Professor Zlatko Bodrožić’s research project will explore the untapped potential of municipally and non-profit run outpatient medical care services in Germany, as a sustainable, community-oriented alternative to investor-driven models.
In 2004, the German Bundestag created the conditions for the establishment of Medizinische Versorgungszentren (MVZs).
Similar to general practices in the UK, MVZs are community care centres – multidisciplinary and specialists – that provide patients with easy access to a range of medical services outside of hospitals.
MVZs enable general practitioners and specialists to come together and set-up new models of care, under contracts funded by the Statutory Health Insurance (SHI) – equivalent to the UK’s National Insurance contributions.
Who funds the German healthcare system?
Germany's healthcare system is a universal, multi-payer system funded by a combination of compulsory statutory health insurance (SHI) and private health insurance (PHI).
Around 89% of the population is covered by SHI, while the remaining 11% are covered by PHI.
Both systems provide comprehensive coverage, including inpatient and outpatient care, medications, and specialist visits.
This is part of the German government’s efforts to ensure equal and timely access to SHI services throughout the country, promote prevention and enhance patient rights.
MVZs are normally owned by healthcare professionals or hospitals, but the introduction of the Statutory Health Insurance Strengthening Act (GKV-Versorgungsstärkungsgesetz) in 20215 made MVZs an attractive business venture.
According to recent estimates, approximately 21% of the 4,179 MVZs in Germany are owned by private equity firms, which have primarily invested in profitable services such as dentistry ophthalmology, radiology and orthopaedics.
Private equity investors have also poured money into affluent towns, leaving deprived and less populated rural areas behind.
This has made politicians and SHI decisionmakers uneasy, as well as practitioners who fear profit-oriented investors might restrict their autonomy and therapeutic freedom within MVZs.
In this context, less discussed municipal and non-profit models present an alternative that may bring opportunities to link outpatient healthcare with community needs and structures across sectors.
To shed light on this, Professor Zlatko Bodrožić, is working in a joint project with researchers from German universities, Professors Felix Welti, Stefan Gold (both from University of Kassel) and Stefan Greß (Fulda University of Applied Sciences), on a joint project titled: ‘Medical Care Centers: Strengths and Weaknesses of Municipal and Non-Profit vs. Investor-Driven Models’.
The goal is to explore the strengths and weaknesses of municipal and non-profit (or cooperatively run) business models vs investor-driven options.
Using a case study research design1, the investigation will compare different MVZ ownership models and legal forms, organisational and business management factors, and performance dimensions (eg patient care, working conditions, diversity, co-determination2 and social space development).
From a legal perspective, the research will assess whether social, professional and municipal law regulations are suitable or detrimental to promoting public-interest-oriented medical care centres with good working conditions.
The goal is to examine the status quo of ideal MVZ models in Germany and possible paths toward a sustainable transformation of the healthcare system, which will provide important lessons for other countries like the UK.
“German MVZs offer a unique lens through which to examine the diversity of healthcare delivery models in Germany,” said Zlatko.
“This project presents a great opportunity to study different organisational forms and assess which models are most effective in meeting healthcare needs.
“Of particular interest is the potential to strengthen the role of local communities within these models.
“Through this research, we aim to generate insights that can contribute to improving healthcare in Germany – and potentially offer inspiration for reforms in other systems, including the NHS."
1 Qualitative empirical data will be collected through interviews with key stakeholders at the respective medical care centres and, where possible, triangulated with participant observation, internal reports and performance indicators. The data will be analysed using content analysis with the Gioia method.
2 Co-determination is a system where employees, or their representatives, are involved in company decision-making, especially at the board level, giving them a voice in matters affecting their jobs and the company's direction.
 |
Professor of Digital Enterprise |