Et literally began two decades ago on a green meadow with a medical center. Where horses used to graze in Pohlheim in central Hesse, there are now five such buildings. In addition to specialists for stomach and intestinal diseases, there are dentists and an orthodontist, a dermatologist and oral surgeon, a gynecologist and a pediatric practice. There are also physiotherapists, a pharmacy and a medical supply store. The density of doctors in the small town near Gießen with its 18,000 inhabitants is unparalleled. The medical centers were built by IWG Holding AG. The Giessen medium-sized company caused a stir in the healthcare industry in the spring with a personal announcement. He got the long-standing Asklepios manager Christian Höftberger on the board.
The Austrian most recently signed as CEO of the listed Rhön-Klinikum AG, an Asklepios subsidiary. He left the company against the background of the months-long dispute with the state of Hesse over the new future contract for the privatized university hospital in Gießen and Marburg, in which Rhön AG holds 95 percent and the state the rest “ to have done. Because Höftberger has not only been involved with healthcare in general and hospitals in particular throughout his professional life. He also advocates medical care centers with employed and self-employed doctors, as the IWG intends to operate in the future.
This is intended to be the next step in the healthcare market for this unlisted corporation, beyond its medical centers. And it should be in the not too distant future if everything goes as planned, as the new board member suggests. So far, only panel doctors, municipalities and clinics are allowed to operate a medical care center (MVZ), which is basically a large group practice. IWG does not yet belong to this group of operators, but advises municipalities in this regard.
More and more patients, fewer and fewer specialists
At the end of last year, the company signed a purchase agreement for an Asklepios clinic in the Upper Palatinate. According to Höftberger, the so-called closing is expected in the third quarter. There, the Giessen company could build on an existing MVZ and expand it. That would be the test run.
Hoeftberger, born in Salzburg in 1974, basically supports such centers for two reasons. The demographic development puts a double burden on the healthcare system. On the one hand, there are more and more older people in society and therefore more people who tend to need a doctor and care more often. Second, the group of skilled workers is getting smaller. From this, the lawyer concludes: “We have to become more efficient.” Outpatient services are the method of choice for him, especially since not every finding requires inpatient treatment. This goes far beyond meniscus operations and the like. An MVZ or a facility supplemented by nursing staff, called a medical-nursing supply center, serves, in his words, either as an “outpatient door opener” or “filter” before inpatient admission. His motto is: “I started to ensure health care.”
He has already had something to do with the MVZ structure during his career, even if not from the start. After his time at the Institute for Commercial and Business Law at the University of Salzburg and a few years at the state clinics there, he came to Germany in 2005 and worked as the office manager of the then Rhön-AG Vice-Chairman Gerald Meder at the University Hospital Gießen and Marburg. There he was promoted to managing director at the Gießen site and was responsible for the new construction of the central clinic. After working for Asklepios in Lich and Hamburg, he went to Hesse as regional manager for the group. His task: He should reorganize the landscape of the supply centers belonging to Asklepios, give them a uniform appearance, trim them for profitability and ensure legal certainty. The latter not least with a view to the use of clinic infrastructure by MVZ doctors.
Various doctors under one roof – as employees
That was in 2017/18. “It was already clear to me: That’s where the future lies,” says Höftberger. Health Minister Karl Lauterbach (SPD), for his part, wants more outpatient treatments, as he has explained several times. However, he does not want to see any financial investors behind an MVZ. With regard to his new employer, Höftberger assures me that the IWG is not a locust. She also has no plans to buy out independent doctors from a center. In addition to construction, it is also about operation and participation. In many places, the founders of an MVZ were approaching the age limit and wanted to get rid of their shares. The younger colleagues couldn’t pump any more capital into the facility, but they didn’t want to sell it. In such cases, the IWG could step in as a shareholder alongside the younger, independent physicians.
Höftberger also has doctors in mind who would rather work as an employee – under the same roof as other doctors. According to the German Medical Association, their number has skyrocketed in recent years. Last but not least, an MVZ facilitates reliable representation regulations. If there is an operator who takes care of the bureaucracy, the doctors could concentrate on their real work and treat patients.
Meanwhile, his employer is building more medical centers. For example in Rodgau near Offenbach and not far away in Seligenstadt and in Großkrotzenburg. Not to forget Pohlheim. IWG is planning number six there, as Höftberger says.