Since the health reform of 2000, Diagnosis Related Groups (DRGs) have been gradually introduced in German hospitals. This leads to a shift from cost coverage to a performance-oriented reimbursement system. Hospitals are thus facing a comprehensive transformation of their processes and structures to position themselves in the new hospital market. While the effects and functioning of DRGs have been sufficiently studied internationally, few studies focus on the implementation process of DRG-based reimbursement. Vanessa Doege and Susanne Martini address the current development of hospitals' competitiveness in this context. Based on a comprehensive data set from participant observation, document analysis, and interviews, they empirically and theoretically analyze the introduction process of DRGs in a hospital network.