Ticino hospital planning: adequate 2019 data? (cross-border guide)

Context

In Brief

• Consultation launched on June 1, 2026 on hospital mandates
• Questioning on data from 2019 used for calculation of need
• Risk of overestimation of need and impact on healthcare costs

Key Facts

• What: Inquiry on hospital planning and calculation of need
• When: Consultation started on June 1, 2026
• Where: Ticino
• Who: Matteo Quadranti (PLR group leader) at the State Council
• Sectors: Acute care, rehabilitation, psychiatry
• Data base: Data from 2019 (chosen by the commission in 2022)

The Ticino State Council launched a consultation on June 1, 2026 on the proposal for the attribution of hospital performance mandates in the acute care, rehabilitation, and psychiatry sectors. An inquiry by Matteo Quadranti, PLR group leader, questions the technical criteria used to determine the need underlying this planning.

At the center of the issue is the choice to rely on data from 2019 to estimate the need. When the consultative commission was established in 2022, these represented the most recent available: data from 2020 and 2021 had been compromised by the pandemic. Today, however, according to prio.swiss (one of the consulted organizations), this statistical base may not adequately reflect the current reality of the Ticino healthcare system.

Quadranti submits the State Council with a series of specific questions. Firstly, he asks to identify the criticisms emerged during the consultation procedure among the other actors of the healthcare system. Secondly, he raises the risk that a calculation of the need based on data now seven years old (at the time of the publication of the planning in 2026) may lead to an overestimation of the stationary offer necessary.

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Operational details

Because outdated data weighs on planning

The question raised by Quadranti touches on a fundamental technical aspect of health planning: the quality and topicality of the statistical base. Using data from seven years earlier (2019 for a plan published in 2026) implies assuming that demand and supply of hospital services remain constant, which is rarely true in reality.

Between 2019 and 2026, the Ticino and national health system underwent significant transformations. In the period considered, EFAs was implemented and the push towards outpatient care accelerated, potentially reducing the demand for traditional beds. If the calculation of the requirement does not complement these developments, it is likely to overestimate the necessary supply.

Overestimating needs has direct consequences on costs. If too many mandates are assigned (hospital performance contracts), the offer expands beyond what is necessary. The costs remain the responsibility of LAMal, the mandatory health insurance for Swiss residents. Greater supply does not necessarily mean better care: it often incentivises non-essential performance, with an impact on the costo della vita for Swiss families.

The consultation procedure as a control and transparency tool

The consultation launched on 1 June 2026 is, from a procedural point of view, the crucial moment when stakeholders — hospitals, medical associations,

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Key points

What post-pandemic data is available? One of the central questions posed by Quadranti concerns the availability of more recent data for a potential update of the hospital demand calculation. When the Government responds, it will be possible to evaluate whether a planning based on 2023, 2024, or 2025 data would be feasible from an administrative point of view. The availability of complete statistical data — clinical outcomes, number of hospitalizations, average length of stay, diagnoses — depends on the information systems of the cantons and the reporting obligations to the Confederation. Typically, these data have a 12-18 month lag compared to the reference period: 2024 data may be complete only in 2025-2026. It is therefore possible that, at the time of the summer consultation in 2026, the most recent available data would still be those of 2024 or 2023, and not yet those of 2025. ### What changes if the calculation is updated If the Government decides to update the hospital demand calculation based on post-pandemic data, the planning may be revised according to three scenarios: Minimum scenario: demand is lower than that calculated with 2019 data. Ambulatory care predominance reduces stationary demand. Reduced mandates, lower overall costs for LAMal. Medium scenario: demand remains similar to that calculated. Planning remains substantially unchanged compared to the initial proposal. Maximum scenario: demand is higher than estimated. Unforeseen clinical needs, increased population or clinical complexity. Increased mandates, potentially higher costs. Quadranti explicitly asks the Government where the most recent post-pandemic data sit in relation to these three scenarios, in order to evaluate whether the current planning reflects reality. ### Next steps and impact on the healthcare system The response of the State Council to this interrogation will be public and will contribute to defining the trajectory of Ticinese hospital planning. If the Government decides to update the calculation, this would involve a revision of the consultation and the implementation schedule. If, instead, it maintains the 2019 base, it will need to justify this choice and manage the risk of legal challenges. Swiss residents, particularly those in Ticino, have a direct interest in a solid and transparent hospital planning, as it affects the overall efficiency of LAMal and the premiums they pay to the sick funds. Greater clarity on the technical basis of the planning is therefore in the interest of all insured parties.