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MVZ – Medical Care Centre |
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MVZ – Medical Care Centre – Questions and Answers
Source of information: Federal Ministry of Health
Date of information: 1st March 2007
According to the health care reform 2004, not only SHI (social health insurances)- and other authorised physicians, but also medical care centres may take part in the ambulant care of the official health insurance schemes.
Medical care centres are institutions where physicians of different specialised areas cooperate ambulantly and interdisciplinary. It is of crucial importance for every MVZ to have a joint supporting organisation for administrative purposes and a medical board for the supervison of the physicians and to operate under a common address. Medical care must be guaranteed by at least two physicians of different specialisations or different medical care suppliers. Therefore, a general practitioner, a specialist and/or a psychiatrist or psychotherapist should work together in a MVZ. This is possible for employed physicians as well as for SHI physicians. Psychotherapists, other non-medical health care professionals and staff belonging to medical suppliers or specialist orthopaedical stores, pharmacists and ambulant nursing care companies may also cooperate with MVZs. Subject to the condition that their services are closely coordinated with the physicians of the respective MVZ. MVZs offer ambulant one-stop care to their patients.
This implicates a close collaboration of all people involved in therapy and a common agreement in view of etiopathology, aim of the treatment and therapy itself. Clinic operating organisations, institutions or companies rendering physio rehabilitation and pharmacists are also authorized to establish MVZs.
Where does the idea for Medical Care Centres come from?
- In the 18th century a physician called Christoph Wilhelm Hufeland had the idea of founding polyclinics, which can be compared with today´s MVZs .
- During the strike of Germany´s physicians in 1926/27, the statutory health insurance schemes set up ambulatories and polyclinics. They employed physicians, who were strike breakers. The reason for this conflict was because physicians longer accepted the official health insurance schemes. They wanted to be paid directly by their patients.
- During the “Dritte Reich” (Third Reich) polyclinics were closed. After the war they were re-opened all over the country.
- In the German Democratic Republic (GDR) polyclinics became the supporting pillars of ambulant care. Several employed physicians worked together in a consolidated manner. Approximately 1650 polyclinics and ambulatories existed until 1989 in GDR.
- After the German reunification, medical care in the new federal states was organised according to the West German model for establishment. Formerly employed physicians set up practices according to the West German SHI physician system.
- The few medical care centres left were authorised to operate until 31st Decemer 1995. After the amendment effected by the Health Care Structure Act of 1st October 1992, the medical care centres were granted unlimited permission to safeguard medical care. It was not permitted to establish new medical care centres.
- Especially in Berlin and Brandenburg new models were developed for maintaining this ambulant medical care. In this context we must especially mention the deceased former federal minister for Work, Social Affairs and Health, Regine Hildebrandt, MD (SPD = German Social Democratic Party). She actively participated in the task of transforming polyclinics into medical care centres.
- In 2002 MVZs received authorisation to employ new physicians.
- According to GKV (SHI Modernisation Act) of 14 November 2003 not only SHI physicians and authorised physicians but also MVZs can become part of the ambulant medical care of SHI patients since 1st January 2004.
Which advantages and chances do Medical Care Centres offer?
- Grouping of medical and consolidated competence
- Patients save time because there are only short distances between specialists and other health service providers
- A more structured treatment, due to close cooperation among the physicians
- Double performed medical examinations can be avoided and thus save treatment costs
- Fewer administrative tasks for the medical staff
- Joint use of medical technical devices
- Elimination of economical risks for physicians who want to establish a practice
- More flexible working hours
Which are the legal regulations for Medical Care Centres?
- According to the reformation of health care 2004, MVZs are also admitted in the Western part of Germany (former Federal Republic of Germany). The corresponding amendment of paragraph 95 SGB V (Book V of the Social Code ) envisions that physicians may work as employees or contracted physicians in MVZs and thus take part in ambulant health care. Before this, they were only allowed to set up a practice and become its operator.
- This opened up the way to establish MVZs in the “old federal states” and benefit from the economical and qualitative advantages.
What size are Medical Care Centres?
- The size of medical care centres is not determined and the spectrum of services is optional.
- Medical care must be guaranteed by at least two physicians of different specialities or different medical care suppliers.
How many Medical Care Centres do exist?
- It is very straightforward to set up a MVZ. On 31 March 2006 already 420 MVZs had been licensed in all federal German states with 1.648 physicians, 980 of them working as employees (source of information: KBV, National Association of Statutory Health Insurance Physicians).
- 30 former polyclinics were transformed into medical care centres in the “new federal states”.
- Due to the great demand, it is very probable the the number of MVZs will increase significantly in the coming months.
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