Covid-10 Health System Response Monitor (15.06.2020) In consideration of a potential second wave of COVID-19, all countries in Europe will have to find solutions to adequately reimburse hospitals for their additional resource needs related to the care for COVID-19 patients, e.g. by adjusting DRG-based payments, increasing per diem rates, or adding additional fees to FFS system. In addition, given the risk of future pandemics, processes need to be put in place to rapidly adjust payment systems to meet new challenges where needed. Concerning revenue shortfalls, keeping the existing budget intact can be an effective safety net for hospitals. However, it also reduces the incentive for hospitals to restructure service delivery in line with new provision needs during the pandemic. Ultimately, reducing the impact of COVID-19 on regular service provision (e.g. by concentrating care for these patients at fewer providers) will also reduce the need for compensating revenue shortfalls. Given the short timeframe since health system responses to the crisis began, it is not yet possible to draw conclusions about optimal payment approaches for hospitals.