The division into open and closed care areas is a central element of location planning for medical facilities. This categorization determines where doctors can open new practices or take over existing ones. Open areas offer opportunities to set up new practices, while closed areas are limited by existing care structures and only allow takeovers.
Open supply area
In open care areas, the need for medical services is not yet fully met. This offers doctors two options:
- Practice establishment
- Practice takeover
The open areas are particularly attractive for professionals who want to actively shape and respond directly to the needs of the local population. A strategic decision regarding the location (location analysis) and the offer is important here and can contribute significantly to professional success. The legal basis in open planning areas makes it possible to respond flexibly to gaps in the market and to introduce new medical specialties. A precise analysis of the demographic data and the medical facilities already available is crucial to avoid oversupply and to meet the needs of the population.
Restricted area
In closed care areas, the legal framework is much stricter. There is usually an oversupply here, and new practice approvals are very limited. Doctors who want to set up here must in most cases take over an existing practice. This requires close cooperation and coordination with the Association of Statutory Health Insurance Physicians in order to take over the approval or, if necessary, to obtain a special permit. However, if there are special medical care needs in a closed area, a special permit can be considered. This could be the case, for example, if there is a shortage of specialists in certain medical specialties.
These legal restrictions mean that doctors have less flexibility in choosing their location. The advantage, however, is that they can rely on an existing infrastructure and an established patient base. This can make starting out much easier.
An alternative is to set up practice as a private doctor .
Significance for doctors
Knowledge of the service areas is essential as it directly influences the choice of location. In open areas, there is freedom to establish a practice wherever one wants. This allows one to develop innovative medical services and occupy market niches that are not available in densely populated or saturated markets.
In contrast, taking over a practice in closed areas requires asserting oneself within predetermined structures. This brings with it strategic challenges such as differentiating oneself from competitors. In addition, knowledge of specific legal requirements in both areas of care is essential in order to avoid regulatory sanctions and to run the practice sustainably. This includes understanding the licensing processes and adhering to the guidelines set by the statutory health insurance associations.
While starting a practice in open areas requires high initial investment but offers the potential for long-term growth and increased revenue, taking over an established practice in closed areas can lead to faster profitability but often with limited growth opportunities.
What do you have to consider?
Anyone planning to set up practice in an open or closed care area should fully understand the legal basis and licensing procedures of the associations of statutory health insurance physicians. These set the conditions for licensing and require doctors to familiarize themselves with the regulations and submit the relevant applications. A thorough market analysis is also crucial.
In addition, infrastructural considerations play a major role. The availability of suitable practice space, accessibility for patients and proximity to other medical facilities are crucial factors that must be considered when choosing a location. In restricted areas, it is particularly important to pay attention to profitability and the potential for long-term success. This includes analyzing patient numbers and assessing the practice’s financial situation to ensure that the practice can continue to be run successfully in the future.
Application process
First, the doctor must contact the relevant association of statutory health insurance physicians (KV). This will inform them about the current conditions and required documents in their desired region. They then submit their application to the relevant KV. This should include the following:
- a current CV
- medical qualifications
- Evidence of your professional experience
- a concept for the planned practice
- if applicable, evidence of additional qualifications
The application is then reviewed by the admissions committee. This is made up of representatives of the medical profession and the health insurance companies. Here it is decided whether the formal criteria are met. You will then receive either an approval or a rejection notice. If you are rejected, you have the option of filing an appeal. The committee will review the case again. After approval, you sign contracts with the health insurance companies. These regulate, among other things, the billing conditions for statutory health insurance services. With the approval and signed contracts, you can open the practice and start caring for patients straight away.
You should also consider seeking support from an experienced medical lawyer. This is particularly important for more complex processes such as special approvals or taking over a practice in restricted areas.
- : public
