represents a significant paradigm shift: in future, the cantons will systematically contribute to the funding of all medical services, rather than merely covering remaining costs.
EFAS reform from 2032: a fundamental shift
From 1 January 2032, long-term care will be fully integrated into the standardized EFAS funding system. In practical terms, this means that:
- Patients’ co-payments will remain in place. Thus, for care services provided to them on an outpatient basis or by a medical-social institution, insured persons will also make a contribution towards the costs of these care services.
- Insurers will then cover approximately 73 per cent of the costs
- The cantons will cover approximately 27 per cent
- The cantons’ current residual funding is thus abolished
This represents a significant paradigm shift: in future, the cantons will systematically contribute to the funding of all medical services, rather than merely covering remaining costs.
Consequences for insured persons: a rise in costs?
One of the main criticisms concerns the potential rise in premiums. The current contribution from the AOS/OKP is limited to fixed amounts. In future, this cap will be removed. Insured persons could therefore find themselves directly facing a heavier financial burden (an increase in AOS/OKP premiums).
Given the current rise in healthcare costs, this issue is causing serious concern.
Lack of reliable data: what is the real cost of long-term care?
Another critical factor is the lack of cost transparency:
- Different calculation methods depending on the provider
- Heterogeneous systems for assessing care needs
- Difficulty in comparing data
Transition period until 2032: time to find solutions
To prepare for the reform, a transition phase running until 2032 has been planned. During this period, a number of major projects are underway:
1. Greater cost transparency
- Introduction of harmonised billing systems
- Standardised data collection from healthcare providers
- Objective: comparable and transparent cost structures
2. National pricing structure for healthcare
- Replacement of the current flat-rate payments
- Introduction of service-based tariffs
- Priority given to criteria of efficiency, quality and cost-effectiveness
3. Standardised needs assessment
- Harmonisation of the assessment of care needs
- Equal treatment of comparable cases throughout Switzerland
- An essential basis for fair tariffs and funding
Conclusion: strong potential, but real uncertainty
The EFAS uniform funding reform represents an important step forward for the Swiss healthcare system, promising greater consistency and efficiency. However, it also raises significant challenges, particularly in the area of long-term care.
Key issues—such as the transfer of costs to insurance premiums and uncertainty about future funding levels—will be decisive in the coming years. The ultimate success of the reform will depend on stakeholders’ ability to address these challenges before 2032 and ensure that modernisation does not result in unintended financial consequences for insured persons. At the same time, the role of informal family carers – highlighted in a previous blog post – should be addressed as part of this broader reform effort.
